scholarly journals Express procedure of intraoperative estimation of viability of small bowel in experiment and clinic

2020 ◽  
Vol 87 (9-10) ◽  
pp. 74-83
Author(s):  
M. E. Tymchenko ◽  
Yu. V. Ivanova ◽  
V. K. Ivanov ◽  
V. K. Logachov
Keyword(s):  
Abdominal Cavity ◽  
Intestinal Resection ◽  
Intestinal Wall ◽  
Control Group ◽  
Acute Ischemia ◽  
Intestinal Loop ◽  
Electric Resistance ◽  
Temporary Ischemia ◽  
Viability Determination

Objective. Elaboration of effective and informative method of the small intestine viability determination for improvement of the surgical treatment results in pathologies, which need performance of resection of its segments. Materials and methods. The work is considered as experimentally-clinic one. Its experimental part was conducted on the rats; temporary ischemia was simulated, using application of tourniquet on the intestinal loop, taken from abdominal cavity after doing laparotomy; the animals were distributed on the groups, depending on the ischemia duration applied. Clinical part of the investigation was performed on 68 patients, including a control group of 50 patients, in whom intestinal resection was done, taking into account subjective estimation of the gut viability, and the main group, consisted of 18 patients, in whom intestinal resection was performed, basing on the gut viability estimation data, obtained using the method elaborated. Results. In the animals, on which temporary noncritical ischemia (up to 10 min) was simulated, the ischemia zone did not differed visually from other intestinal segments, while after persistence of ischemia up to 20- and 25-min the changes have had appeared necrotic with presence of peritonitis. Studying of intestinal specimen in the animals, in whom an acute ischemia was simulated, have shown the mostly expressed changes in endotheliocytes of microcirculatory bed, depending on duration of the ischemia dystrophic changes have been enhanced up to destructive. Total electric resistance (іmpedance) was measured on various frequencies. On all the frequencies, the raising of total electric resistance with more durable ischemia period was observed. Conclusion. Changes of total electric resistance are reflecting the degree of the blood flow disorder in intestinal wall and may be exploited as a criterion of determination of its viability (capacity of the anastomosis to heal). Objectivization of estimation of the intestinal wall state reduces the quantity of resection of injured intestinal segment and the morbidity.

scholarly journals HOW TO DEFINE THE LEVEL OF INTESTINAL RESECTION IN COMPLICATED FORMS OF INTESTINAL OBSTRUCTION IN CHILDREN

2020 ◽  
Vol 24 (2) ◽  
pp. 78-82
Author(s):  
I. I. Babich ◽  
Yuri N. Melnikov
Keyword(s):  
Intestinal Obstruction ◽  
Russian Federation ◽  
Intestinal Resection ◽  
Intestinal Wall ◽  
Control Group ◽  
Intestinal Necrosis ◽  
Congenital Origin ◽  
Accelerated Rehabilitation ◽  
Medical Facilities ◽  
Local Necrosis

Introduction. The bowel (intestinal) obstruction is a very common case in pediatric surgical practice. Intestinal transit disorders in children are caused by organic or functional problems of congenital origin or by acquired pathology. The incidence of intestinal obstruction is steadily increasing. This is due to an increasing number of cases with congenital gastrointestinal tract malformations as well as to an increasing number and volume of surgical intestinal interventions. Materials and methods. 76 patients, aged 0 months - 14 years, with various forms of intestinal obstruction were taken into the study. All patients were divided into 2 groups. The control group had 30 patients who were treated in medical facilities of the first level; the studied group included 46 patients who were operated in our clinic. In patients from the studied group, the viability of intestine and the level of resection were defined using the original technique “ Detection of the area of local necrosis and the level of intestine resection in children with intestinal obstruction “ , patent No 2 690744, Russian Federation, developed on the basis of another patent No 2 594 978 of Russian Federation “A technique for modeling local intestinal wall necrosis in the experiment.” The technique is as follows: While performing electrical stimulation of the intestinal wall with neurostimulator HNS 12, one can see a characteristic funnel-shaped depression indicating intestinal necrosis. The level of resection is determined by moving the electrode from the central part of the studied zone to distal and proximal directions until the circular contraction of the intestine appears. Results. This technique prevented relaparotomies, reduced transfer to enteral feeding by 33%, reduced the incidence of prolonged intestinal paresis by 62.5%, reduced patients’ stay in ICU by 41% and postoperative hospital stay by 24% as well as accelerated rehabilitation process by 27.3%. Conclusion. The technique developed for detecting the area of local necrosis and the level of intestinal resection promotes a most careful resection of the affected area of the intestine till healthy tissues, as well as prevents complications requiring surgical correction.

