Splenic capping in the treatment of severe spleen injuries

Introduction Permanent and lifelong threat of developing fatal sepsis and other severe infections in splenectomized patients is an important reason for promoting splenic preservation. Material and methods Experimental preservation of severe spleen injuries (grade IV), with splenic-capping, was performed in 30 dogs, operated using Ketalar anesthesia. Spleen preservation and concomitant treatment of excessive hemorrhage were achieved by highly controlled "conic" compression of injuried spleen parenchyma, additional hemostatic Z-sutures and fibrin tissue adhesion. Results Satisfactory hemostasis and complete preservation of the spleen parenchyma damage were achieved in 20% bv splenic capping splenorraphy, alone. Additional placement of hemostatic sutures was necessary in 30%, and concomitant application of serum thymic factor (STF) FTA (along with sutures) in 50% of patients. The abovementioned techniques were very effective in achieving hemostasis (100%), with no mortality and low rate of postoperative complications - 6.7% (1 intrasplenic abscess and 1 adhesive ileus). Conclusion Excellent results and efficacy, splenic capping-splenorraphy is the method of choice in the treatment of severe and multiple transcapsular spleen injuries with involvement of segmental vessels.

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The Use of Fibrin-based Tissue Adhesives for Breast in Reconstructive and Plastic Surgery

Current Topics in Medicinal Chemistry ◽

10.2174/1568026619666191112101448 ◽

2020 ◽

Vol 19 (32) ◽

pp. 2985-2990 ◽

Cited By ~ 1

Author(s):

Kuo Chen ◽

Mikhail Y. Sinelnikov ◽

Vladimir N. Nikolenko ◽

Igor V. Reshetov ◽

Yu Cao ◽

...

Keyword(s):

Quality Of Life ◽

Postoperative Complications ◽

Plastic Surgery ◽

Fibrin Glue ◽

Reconstructive Surgery ◽

Tissue Adhesives ◽

Tissue Adhesion ◽

Advanced Technologies ◽

Breast Plastic Surgery

Background: Breast plastic surgery is a rapidly evolving field of medicine. The modern view of surgical trends reflects the desire to minimize complications and introduce advanced technologies. These always will be priorities for surgeons. Reconstructive surgery, a branch of plastic surgery focusing on restoration of lost functional and aesthetic component, seeks to enhance psychological rehabilitation and improves the quality of life, as well as aesthetic recovery. Objective: This review addresses the action of fibrin agents and their effect on the quality of surgical hemostasis. Discussion and Conclusion: The fundamental goals for the surgeon are to perform a minimally traumatic intervention and to prevent any form of complication. Achieving complete hemostasis is an intraoperative necessity. Timely prevention of bleeding and hemorrhagic phenomena can affect not only the outcome of the operation, but also the incidence of postoperative complications. Topics include the integrity of microvascular anastomoses, tissue adhesion, and the incidence of seromas and hematomas associated with fibrin glue usage. The literature on fibrin adhesives with respect to prevention of postoperative complications, and the effectiveness with active drainage also are analyzed.

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The “Jacobsen Flap” for the Treatment of Stages III–IV Dupuytren’s Disease: A Review of 98 Cases

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193408091350 ◽

2008 ◽

Vol 33 (6) ◽

pp. 779-782 ◽

Cited By ~ 11

Author(s):

M. TRIPOLI ◽

M. MERLE

Keyword(s):

Postoperative Complications ◽

Dupuytren’S Disease ◽

Dupuytren's Disease ◽

Flap Procedure ◽

Significant Correction ◽

Low Rate ◽

Little Finger

The treatment of severe Dupuytren’s disease of the little finger is controversial: several techniques have been described with variable reported results and postoperative complications. This paper reviews 98 cases that underwent surgery between 2001 and 2006 using the Jacobsen flap procedure, a modification of the McCash technique. We found this technique relatively simple and it allowed significant correction of the contracture, with a low rate of complication. We believe this is an excellent alternative to dermofasciectomy or amputation.

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Biologic Disease-modifying Antirheumatic Drug (bDMARD)-induced Neutropenia: A Registry from a Retrospective Cohort of Patients with Rheumatic Diseases Treated with 3 Classes of Intravenous bDMARD

The Journal of Rheumatology ◽

10.3899/jrheum.150457 ◽

2017 ◽

Vol 44 (6) ◽

pp. 844-849 ◽

Cited By ~ 8

Author(s):

Francisco Espinoza ◽

Pierre Le Blay ◽

Bernard Combe

Keyword(s):

