scholarly journals COLOPLASTY: AN ALTERNATIVE TO GASTRIC PULL-UP IN BENIGN DISEASES OF ESOPHAGUS

2020 ◽  
pp. 1-3
Author(s):  
Nitin R Nangare
Keyword(s):  
Posterior Part ◽  
Vascular Anatomy ◽  
Single Layer ◽  
Functional Results ◽  
Colon Interposition ◽  
Esophageal Reconstruction ◽  
Jejunal Loop ◽  
Esophageal Disease ◽  
Vagus Nerves ◽  
The Right

Restoration of swallowing in a patient with dysphagia due to nondilatable corrosive stricture of esophagus remains a surgical challenge. Organs available for replacement are stomach, jejunum, or colon. Jejunum is useful to replace a small segment, whereas stomach and colon are required for a long-segment replacement. In cases where the stomach is also injured, colon remains the only option. The route of colonic interposition has also been a subject of debate over the years. The choice of the colon as an esophageal substitute results primarily from the unavailability of the stomach. However, given its durability and function, colon interposition keeps elective indications in patients with benign or malignant esophageal disease who are potential candidates for long survival. The choice of the colonic portion used for esophageal reconstruction depends on the required length of the graft, and the encountered colonic vascular anatomy, the last being characterized by the near-invariability of the left colonic vessels, in contrast to the vascular pattern of the right side of the colon. Accordingly, the transverse colon with all or part of the ascending colon is the substitute of choice, positioned in the isoperistaltic direction, and supplied either from the left colic vessels for long grafts or middle colic vessels for shorter grafts. Technical key points are: full mobilization of the entire colon, identication of the main colonic vessels and collaterals, and a prolonged clamping test to ensure the permeability of the chosen nourishing pedicle. Transposition through the posterior mediastinum in the esophageal bed is the shortest one and thereby offers the best functional results. When the esophageal bed is not available, the retrosternal route is the preferred alternative option. The food bolus traveling mainly by gravity makes straightness of the conduit of paramount importance. The proximal anastomosis is a single-layer hand-fashioned endto- end anastomosis to prevent narrowing. When the stomach is available, the distal anastomosis is best performed at the posterior part of the antrum for the reasons of pedicle positioning and reux prevention, and a gastric drainage procedure is added when the esophagus and vagus nerves have been removed. In the other cases, a Roux-en-Y jejunal loop is preferable to prevent bile reux into the colon.To construct a colon interposition graft that is long enough, we examined a procedure in which the colon is transected proximally at the site of the cecum and the right colic artery is transected, in addition to ligation of the middle artery. Here we examined the series of 20 procedures for post-corrosive esophageal strictures treated with retrosternal colonic interpositions.

A clinical case of transcleral fixation of an artificial iridochrustalic diaphragm during its decentration in a patient with aniridia and aphakia

2021 ◽  
pp. 206-208
Author(s):  
D.O. Shkvorchenko ◽  
◽  
I.M. Gorshkov ◽  
S.A. Kakunina ◽  
K.S. Norman ◽  
...  
Keyword(s):  
Key Words ◽  
Russian Federation ◽  
Clinical Case ◽  
Functional Results ◽  
Successful Implementation ◽  
Ministry Of Health ◽  
Visual Functions ◽  
The Russian Federation ◽  
The Right

Purpose. To evaluate the clinical and functional results of the technique of transcleral fixation of the artificial iridochrustalic diaphragm during its decentration in a patient with aniridia and aphakia. Material and methods. Under observation was a 32-year-old patient K. with a diagnosis on the right eye: iridochrustalic diaphragm decentralization, posttraumatic aniridia, posttraumatic aphakia, who underwent a method of transcleral fixation of a displaced artificial iridochrustalic diaphragm developed at the Academician S. N. Fedorov Eye Microsurgery of the Moscow Ministry of Health of the Russian Federation. Results. Patient K. is subjectively satisfied with the visual functions obtained in the right eye. Conclusion. Thus, this clinical case demonstrates a very successful implementation of the fixation of the iridochrustalic diaphragm with its displacement to obtain satisfactory visual functions in the patient. Key words: aniridia, iridochrustalic diaphragm, transcleral fixation.

