A Novel Technique for Endoscope Progression in Gastroscopy Resection: “6”- Turn of Gastroscopy Along The Greater Curvature Wall for Dissection of Stromal Tumor in The Muscularis Propria of The Gastric Fundus

Abstract Objective The fundus of the stomach is a challenging region for endoscopic resection of gastrointestinal stromal tumors (GISTs), especially in the anterior wall of the fornix at the side of the greater curvature. The aim of this study was to introduce using the “6”-turn of gastroscopy along the greater curvature wall (6TGS) technique in operation on the gastric fundus and provide evidence of its advantages. Methods The clinical data of patients with stromal tumor in muscularis propria at the gastric fundus (STMF) at the Fourth Hospital of China Medical University between July 2016 and Dec 2020 were reviewed. The novel 6TGS technique was used in the procedure. The beneficial effects, suitability, applicable lesion site, influencing factors, and success rates of 6TGS were analyzed. Results Ten cases in total were reviewed, and the 6TGS technique was successfully performed in 7 cases (70%). In all 7 patients, the gastroscope’s tip could access the location just below the gastric cardia, and all angles/sites of the fundus of the stomach could be operated on. The lesion was easily accessed, and the gastroscope was stable with good left-right movement ability and moderate forward and backward movement ability. Conclusion 6TGS can improve the safety of gastroscopy resection of STMF and facilitate the excision of tumors in challenging sites in the gastric fundus. Patients need to be under general anesthesia with endotracheal intubation in the supine position to perform the 6TGS technique after distending the stomach with less air.

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TOMOGRAPHIC FINDINGS OF GASTRIC GASTROINTESTINAL STROMAL TUMOR AND CORRELATION WITH THE MITOTIC INDEX

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032013000400002 ◽

2013 ◽

Vol 50 (4) ◽

pp. 244-250 ◽

Cited By ~ 2

Author(s):

Gustavo Lemos PELANDRÉ ◽

Maria Célia DJAHJAH ◽

Emerson Leandro GASPARETTO ◽

Marcelo Souto NACIF ◽

Edson MARCHIORI ◽

...

Keyword(s):

Gastrointestinal Stromal Tumor ◽

Mitotic Index ◽

Statistical Correlation ◽

Gastric Fundus ◽

The Body ◽

Stromal Tumor ◽

Gastric Body ◽

Dense Area ◽

Stromal Tumors ◽

Mesenteric Fat

ContextGastrointestinal stromal tumors are uncommon abdominal neoplasms and can affect any portion of the gastrointestinal tract.ObjectivesDescribe the tomographic findings of the gastrointestinal stromal tumor of gastric origin, correlating it with the mitotic index.MethodsTwenty-one patients were selected within the period of January 2000 and 2008, with histopathological and immunohistochemical diagnosis of gastric gastrointestinal stromal tumors, who presented computed tomography done before the treatment. The tomographic variables analyzed were lesion topography, dimensions, contours, morphology, pattern and intensity enhancement through venous contrast, growth pattern, invasion of adjacent organs, presence of ulceration, fistula, calcifications, infiltration of mesenteric fat, lymphadenopathy and metastasis. The mitotic index was determined through optic microscopy, counting the number of mitosis figures in 50 high power fields.ResultsThe tumors were located in the body (66.7%) or gastric fundus (33.3%), with dimensions varying between 4.2 and 21.2 cm (average of 10.5 cm). The growth was predominantly extraluminal (47.6%) or intra/extra luminal (28.6%). The enhancement by venous contrast was heterogeneous in 66.7%. The statistical analysis showed that irregular morphology (P = 0.027) and infiltration of mesenteric fat (P = 0.012) presented correlation with the high mitotic index.ConclusionsIn the present study, most part of the tumors were located in the gastric body, with average size of 10.5 cm, presenting central hypo dense area, heterogeneous enhancement through contrast and predominantly extra luminal growth. Irregular morphology and infiltration of mesenteric fat present statistical correlation with high mitotic level.

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Lack of Antinociceptive Activity of Sumatriptan in Rodents

Cephalalgia ◽

10.1046/j.1468-2982.1990.1005207.x ◽

1990 ◽

Vol 10 (5) ◽

pp. 207-212 ◽

Cited By ~ 39

Author(s):

Malcolm Skingle ◽

Phillip J Birch ◽

Glynnis E Leighton ◽

Patrick PA Humphrey

Keyword(s):

Antinociceptive Activity ◽

The Novel ◽

Analgesic Action ◽

Beneficial Effects ◽

Noxious Stimuli ◽

Anti Migraine Drug

The present study attempts to determine whether the novel anti-migraine drug sumatriptan has antinociceptive activity in rodents. Sumatriptan had little or no antinociceptive activity against a range of noxious stimuli and we therefore conclude that it is unlikely that the beneficial effects of the drug in treating migraine are due to a non-specific analgesic action.