Rheumatic Diseases ◽

Retrospective Cohort ◽

Concomitant Treatment ◽

Disease Modifying Antirheumatic Drugs ◽

Antirheumatic Drugs ◽

Drug Survival ◽

History Of ◽

Severe Infections ◽

Risks Factors ◽

Disease Modifying

Objective.To examine the rate, risks factors, and consequences of neutropenia induced by intravenous (IV) biologic disease-modifying antirheumatic drugs (bDMARD).Methods.We conducted a retrospective cohort study in 499 patients with rheumatic diseases treated by IV abatacept (ABA), infliximab (IFX), or tocilizumab (TCZ).Results.Rheumatoid arthritis (RA) was the most frequent diagnosis (72%). Fifty-two patients (10.4%) experienced at least 1 episode of neutropenia. No episodes of grade 4 neutropenia were documented. TCZ was more frequently related to neutropenia than ABA or IFX (18.6% vs 3.8% and 2.8%, respectively, p < 0.001). The following factors were identified as predictors of experiencing neutropenia with IV bDMARD: history of neutropenia with methotrexate (MTX; synthetic DMARD; OR 1.56, 95% CI 1.17–7.14), concomitant treatment by MTX (OR 1.21, 95% CI 1.01–2.64), and TCZ treatment (OR 2.72, 95% CI 1.53–9.05). Patients experiencing a TCZ-induced neutropenia did not show a higher risk of severe infections; however, this group had a shorter drug survival (9 mos vs 20 mos, p < 0.02) compared with TCZ patients without neutropenia.Conclusion.Among 3 different classes of IV bDMARD, TCZ is associated with the higher risk of neutropenia. No increased frequency of infection episodes was documented in this group.

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Evaluation of the Surgical Treatment for Congenital Blepharoptosis Using Mustarde’s Modified Method

Polish Journal of Surgery ◽

10.1515/pjs-2016-0044 ◽

2016 ◽

Vol 88 (3) ◽

Author(s):

Aleksandra Iljin ◽

Andrzej Zieliński ◽

Edward Lewandowicz ◽

Bogusław Antoszewski ◽

Tomasz Zieliński

Keyword(s):

Surgical Treatment ◽

Postoperative Complications ◽

Surgical Technique ◽

Surgical Correction ◽

Small Range ◽

Modified Method ◽

Aesthetic Results ◽

Low Rate

AbstractThe aim of the study was evaluation of the results of surgical treatment of congenital blepharoptosis (CBP) using Mustarde’s modified method.Material and methods. Between 2005-2014 forty eight children with CBP underwent surgical correction of CBP by Mustarde’s modified method. Basing on the results of ophthalmic and orthoptic examination, and standard measurements, we estimated postoperative difference in the position and symmetry of the upper eyelids, and postoperative complications in our patients.Results. Very good results were obtained in all cases with mild, in 89.5% with moderate, and in 85.7% with severe unilateral CBP after correction by Mustarde’s modified method. Lagophthalmos was seen in 6.25%, and undercorrection in 12.5% of cases.Conclusions. 1. Mustarde’s modified method allows for obtaining very good functional and aesthetic results in CBP patients. 2. Mustarde’s modified method is a valuable supplemental surgical technique in CBP, and contributes to a low rate and small range of lagophthalmos.

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Nissen Fundoplication–Preserving Laparoscopic Sleeve Gastrectomy

The American Surgeon ◽

10.1177/000313481908500224 ◽

2019 ◽

Vol 85 (2) ◽

pp. 173-176 ◽

Cited By ~ 3

Author(s):

Craig R. Smith ◽

Jeffrey T. Gardner ◽

Lexie H. Vaughn ◽

Robert J. Kelly ◽

Oliver C. Whipple

Keyword(s):

Weight Loss ◽

Sleeve Gastrectomy ◽

Postoperative Complications ◽

Laparoscopic Sleeve Gastrectomy ◽

Excess Weight Loss ◽

Nissen Fundoplication ◽

Excess Weight ◽

Concomitant Treatment ◽

The Mean ◽

Gerd Symptoms

Gastroesophageal reflux disease (GERD) is significantly more prevalent in obese patients. Nissen fundoplication alleviates symptoms in those refractory to dietary changes and optimal medical management. The need for concomitant treatment of GERD and obesity is becoming more prevalent. The objective of this study was to determine whether Nissen-preserving laparoscopic sleeve gastrectomy (SG) is a safe and effective weight loss option for patients with pre-existing Nissen fundoplication. The study was conducted at the Hospital Corporation of America, Memorial Health, Savannah, Georgia, academic institution. We retrospectively reviewed five patients who underwent laparoscopic Nissen-preserving SG between 2011 and 2017. We compared pre- and postoperative subjective GERD symptoms, occurrence of any immediate postoperative complications, change in BMI, and excess weight loss. Of the five patients, four were female and one was male. The mean age was 50.6 years. The mean preoperative BMI was 44.8 ± 5.4, one-month postoperative BMI was 41.2 ± 6.1 (P < 0.001), and six-month postoperative BMI was 37.5 ± 8.1 (P < 0.009), with mean excess weight loss at six months of 33.9 ± 23 per cent. There were no immediate postoperative complications. Subjective GERD symptoms were unchanged in two patients and improved in the other three. We demonstrate the early feasibility of Nissen-preserving SG for surgical weight loss in patients with existing Nissen fundoplication. Although our results are early, we feel encouraged by mean excess weight loss to date and control of GERD symptoms.