Pharmacognostical Investigation of Trapa natans L Leaves

2021 ◽  
pp. 4680-4684
Author(s):  
Chandana Majee ◽  
Rupa Mazumder ◽  
Alka N. Choudhary
Keyword(s):  
Aquatic Plant ◽  
Single Layer ◽  
Total Phenolic ◽  
Phytochemical Analysis ◽  
Trapa Natans ◽  
Microscopic Evaluation ◽  
Anomocytic Stomata ◽  
Physicochemical Evaluation ◽  
The Right ◽  
Who Guideline

Background: Trapa natans L., is annual aquatic plant generally kwon as Water caltrp, Water chest nut belonging to the Trapaceae or Lytraceae family. Trapa natans L is use for the treatment of wide no of diseases without proper standardization. Objective: To give the right pharmacognostical and photochemical information of the Trapanatan L leaves. In this study pharmacognostical investigation of the fresh leaves and powder drug were done to determine the macroscopical, microscopical, quantitative physicochemical and phytochemical property of the drugs. Method: Macroscopical, quantitative and qualitative microscopy, physicochemical evaluation, extractive value, florescence analysis and phytochemical analysis were done according to the WHO guideline. Result: Macroscopical analysis showed that, leaves are greenish to purplish color, rhomboidal shape; alternate, acute, margin is dentate, pinnate venation. Microscopic evaluation showed that leaf is dorsi ventral in nature, upper layer epidermis cells were covered with cuticle layer. Single layer of barrel shape cell were present bellow the upper epidermis layer. Trichomes are generally multicellular. Anomocytic stomata were observed in upper epidermis. From the experiment it was found that methanolic extract give the highest extractive value. Phytochemical analysis gives the evidence for the presence of carbohydrate, alkaloids, glycoside, steroids, flavonoids, tannin, and triterpenoids. Qualitative phytochemical analysis give the evidence for presence of high amount total phenolic content. Conclusion: Different pharmacognostical parameters assessed in this examination help to detection and standardization of Trapa natans L., leaves.

scholarly journals Small vessels study using a radiopaque dye

2002 ◽  
Vol 10 (3) ◽  
pp. 05-08
Author(s):  
Fábio Richieri Hanania ◽  
Maurício Masasi Iamaguchi ◽  
Marcelo Rosa de Rezende
Keyword(s):  
Abdominal Aorta ◽  
Femoral Artery ◽  
Vascular Anatomy ◽  
Radiographic Study ◽  
Small Vessels ◽  
Left Femoral Artery ◽  
The Right ◽  
Pioneer Research ◽  
Do So

The purpose of our research consists of studying a new dye which, besides allowing the macroscopic study of small vessels <FONT FACE=Symbol>¾</FONT> following the pioneer research of Salmon(3) <FONT FACE=Symbol>¾</FONT>, permits the radiographic study due to its radiopacity. To do so, ten rats were utilized and their abdominal aorta was catheterized for the injection of the dye towards the periphery, being the flow of the dye observed along the left femoral artery (the right one was cauterized for occlusion). The results of this injection revealed that the dye penetrates well in extremely small vessels and allows dissection without extravasations. Thus, we believe that this dye has the necessary requirements for the study of details of the vascular anatomy.

scholarly journals COLON INTERPOSITION FOR ESOPHAGEAL RECONSTRUCTION (ESOPHAGOCOLOPLASTY)

2013 ◽  
Vol 9 (3) ◽  
pp. 225-233
Author(s):  
R.M. Neagoe R.M. Neagoe ◽  
Daniela Sala ◽  
D. Zamfir ◽  
S. Bancu ◽  
L. Kiss
Keyword(s):  
Colon Interposition ◽  
Esophageal Reconstruction

scholarly journals Definite management of bilateral lower leg nonunion fractures by Ilizarov apparatus in polytraumatized patient: Case report

