scholarly journals Histopathology of human intestinal anastomosis

2021 ◽  
Vol 9 (3) ◽  
pp. 413-421 ◽  
Author(s):  
M. Shomaf

The faultless seal of the anastomosis is an important aspect of abdominal surgery but opportunities to make a histological evaluation of human intestinal anastomosis sites are rare. This retrospective study examined 30 anastomoses that had been resected following complications or postmortem; the aim was to describe the histological changes at various stages of healing ranging from 4 days to 3.5 years post-surgery. Anastomosis dehiscence showed features of extensive mucosal necrosis and bad submucosal apposition. Old healed anastomoses continued to have chronic inflammatory cells and muscular discontinuity with areas of intervening fibrosis. It would be useful to underst and more about how the intraluminal contents are propelled through this scarred area

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Gianluca Villa ◽  
Silvia De Rosa ◽  
Caterina Scirè Calabrisotto ◽  
Alessandro Nerini ◽  
Thomas Saitta ◽  
...  

Abstract Background Postoperative acute kidney injury (PO-AKI) is a leading cause of short- and long-term morbidity and mortality, as well as progression to chronic kidney disease (CKD). The aim of this study was to explore the physicians’ attitude toward the use of perioperative serum creatinine (sCr) for the identification of patients at risk for PO-AKI and long-term CKD. We also evaluated the incidence and risk factors associated with PO-AKI and renal function deterioration in patients undergoing major surgery for malignant disease. Methods Adult oncological patients who underwent major abdominal surgery from November 2016 to February 2017 were considered for this single-centre, observational retrospective study. Routinely available sCr values were used to define AKI in the first three postoperative days. Long-term kidney dysfunction (LT-KDys) was defined as a reduction in the estimated glomerular filtration rate by more than 10 ml/min/m2 at 12 months postoperatively. A questionnaire was administered to 125 physicians caring for the enrolled patients to collect information on local attitudes regarding the use of sCr perioperatively and its relationship with PO-AKI. Results A total of 423 patients were observed. sCr was not available in 59 patients (13.9%); the remaining 364 (86.1%) had at least one sCr value measured to allow for detection of postoperative kidney impairment. Among these, PO-AKI was diagnosed in 8.2% of cases. Of the 334 patients who had a sCr result available at 12-month follow-up, 56 (16.8%) developed LT-KDys. Data on long-term kidney function were not available for 21% of patients. Interestingly, 33 of 423 patients (7.8%) did not have a sCr result available in the immediate postoperative period or long term. All the physicians who participated in the survey (83 out of 125) recognised that postoperative assessment of sCr is required after major oncological abdominal surgery, particularly in those patients at high risk for PO-AKI and LT-KDys. Conclusion PO-AKI after major surgery for malignant disease is common, but clinical practice of measuring sCr is variable. As a result, the exact incidence of PO-AKI and long-term renal prognosis are unclear, including in high-risk patients. Trial registration ClinicalTrials.gov, NCT04341974.


Author(s):  
Mattia Portinari ◽  
Lara Bianchi ◽  
Alessandro De Troia ◽  
Giorgia Valpiani ◽  
Savino Spadaro ◽  
...  

Pharmaceutics ◽  
2018 ◽  
Vol 10 (4) ◽  
pp. 227 ◽  
Author(s):  
Bayan Darwesh ◽  
Hibah Aldawsari ◽  
Shaimaa Badr-Eldin

(1) Background: Fluconazole, used orally for vaginal candidiasis, has reported gastrointestinal side effects. Therefore, researchers directed towards the drug vaginal delivery. However, vaginal delivery is limited by poor retention and leakage. Thus, this work aimed at exploring chitosan/anion polyelectrolyte complex (PEC) for the formulation of fluconazole vaginal inserts with controlled release and appreciable mucoadhesion. (2) Methods: PECs were prepared and assessed for interactions. Fluconazole PEC based vaginal inserts were prepared by lyophilization using mannitol. 3151 factorial design was applied to investigate the effect of the anion type and Chitosan/anion ratio on the inserts mucoadhesion and release properties. The optimized insert [based on 5:5 chitosan: anionic polymer (sodium alginate)] release was modulated by the release retardant; Compritol® 888. The selected formulation was subjected to microbiological and histological evaluation. (3) Results: Fluconazole inserts showed satisfactory drug content, acceptable friability percentages and highest swelling indices at six hours. Statistical analysis showed significant effect of the studied factors on detachment force and release properties. Microbiological assays revealed significantly higher antifungal activity of inserts compared to fluconazole solution. Reduced inflammatory cells were confirmed by histological evaluation. (4) Conclusion: CH/Alg based vaginal insert could be a promising platform for vaginal delivery of antifungal drugs used for vaginal candidiasis treatment.