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Procedure for prolapse and hemorrhoids (PPH) with low rectal anastomosis using a PPH 03 stapler: low rate of recurrence and postoperative complications

International Journal of Colorectal Disease ◽

10.1007/s00384-017-2908-3 ◽

2017 ◽

Vol 32 (12) ◽

pp. 1687-1692 ◽

Cited By ~ 3

Author(s):

Yoshiro Iida ◽

Hideo Saito ◽

Yoshihiro Takashima ◽

Kenichiro Saitou ◽

Yoshinori Munemoto

Keyword(s):

Postoperative Complications ◽

Rectal Anastomosis ◽

Low Rectal Anastomosis ◽

Low Rate

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The Dimpleplasty: A New Streamlined Approach to Surgical Creation of Dynamic Facial Dimples, Our Experience, and Results

The American Journal of Cosmetic Surgery ◽

10.1177/0748806818814142 ◽

2018 ◽

Vol 36 (3) ◽

pp. 138-142

Author(s):

Achih Chen ◽

Daniel Gerry ◽

Zachary Zimmerman

Keyword(s):

Patient Satisfaction ◽

Postoperative Complications ◽

Postoperative Infection ◽

Adverse Outcomes ◽

Consecutive Series ◽

Surgical Time ◽

Primary Endpoints ◽

Aesthetic Results ◽

Static Versus Dynamic ◽

Low Rate

The purpose of the study is to provide a review of published techniques for creating facial dimples as context for describing a new streamlined approach, and to describe our experience and results in a series of 20 patients. A consecutive series of 20 patients was selected. All patients underwent bilateral open, trans-oral dimpleplasty procedures consisting of the use of an 8-mm punch to excise a core of tissue extending from mucosa to subcutaneous fascia, followed by placement of intradermal polydioxanone (PDS) sutures placed from the intra-oral mucosa, including the dermis, and all intervening layers. Patients were followed for a period of 6 months, with postoperative complications, persistence of static versus dynamic dimple formation, and overall patient satisfaction recorded as primary endpoints. Out of 20 patients, 2 adverse outcomes were reported: one reversal of dimpling was associated with accidental removal of PDS sutures by the patient’s dentist, and one, unilateral, postoperative infection was associated with postoperative antibiotic noncompliance. All other patients reported persistent bilateral dynamic dimple formation and excellent overall satisfaction with aesthetic results. Our experience with a new streamlined approach to surgical dimple creation produced consistent, reliable, and durable results with a low rate of complications, minimal investment of surgical time, and excellent patient satisfaction with their aesthetic results.

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Electron microscope study of the secretory activity of epithelial cells in embryonic thymus

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s042482010015945x ◽

1990 ◽

Vol 48 (3) ◽

pp. 382-383

Author(s):

H. Alasam

Keyword(s):

Cell Differentiation ◽

T Cell ◽

Epithelial Cells ◽

Electron Density ◽

Secretory Activity ◽

T Cell Differentiation ◽

High Electron ◽

Transmission Electron ◽

Medullary Epithelial Cells ◽

Thymic Factor

The possibility that intrathymic T-cell differentiation involves stem cell-lymphoid interactions in embryos led us to study the ultrastructure of epithelial cell in normal embryonic thymus. Studies in adult thymus showed that it produces several peptides that induce T-cell differentiation. Several of them have been chemically characterized, such as thymosin α 1, thymopoietin, thymic humoral factor or the serum thymic factor. It was suggested that most of these factors are secreted by populations of A and B-epithelial cells.Embryonic materials were obtained from inbred matings of Swiss Albino mice. Thymuses were disected from embryos 17 days old and prepared for transmission electron microscopy. Our studies showed that embryonic thymus at this stage contains undifferentiated and differentiated epithelial cells, large lymphoblasts, medium and few small lymphocytes (Fig. 5). No differences were found between cortical and medullary epithelial cells, in contrast to the findings of Van Vliet et al,. Epithelial cells were mostly of the A-type with low electron density in both cytoplasm and nucleus. However few B-type with high electron density were also found (Fig. 7).

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