2015 ◽  
Vol 68 (3-4) ◽  
pp. 137-142
Author(s):  
Ivica Lalic ◽  
Mirko Obradovic ◽  
Mirka Lukic-Sarkanovic ◽  
Vladimir Djan
Keyword(s):  
Case Report ◽  
Joint Stiffness ◽  
Functional Results ◽  
Shaft Fracture ◽  
Lower Leg ◽  
Negative Effects ◽  
Lower Leg Fracture ◽  
Ilizarov Apparatus ◽  
Fracture Nonunions ◽  
The Right

Introduction. Nonunion of long bones may often be associated with significant function loss of affected extremity, joint stiffness, and even extremity amputation or systemic manifestations in the case of infection. The aim of this case report is to highlight the possibilities of Ilizarov apparatus in the treatment of fracture nonunions of both lower legs treated by different operative methods and to show that it is not necessary to remove osteosynthetic material (intramedullary nail) in every case when nonunion occurs to achieve its recovery. Case Report. A 62 year-old man was injured in a traffic accident as a pedestrian in April 2012, when he experienced polytrauma, including shaft fracture of the right femur, and segmental open fractures of the right (Gustillo-Anderson grade I) and left (Gustillo-Anderson grade II) lower leg. The fractures of right femur and right tibia were stabilized initially with intramedullary nails, while the left lower leg fracture was treated by unilateral external fixator. After 5 months, there were no clinical and radiographic signs of union on lower legs, therefore the patient underwent re-surgery. Ilizarov apparatus was applied on both lower legs. The patient was early verticalized and both apparatus were removed after 4 months. According to the modified protocol of the Association for the Study and Application of Methods of Ilizarov, the lower leg bony results were good and excellent, and the functional results were excellent on both sides. Conclusion. Nonunion fracture of the right lower leg initially treated by the method of intramedullary osteosynthesis and afterwards by placing Ilizarov apparatus shows that in some cases it is not indicated to remove fixative material in order to achieve full recovery of fracture, thus eliminating the danger of all negative effects resulting from the classical extensive surgical treatment.

scholarly journals THE INFLUENCE OF THE VAGUS NERVES UPON CONDUCTION BETWEEN AURICLES AND VENTRICLES IN THE DOG DURING AURICULAR FIBRILLATION

1916 ◽  
Vol 24 (5) ◽  
pp. 605-619 ◽  
Author(s):  
G. Canby Robinson
Keyword(s):  
Vagus Nerve ◽  
Vagus Nerves ◽  
The Right ◽  
Left Vagus ◽  
Stimulation Of

The experiments that have been reported indicate that stimulation of either the right vagus or the left vagus nerve is equally effectual in blocking impulses from the auricles to the ventricles when auricular fibrillation is present. Stimulation of the left vagus nerve is as effectual in blocking impulses from the normally beating auricles as from the auricles when in a state of fibrillation, and the type of auricular activity has apparently no influence on the effect which stimulation of the left vagus has on auriculoventricular conduction.

The selective contribution of the right cerebellar lobule VI to reading

2021 ◽  
Author(s):  
Hehui Li ◽  
Rebecca A. Marks ◽  
Lanfang Liu ◽  
Jia Zhang ◽  
Hejing Zhong ◽  
...  
Keyword(s):  
Phonological Processing ◽  
Posterior Part ◽  
Chinese Characters ◽  
Functional Magnetic Resonance ◽  
Resonance Imaging ◽  
Viewing Condition ◽  
Activation Patterns ◽  
English Bilingual ◽  
Passive Viewing ◽  
The Right

Extensive studies have reported significant cerebellar activation during reading tasks. However, it is still unclear which regions in the cerebellum are specifically involved in reading and what this involvement entails. With functional magnetic resonance imaging, we compared Chinese-English bilingual children’s cerebellar neural activity between reading and non-reading conditions and between Chinese characters and English words in a passive viewing paradigm. We observed that the posterior part of the right lobule VI showed greater activation in the reading compared to non-reading tasks. Reading specificity index was significantly in this region. Functional decoding via Neurosynth further showed that this region was responsible for phonological processing and connected with the cerebral reading areas. These results suggest that the posterior part of the right lobule VI might be a reading-selective region in the cerebellum. However, we did not observe any significantly separable activation patterns in the cerebellum between Chinese characters and English words, indicating that the region preferentially responding to reading may not be able to differentiate scripts in a passive viewing condition. In general, these findings deepen our understanding of how the cerebellum contributes to reading.