scholarly journals Intestine wall histostructure peculiarities with peritonitis and mechanical intestine obstruction (experimental study)

2020 ◽  
pp. 27-34
Author(s):  
Т. I. Tamm ◽  
V. V. Nepomnyaschy ◽  
O. А. Shakalova ◽  
А. Ya. Barduck
Keyword(s):  
Small Intestine ◽  
Mucous Membrane ◽  
Morphological Changes ◽  
Abdominal Cavity ◽  
Statistical Processing ◽  
Intestinal Wall ◽  
Control Group ◽  
Mechanical Ileus ◽  
Fecal Suspension ◽  
Dynamic Ileus

Today, the histological criteria for differential diagnosis of dynamic ileus due to peritonitis and mechanical obstruction of the intestine remain undeveloped. In this regard, the aim of the work was to establish the difference in morphological changes occurring in the intestinal wall during dynamic and mechanical ileus in the experiment. The experiment was conducted on 33 sexually mature Wistar rats. In 15 animals of the first group, mechanical ileus was modeled by ligation of the lumen of the small intestine at the middle of the distance between the duodenojejunal junction and the ileocecal angle. In 15 rats of the second group, a dynamic ileus model was formed in the form of peritonitis by introducing fecal suspension into the lumen of the abdominal cavity. The control group included 3 animals who underwent laparotomy without the formation of mechanical ileus and peritonitis. For histological examination, fragments of the intestinal wall were sampled 1 cm above the site of the obstruction with mechanical ileus and the portion of the small intestine with peritonitis. Statistical processing was performed in an Excel package using parametric statistics methods. It was stated that with mechanical ileus purulent inflammation develops in the intestine wall beginning from the mucous membrane spreading over wall thickness which can cause its destruction within 48 hours; with dynamical ileus purulent inflammation develops in the intestine wall, it captures particularly serous and muscle layers without causing violations of mucosa cover structure and without intestine wall destruction within 48 hours. Under experimental dynamic ileus, changes in the mucous membrane were reactive in nature and consisted of manifestations of compensatory-adaptive and regenerative processes in response to a violation of the trophism of various structures of the intestinal wall.

FRACTIONAL DETERMINATIONS OF URINARY 17-KETOSTEROIDS IN HYPEREMESIS GRAVIDARUM

1962 ◽  
Vol 41 (1) ◽  
pp. 123-128 ◽  
Author(s):  
Pentti A. Järvinen ◽  
Sykkö Pesonen ◽  
Pirkko Väänänen
Keyword(s):  
Hyperemesis Gravidarum ◽  
First Trimester ◽  
Control Group ◽  
Before And After ◽  
Daily Urine ◽  
First Trimester Of Pregnancy ◽  
The Difference

ABSTRACT The fractional determination of 17-ketosteroids in the daily urine was performed in nine cases of hyperemesis gravidarum and in four control cases, in the first trimester of pregnancy both before and after corticotrophin administration. The excretion of total 17-KS is similar in the two groups. Only in the hyperemesis group does the excretion of total 17-KS increase significantly after corticotrophin administration. The fractional determination reveals no difference between the two groups of patients with regard to the values of the fractions U (unidentified 17-KS), A (androsterone) and Rest (11-oxygenated 17-KS). The excretion of dehydroepiandrosterone is significantly higher in the hyperemesis group than in the control group. The excretion of androstanolone seems to be lower in the hyperemesis group than in the control group, but the difference is not statistically significant. The differences in the correlation between dehydroepiandrosterone and androstanolone in the two groups is significant. The high excretion of dehydroepiandrosterone and low excretion of androstanolone in cases of hyperemesis gravidarum is a sign of adrenal dysfunction.