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The Knowledge of a Selected Group of Medical Students on Hyperbaric Oxygen Therapy

Polish Hyperbaric Research ◽

10.2478/phr-2018-0006 ◽

2018 ◽

Vol 62 (1) ◽

pp. 75-83

Author(s):

Gabriela Henrykowska ◽

Andrzej Buczyński ◽

Małgorzata Lewicka ◽

Magdalena Zawadzka

Keyword(s):

Medical Students ◽

Hyperbaric Oxygen ◽

Hyperbaric Oxygen Therapy ◽

Oxygen Therapy ◽

Rapid Development ◽

Modern Medicine ◽

Medical Faculty ◽

Beneficial Effects ◽

Medical University ◽

The Military

Abstract During the last decades, there has been a rapid development in the research and use of hyperbaric oxygen therapy (HBO), and modern medicine is increasingly taking advantage of its beneficial effects. The aim of the study was to check the level of knowledge of future doctors (medical students) on hyperbaric oxygen therapy. The survey was conducted among 240 students of the medical faculty (3rd and 5th year of study) of the Military and Medical Faculty of the Medical University of Lodz. The author’s questionnaire with forced-choice questions was used as research tool. The students’ knowledge of hyperbaric oxygen therapy was varied and in some cases was not dependent on the year of study. It was observed that students’ knowledge of the subject matter depends on the number of teaching hours allocated to it.

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Exosomes are the novel players involved in the beneficial effects of exercise on type 2 diabetes

Journal of Cellular Physiology ◽

10.1002/jcp.28319 ◽

2019 ◽

Vol 234 (9) ◽

pp. 14896-14905 ◽

Cited By ~ 7

Author(s):

Gaohua Li ◽

Hua Liu ◽

Chunlian Ma ◽

Yanfang Chen ◽

Jinju Wang ◽

...

Keyword(s):

Type 2 Diabetes ◽

The Novel ◽

Beneficial Effects

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Safety and effectiveness of a novel generator algorithm for bipolar vessel sealing: a randomised controlled chronic animal study

BMC Surgery ◽

10.1186/s12893-019-0625-2 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Bernhard Kraemer ◽

Christos Tsaousidis ◽

Stephan Kruck ◽

Martin Schenk ◽

Marcus Scharpf ◽

...

Keyword(s):

Animal Study ◽

Clinical Success ◽

Lateral Spread ◽

Histological Evaluation ◽

Vascular Bundles ◽

The Novel ◽

Success Rates ◽

Vessel Sealing ◽

Thermal Spread

Abstract Background Electrosurgical vessel sealers are gradually replacing conventional techniques such as ligation and clipping. Algorithms that control electrosurgical units (ESU), known as modes, are important for applications in different surgical disciplines. This chronic porcine animal study aimed to evaluate the safety and effectiveness of the novel thermoSEAL electrosurgical vessel sealing mode (TSM). The BiClamp® mode (BCM) of the renowned VIO® 300 D ESU served as control. BCM has been widely available since 2002 and has since been successfully used in many surgical disciplines. The TSM, for the novel VIO® 3 ESU, was developed to reduce sealing time and/or thermal lateral spread adjacent to the seal while maintaining clinical success rates. The primary aim of this study was to investigate the long-term and intraoperative seal quality of TSM. Methods The BiCision® device was used for vessel sealing with TSM and BCM in ten German Landrace pigs which underwent splenectomy and unilateral nephrectomy during the first intervention of the study. The seals were cut with the BiCision® knife. Ninety-nine arteries, veins and vascular bundles were chronically sealed for 5 or 21 days. Thereafter, during the second and terminal intervention of the study, 97 additional arteries and veins were sealed. The carotid arteries were used for histological evaluation of thermal spread. Results After each survival period, no long-term complications occurred with either mode. The intraoperative seal failure rates, i.e. vessel leaking or residual blood flow after the first sealing activation, were 2% with TSM versus 6% with BCM (p = 0.28). The sealing time was significantly shorter with TSM (3.5 ± 0.69 s vs. 7.3 ± 1.3 s, p < 0.0001). The thermal spread and burst pressure of arteries sealed with both modes were similar (p = 0.18 and p = 0.61) and corresponded to the histological evaluation. The measured tissue sticking parameter was rare with both modes (p = 0.33). Tissue charring did not occur. Regarding the cut quality, 97% of the seals were severed in the first and 3% in the second attempt (both with TSM and BCM). Conclusions The novel TSM seals blood vessels twice as fast as the BCM while maintaining excellent tissue effect and clinical success rates. Trial registration Not applicable.

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