2019 ◽  
Vol 29 (5) ◽  
pp. 851-856 ◽  
Author(s):  
Miriam Cremer ◽  
Karla Alfaro ◽  
Jillian Garai ◽  
Manuel Salinas ◽  
Mauricio Maza ◽  
...  

IntroductionGas-based cryotherapy is the conventional ablative treatment for cervical pre-cancer in low-income settings, but the use of gas poses significant challenges. We compared the depth of necrosis induced by gas-based cryotherapy with two gas-free alternatives: cryotherapy using CryoPen,and thermoablation.MethodsWe conducted a five-arm randomized non-inferiority trial: double-freeze carbon dioxide (CO2) cryotherapy (referent), single-freeze CO2 cryotherapy, double-freeze CryoPen, single-freeze CryoPen, and thermoablation. Subjects were 130 women scheduled for hysterectomy for indications other than cervical pathology, and thus with healthy cervical tissue available for histological evaluation of depth of necrosis post-surgery. The null hypothesis was rejected (ie, conclude non-inferiority) if the upper bound of the 90% confidence interval (90% CI) for the difference in mean depth of necrosis (referent minus each experimental method) was <1.14 mm. Patient pain during treatment was reported on a scale of 0 (no pain) to 10 (worst pain).ResultsA total of 133 patients were enrolled in the study. The slides from three women were deemed unreadable. One patient was excluded because her hysterectomy was postponed for reasons unrelated to the study, and two patients were excluded because treatment application did not follow the established protocol. For the remaining 127 women, mean depth of necrosis for double-freeze CO2 (referent) was 6.0±1.6 mm. Differences between this and other methods were: single-freeze CO2 = 0.4 mm (90% CI −0.4 to 1.2 mm), double-freeze CryoPen= 0.7 mm (90% CI 0.04 to 1.4 mm), single-freeze CryoPen= 0.5 mm (90% CI −0.2 to 1.2 mm), and thermoablation = 2.6 mm (90% CI 2.0 to 3.1 mm). Mean pain levels were 2.2±1.0 (double-freeze CO2 cryotherapy), 1.8±0.8 (single-freeze CO2 cryotherapy), 2.5±1.4 (double-freeze CryoPen), 2.6±1.4 (single-freeze CryoPen), and 4.1±2.3 (thermoablation).DiscussionCompared with the referent, non-inferiority could not be concluded for other methods. Mean pain scores were low for all treatments. Depth of necrosis is a surrogate for treatment efficacy, but a randomized clinical trial is necessary to establish true cure rates.


Author(s):  
Shafiqa Mohammed Haidra Masdoose ◽  
Akram Thabet Nasher ◽  
Monya A. El-Zine ◽  
Ameen Abdullah Yahya Al-Akwa ◽  
Hassan Abdulwahab Al-Shamahy ◽  
...  

Background: Prophylactic extraction of the asymptomatic impacted third molar is routinely practiced in Europe and the United States. The justification for prophylactic extraction includes the need to reduce the risk of pathologic changes such as cysts and tumors.   Objectives: This study aimed to study the histological and radiological changes in the tooth follicles of upper and lower complete impacted 3rd molars -which appeared radiologically normal. Material and method: A prospective study included fifty patients aged 20 years and above who were referred to the Oral Surgery Clinic, Faculty of Dentistry, University of Sana'a. Patients had follicular space between (2.5mm -3mm) as measured by the panoramic X-ray. These teeth were removed surgically and the follicle was sent for histopathological examination. Results: Most histopathological changes were in dental follicles with a size of <2.5 mm (86%), and only 14% with 2.5 mm - 3 mm. There was statistical significance between the smallest size of dental follicles with the incidence of pathological histological changes indicating a high probability of developing neoplasm (p =0.008).  Of the 50 follicular patients, 28% showed HC, nine (64%) had ameloblastoma, four (29%) had a dentigerous cyst, and only one case (7%) had a multicalcified focus with islands of odontogenic epithelium. While 72% of the samples had normal follicles and non-specific chronic inflammatory cells. There is an association between female sex and pathological histological changes (12 females: 2 males, p =0.008), age group 21-25 years (93% HC), with mandibles (65% HC). Regarding angle and histopathological changes, 36% were vertical, 29% mesioangular, 14.2% horizontal and destioangular, and 7.1% buccoangular. Conclusion:  High incidence of HC occurred in patients with DF, and it was associated with smaller dental follicle size, most HC was ameloblastoma, followed by dentigerous cyst, while 72% of samples had normal follicles and non-specific chronic inflammatory cells. There is a correlation between female gender, younger age group, and jaw position with HC. Prophylactic extraction of the asymptomatic impacted third molar should be routinely practiced in Yemen, to reduce the risk of pathological changes, especially in females and younger age groups.                            Peer Review History: Received 11 January 2021; Revised 8 February; Accepted 28 February, Available online 15 March 2021 UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency.  Received file:                Reviewer's Comments: Average Peer review marks at initial stage: 5.5/10 Average Peer review marks at publication stage: 7.5/10 Reviewer(s) detail: Dr. A.A. Mgbahurike, University of Port Harcourt, Nigeria, [email protected] Dr. Alfonso Alexander Aguileral, University of Veracruz,  Mexico, [email protected]   Similar Articles: RADIOGRAPHIC ASSESSMENT OF THE COURSE AND VISIBILITY OF THE MANDIBULAR CANAL BY PANORAMIC RADIOGRAPHY