scholarly journals Vascular Structures of the Right Colon: Incidence and Variations with Their Clinical Implications

2016 ◽  
Vol 106 (2) ◽  
pp. 107-115 ◽  
Author(s):  
J. Alsabilah ◽  
W. R. Kim ◽  
N. K. Kim
Keyword(s):  
Colon Cancer ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Vascular Anatomy ◽  
Colic Artery ◽  
Right Colon ◽  
Right Colon Cancer ◽  
Vascular Structures ◽  
Gastrocolic Trunk ◽  
The Right

Background and Aims: There is a demand for a better understanding of the vascular structures around the right colonic area. Although right hemicolectomy with the recent concept of meticulous lymph node dissection is a standardized procedure for malignant diseases among most surgeons, variations in the actual anatomical vascular are not well understood. The aim of the present review was to present a detailed overview of the vascular variation pertinent to the surgery for right colon cancer. Materials and Methods: Medical literature was searched for the articles highlighting the vascular variation relevant to the right colon cancer surgery. Results: Recently, there have been many detailed studies on applied surgical vascular anatomy based on cadaveric dissections, as well as radiological and intraoperative examinations to overcome misconceptions concerning the arterial supply and venous drainage to the right colon. Ileocolic artery and middle colic artery are consistently present in all patients arising from the superior mesenteric artery. Even though the ileocolic artery passes posterior to the superior mesenteric vein in most of the cases, in some cases courses anterior to the superior mesenteric artery. The right colic artery is inconsistently present ranging from 63% to 10% across different studies. Ileocolic vein and middle colic vein is always present, while the right colic vein is absent in 50% of patients. The gastrocolic trunk of Henle is present in 46%–100% patients across many studies with variation in the tributaries ranging from bipodal to tetrapodal. Commonly, it is found that the right colonic veins, including the right colic vein, middle colic vein, and superior right colic vein, share the confluence forming the gastrocolic trunk of Henle in a highly variable frequency and different forms. Conclusion: Understanding the incidence and variations of the vascular anatomy of right side colon is of crucial importance. Failure to recognize the variation during surgery can result in troublesome bleeding especially during minimal invasive surgery.

scholarly journals Colon Interposition for Esophageal Reconstruction in Cancer Patients

2018 ◽  
Vol 103 (5-6) ◽  
pp. 238-247
Author(s):  
Martin H. Hangaard ◽  
Michael B. Mortensen
Keyword(s):  
Cancer Patients ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Colon Interposition ◽  
Esophageal Reconstruction ◽  
Low Grade ◽  
Extensive Review ◽  
First Choice ◽  
Patient Reported ◽  
Esophagectomy For Cancer

Objective: The aim of this study was to report our experience with colon interposition (COI) and to compare the results with an extensive review of the COI literature. Summary of Background Data: The stomach is the first choice as an esophageal substitute following esophagectomy in cancer patients, while COI is reserved for patients where the stomach is not available or must be included in the resection due to cancer. Methods: We retrospectively reviewed the records of cancer patients undergoing colon interposition from 2006 to 2017. Outcomes were compared with an extensive review of the literature published between 2000 and 2017. Results: A total of 13 patients underwent planned COI. Mortality was zero and overall morbidity was 53%; 4 patients suffered from leakage and 2 patients from strictures. None of the patients suffered from necrosis of the interponat and there was no need for subsequent redundancy operations. The extensive review identified 23 publications. Overall study grading was low (grade C). Only 3 studies were prospective, no randomized studies were found, and many outcomes were poorly defined. The rates for 30-day and in-hospital mortality were 1% and 2%, respectively. Overall morbidity was 43%. The reported number of leakages, strictures, necrosis of the interponat, and redundancy operations varied between 0% and 50%, 0% and 21%, 0% and 9%, and 0% and 2%, respectively. Conclusions: COI is a complex technique that is necessary in a relatively small group of selected patients after esophagectomy for cancer. Prospective and comparative studies with strict outcome definitions, long-term follow up, and patient reported outcome measures are lacking.

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