Determination of clinical efficiency of deproteinized dialysate from blood of milk-fed calves after endoprosthetics in patients with ventral hernias

2020 ◽  
Vol 28 (3) ◽  
pp. 323-333
Author(s):  
Sergej V. Ivanov ◽  
Ilya S. Ivanov ◽  
Evgenij G. Obyedkov ◽  
Liliya P. Popova
Keyword(s):  
Abdominal Wall ◽  
Inflammatory Reaction ◽  
Inflammatory Process ◽  
Anterior Abdominal Wall ◽  
Dynamic Change ◽  
Main Group ◽  
Control Group ◽  
Surgical Department ◽  
Regeneration Stage

Aim. To study the influence of deproteinized dialysate from blood of milk-fed calves on the type of exudative discharge and dynamics of inflammatory reaction after hernia repair with plastics of the anterior abdominal wall with hernioendoprosthesis of polypropylene. Materials and Methods. The study involved 59 patients being on stationary treatment in the surgical department of Kursk Regional Clinical Hospital. Patients were hospitalized for the herniation of small or medium dimension. The patients were divided to two groups: the main (n=30) and control (n=29) groups. After endoprosthetics, the patients of the control group were given complex conservative treatment. The patients of the main group, besides standard treatment, were administered deproteinized dialysate from blood of milk-fed calves intravenously in drips 10 ml + 200 ml of 0.9% sodium chloride solution within 7 days. For cytological examination and determination of the type of cytograms, the traumatic discharge was collected and analyzed using the method of M.F. Kamaev and M.A. Palthsev. Results. Cytomorphometric examination was conducted on the third, fifth and seventh day after endoprosthetics with the aim of studying dynamic changes. Determination of cell composition and also of its changes characteristic of each studied period, was necessary for obtaining further information characterizing inflammatory process in the region of placement of the endoprosthesis. After endoprosthetics in patients who were administered hemodialysate, the inflammatory reaction was less pronounced than in patients who did not receive the preparation. This was associated with a more dynamic change of stages of the inflammatory process. In patients of the main group who received deproteinized dialysate, regenerative type of inflammation first appeared on the fifth day and made 6.9%; by the seventh day the share of patients with the regenerative type rose to 17.5%, while in the patients of the control group no regeneration stage was observed in both periods. Conclusion. Analysis of the efficiency of influence of hemodialysate on the inflammatory reaction in plastics of the anterior abdominal wall with polypropylene endoprosthesis evidences faster course of all stages of inflammation and reduction of its intensity by 10%.

scholarly journals Biodistribution of the radiophamarceutical sodium pertechnetate (Na99mTcO4) after massive small bowel resection in rats

2007 ◽  
Vol 22 (6) ◽  
pp. 430-435 ◽  
Author(s):  
Dâmaso de Araújo Chacon ◽  
Irami Araújo-Filho ◽  
Arthur Villarim-Neto ◽  
Amália Cínthia Meneses Rêgo ◽  
Ítalo Medeiros Azevedo ◽  
...  
Keyword(s):  
Small Intestine ◽  
Short Bowel Syndrome ◽  
Intestinal Mucosa ◽  
Intestinal Resection ◽  
Small Bowel Resection ◽  
Control Group ◽  
Short Bowel ◽  
Massive Resection ◽  
Mucosal Thickness ◽  
Misleading Interpretation