2021 ◽  
Vol 9 (10) ◽  
pp. 122
Author(s):  
Yasuhiro Nosaka ◽  
Hitomi Nosaka ◽  
Yasushi Nakajima ◽  
Tadasuke Tanioka ◽  
Daniele Botticelli ◽  
...  

An antral pseudocyst (AP) is a common well-defined ‘dome-shaped’ faintly radiopaque lesion of the maxillary sinus, and usually does not require treatment in asymptomatic patients. However, when sinus floor augmentation is required to increase bone volume for implant installation, the elevation of the sinus mucosa might drive the AP against the ostium. This might cause its obstruction and, as possible consequence, sinusitis. The purpose of this study was to investigate the clinical and tomographic conditions of APs to identify a predictable cyst removal that might allow a safety sinus floor augmentation. A total of 52 maxillary sinuses in 46 patients (mean age 55.1 years) presenting AP were examined by cone beam computed tomographies (CBCTs). A two-stage approach was applied. At the first surgery, the cystic lesions were further inspected by an endoscope through the antrostomy, and histopathological diagnosis of the removed tissues was carried out. After the confirmation of decrease of the swelling of sinus membrane by CBCT, the sinus floor augmentation was performed, at least four months after cyst removal. The color and transparency of the 86 cystic lesions were classified into 4 types. The whitish transparent cysts were 34 (39.5%), the yellowish transparent cysts were 18 (20.9%), the dark purple transparent cysts were 8 (9.3%) and the milky-white opaque cysts were 26 (30.2%). The contents of the 60 (69.8%) transparent cysts were serous fluid, but those of milky-white cysts were composed of viscous or elastic soft tissues, and the aspiration of the contents was unsuccessful. The analysis of the preoperative CBCT did not provide certainty on the contents of the cystic lesions. All cystic lesions were diagnosed as AP, and an infection was identified in one AP, presenting marked infiltration of the inflammatory cells. Considering the difficulties of performing a correct diagnosis of the AP content by a CBCT analysis, the risk of failure of the surgery that creates severe afflictions to the patients, and the necessity of a histological evaluation of the cyst, a two-stage surgery appeared to be the most reliable procedure.


2018 ◽  
Vol 12 (4) ◽  
pp. 238-244
Author(s):  
Naser Sargolzaie ◽  
Mehrnaz Rafiee ◽  
Hamideh Salari Sedigh ◽  
Reza Zare Mahmoudabadi ◽  
Hooman Keshavarz

Background. Early bone loss due to tooth extraction can be significantly reduced by socket preservation. The aim of this study was to compare the in vivo effects of hemihydrate calcium sulfate granules (an alloplastic material) and Cerabone (a bovine-derived xenograft) on socket preservation in dogs. Methods. Six male Mongrel dogs were randomly divided into 2 groups (n=3) for sacrificing and histological evaluation 4 and 8 weeks after a surgery. The second and third premolars on both sides of the lower jaw were extracted surgically. The sockets on one side were filled with Cerabone, and with calcium sulfate on the opposite side. In the slides, the ratio of the area of newly formed bone to the area of the entire cavity, and the ratio of the area of fibrous connective tissue to the area of the entire cavity were measured. The presence of inflammation was also examined. Wilcoxon signed-rank test, Sign test and McNemar test were used for statistical analyses (ɑ=0.05). Results. The means of new bone proportion were 11% and 8% for Cerabone and calcium sulfate, respectively (P=0.58). The means of connective tissue proportion were 29% and 33% for Cerabone and calcium sulfate, respectively (P=0.72). No inflammatory cells were observed in the Cerabone group, although 50% of the samples in the calcium sulfate group showed inflammation (P=0.50). Conclusion. The effects of calcium sulfate and Cerabone on socket preservation in dogs on bone formation, fibrous connective tissue and inflammation levels were not significantly different at 4- and 8-week postoperative intervals.


2018 ◽  
Vol 8 (1) ◽  
Author(s):  
María Ángeles Jiménez-Sousa ◽  
Pilar Liu ◽  
Luz María Medrano ◽  
Amanda Fernández-Rodríguez ◽  
Raquel Almansa ◽  
...  

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