PURPOSE: To evaluate the biodistribution of sodium pertecnetate (Na99mTcO4) in organs and tissues, the morphometry of remnant intestinal mucosa and ponderal evolution in rats subjected to massive resection of the small intestine. METHODS: Twenty-one Wistar rats were randomly divided into three groups of 7 animals each. The short bowel (SB) group was subjected to massive resection of the small intestine; the control group (C) rats were not operated on, and soft intestinal handling was performed in sham rats. The animals were weighed weekly. On the 30th postoperative day, 0.l mL of Na99mTcO4, with mean activity of 0.66 MBq was injected intravenously into the orbital plexus. After 30 minutes, the rats were killed with an overdose of anesthetic, and fragments of the liver, spleen, pancreas, stomach, duodenum, small intestine, thyroid, lung, heart, kidney, bladder, muscle, femur and brain were harvested. The biopsies were washed with 0.9% NaCl.,The radioactivity was counted using Gama Counter WizardTM 1470, PerkinElmer. The percentage of radioactivity per gram of tissue (%ATI/g) was calculated. Biopsies of the remaining jejunum were analysed by HE staining to obtain mucosal thickness. Analysis of variance (ANOVA) and the Tukey test for multiple comparisons were used, considering p<0.05 as significant. RESULTS: There were no significant differences in %ATI/g of the Na99mTcO4 in the organs of the groups studied (p>0.05). An increase in the weight of the SB rats was observed after the second postoperative week. The jejunal mucosal thickness of the SB rats was significantly greater than that of C and sham rats (p<0.05). CONCLUSION: In rats with experimentally-produced short bowel syndrome, an adaptive response by the intestinal mucosa reduced weight loss. The biodistribution of Na99mTcO4 was not affected by massive intestinal resection, suggesting that short bowel syndrome is not the cause of misleading interpretation, if an examination using this radiopharmaceutical is indicated.

scholarly journals Right-sided Bochdalek hernia in an adult with hepatic malformation and intestinal malrotation

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Naoki Enomoto ◽  
Kazuhiko Yamada ◽  
Daiki Kato ◽  
Shusuke Yagi ◽  
Hitomi Wake ◽  
...  
Keyword(s):  
Elective Surgery ◽  
Abdominal Cavity ◽  
Three Dimensional ◽  
Simulation Software ◽  
3D Simulation ◽  
Diaphragmatic Defect ◽  
Intestinal Malrotation ◽  
Intestinal Loop ◽  
Bochdalek Hernia ◽  
The Right

Abstract Background Bochdalek hernia is a common congenital diaphragmatic defect that usually manifests with cardiopulmonary insufficiency in neonates. It is very rare in adults, and symptomatic cases are mostly left-sided. Diaphragmatic defects generally warrant immediate surgical intervention to reduce the risk of incarceration or strangulation of the displaced viscera. Case presentation A 47-year-old woman presented with dyspnea on exertion. Computed tomography revealed that a large part of the intestinal loop with superior mesenteric vessels and the right kidney were displaced into the right thoracic cavity. Preoperative three-dimensional (3D) simulation software visualized detailed anatomy of displaced viscera and the precise location and size of the diaphragmatic defect. She underwent elective surgery after concomitant pulmonary hypertension was stabilized preoperatively. The laparotomic approach was adopted. Malformation of the liver and the presence of intestinal malrotation were confirmed during the operation. The distal part of the duodenum, jejunum, ileum, colon, and right kidney were reduced into the abdominal cavity consecutively. A large-sized oval defect was closed with monofilament polypropylene mesh. No complications occurred postoperatively. Conclusion Symptomatic right-sided Bochdalek hernia in adults is exceedingly rare and is frequently accompanied by various visceral anomalies. Accurate diagnosis and appropriate surgical repair are crucial to prevent possible incarceration or strangulation. The preoperative 3D simulation provided comprehensive information on anatomy and concomitant anomalies and helped surgeons plan the operation meticulously and perform procedures safely.

Leukogram and cortisol parameters in Swiss mice experimentally infected with Angiostrongylus costaricensis

2021 ◽  
Vol 95 ◽  
Author(s):  
E. Benvegnú ◽  
C.C. Hermes ◽  
J.A. Guizzo ◽  
S.M. Soares ◽  
M.M. Costa ◽  
...  
Keyword(s):  
Cytokine Profile ◽  
Control Group ◽  
Necrosis Factor Alpha ◽  
Swiss Mice ◽  
Hypochromic Anaemia ◽  
Third Stage ◽  
Factor Alpha ◽  
Cortisol Levels ◽  
Necrosis Factor

Abstract This study describes changes in haematological parameters, cytokine profile, histopathology and cortisol levels in Swiss mice experimentally infected with Angiostrongylus costaricensis. Twenty-eight Swiss mice were divided into two groups (G1 and G2) of 14 animals each. In each group, eight animals were infected orally with ten third-stage larvae of A. costaricensis and six were used as a control group. The mice of groups G1 and G2 were sacrificed 14 and 24 days after infection, respectively. Samples were collected for histopathological and haematological analyses and determination of the cytokine profile and cortisol levels. Granulomatous reaction, eosinophilic infiltrate and vasculitis in the intestinal tract, pancreas, liver and spleen were observed with varying intensity in infected animals. Our results showed that the mice developed normocytic and hypochromic anaemia, and that the histopathological lesions caused by the experimental infection influenced increases in cortisol, neutrophil and monocyte levels. In addition to this, we detected increased interleukin-6 and tumour necrosis factor alpha levels in the infected animals.

The effect of experimental low zearalenone intoxication on ovarian follicles in pre-pubertal bitches

2013 ◽  
Vol 16 (1) ◽  
pp. 45-54 ◽  
Author(s):  
M. Gajęcka
Keyword(s):  
Low Dose ◽  
Companion Animals ◽  
Ovarian Follicles ◽  
Apoptotic Index ◽  
Proliferation Index ◽  
Control Group ◽  
Average Body ◽  
Proliferative Ability

AbstractCompanion animals, including bitches, may be exposed to zearalenone (ZEN) toxins that are often present in feed, and ZEN intoxication may lead to ovarian dysfunction. This study involved evaluation of the degree of ZEN-induced hypo stimulation of ovary by determination of proliferative and apoptotic indices and description of the ultra-structural organization of ovarian follicles in pre-pubertal bitches subjected to experimental, long-term exposure to low-dose ZEN mycotoxicosis. The experiment involved 30 clinically healthy, immature Beagle bitches aged approximately 70 days with initial average body weight of 8 kg, randomly divided into three groups of 10 animals each: two experimental groups (EI and EII) and a control group (C). Over a period of 42 days, ZEN was administered per os to EI animals at a dose of 50 μg/kg BW, and to EII bitches at a dose of 75 μg/kg BW. Control group animals were fed placebo containing no ZEN for 42 days. Analytical samples of the mycotoxin were administered daily in gelatin capsules before morning feeding. All the bitches were subjected to ovario-hysterectomy at the end of the experiment. Proliferation index (PCNA method) and apoptotic index (TUNEL test) values were determined by immune-histological analyses. The median for apoptotic index was determined at 13.45 for group EI, 17.84 for group EII, and 8.59 for group C. The median for proliferation index was determined at 35.25 for group EII, 42.44 for group EI, and 70.60 for group C. The results of ultra-structural examinations of the ovaries revealed that experimental, ZEN-induced hyperestrogenism enhanced apoptosis and lowered the proliferative ability of follicular cells what contributed to organelle destruction in pre-pubertal bitches. The changes observed were particularly advanced in EII animals, which were administered a higher dose of ZEN.

MO432COMPARATIVE ANALYSIS OF INDIRECT IMMUNOFLUORESCENCE AND ENZYME-LINKED IMMUNOSORBENT ASSAYS FOR ANTI-PLA2R ASSESMENT IN PATIENTS WITH PRIMARY MEMBRANOUS NEPHROPATHY

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Olga Galkina ◽  
Evdokia Bogdanova ◽  
Irina Zubina ◽  
Elena Levykina ◽  
Alexei Smirnov
Keyword(s):  
Indirect Immunofluorescence ◽  
Membranous Nephropathy ◽  
Laboratory Diagnosis ◽  
Response To Therapy ◽  
Control Group ◽  
Course Of Disease ◽  
Phospholipase A2 Receptor ◽  
Gender And Age ◽  
Positive Results

Abstract Background and Aims Antibodies to M-type phospholipase A2 receptor (PLA2R-Ab) are considered to be a promising biomarker for laboratory diagnosis of primary membranous nephropathy (PMN) and may be useful in the evaluation of the response to therapy and CKD prognosis. The aim of the study was to compare two immunoassay methods – indirect immunofluorescence (IIF) and enzyme immunoassay (ELISA) for the determination of circulating PLA2R-Ab in patients with PMN. Method The study included 54 patients aged 55 (40-63) yrs. (M: F [33:21]) with PMN before treatment (n=16) and treated with immunosuppressive therapy (IST) (n=38), and apparently healthy individuals of the corresponding gender and age (n=10). Proteinuria and estimated glomerular filtration rate (eGFR) were determined in all participants. The levels of PLA2R-Ab were determined by IIF and quantitative/ semi-quantitative ELISA (EURUIMMUN AG test, Germany). In 16 PMN patients without treatment and 28 PMN patients treated with IST the level of PLA2R-Ab was measured one time and in 10 PMN patients treated IST – in dynamic, from 2 to 5 times. Statistical comparisons among groups were performed using Mann–Whitney U-test and Kruskal-Wallis H tests. The association between variables was estimated using Spearman’s coefficient. Sensitivity and specificity of the methods were calculated. Results The correlation coefficient between IIF and ELISA was 0.82 (p &lt;0.005). There were more PLA2R-Ab-positive cases detected by ELISA, both before treatment (ELISA - 80%, IIF - 67%) and among patients treated with IST (ELISA - 63%, IIF - 50%). In control group, ELISA showed no positive results for PLA2R-Ab (specificity was 100%). The levels of proteinuria and eGFR were associated with autoantibodies determined by ELISA, both quantitative and semi-quantitative (proteinuria: r = 0.69, p = 0.001; eGFR: r = -0.38, p = 0.035) but not by IIF (proteinuria: r=0.33, p=0.061; eGFR: r=-0.26, p=0.082). The levels of PLA2R-Ab measured by ELISA correlated with the course of disease in patients treated with IST, while IIF did not show any dynamics is some cases. Conclusion Both quantitative and semi-quantitative ELISA were considered to be more preferable methods since the obtained results correlate with renal dysfunction and allow to assess the concentration of PLA2R-Ab in the course of disease more accurately, that may contribute to timely correction of treatment and improvement of outcome.

Phenotypes of professional bronchial asthma from the standpoint of spirometry

2021 ◽  
pp. 43-54
Author(s):  
Antonina G. Baykova ◽  
Marina Yuryevna Vostroknutova ◽  
Natalia A. Ostryakova ◽  
Tatyana Mikhailovna Kiryushina
Keyword(s):  
Comparative Analysis ◽  
Bronchial Asthma ◽  
Clinical Stage ◽  
Molecular Genetic ◽  
Control Group ◽  
Forced Exhalation ◽  
Choice Of Treatment ◽  
Genetic Examination

The aim of the study was to conduct a comparative analysis of spirometric indicators of respiration in various phenotypes of occupational bronchial asthma. Materials and methods. At the clinical stage of the work, a comprehensive clinical, radiological, spirographic, echocardiographic, immunological and molecular genetic examination of 170 patients of the main groups and 50 individuals of the control group was carried out. The results of the study. Dynamic determination of the speed indicators of forced exhalation in various phenotypes of occupational bronchial asthma can improve the diagnosis of obstructive disorders in this pathology, optimize the choice of treatment tactics, and predict the course of this pathology.

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