scholarly journals LIVER ECHINOCOCCOSIS: DIAGNOSIS AND SURGICAL TREATMENT EXPERIENCE

2021 ◽  
pp. 66-71
Author(s):  
V. A. Shaprinsky ◽  
O. O. Vorovsky ◽  
О. О. Kamins’kyy ◽  
A. V. Verba ◽  
A. M. Formanchuk ◽  
...  
Keyword(s):  
Blood Loss ◽  
Abdominal Cavity ◽  
Complete Recovery ◽  
Diagnostic Value ◽  
Liver Cysts ◽  
Results Of Treatment ◽  
Before And After ◽  
Residual Cavity ◽  
The Right ◽  
Duration Of Operation

Summary. The purpose: to analyze the results of treatment of patients with liver echinococcosis. Materials and methods: results of treatment of 76 patients with echinococcosis of the liver were analyzed, women — 66 (86,8 %), men — 10 (13,2 %). Primary echinococcosis was detected in 73 (96,1 %) patients, secondary — in 3 (3,9 %). Among instrumental research methods, ultrasound and computed tomography examination were of diagnostic value. Single liver cysts were found in 66 (86,8 %) patients, multiple — in 10 (13,2 %). Among patients with solitary cysts, the right lobe was more often affected in 56 (73,7 %) patients than the left — 20 (26,3 %) cases. Echinococcosis complications were observed in 16 (21,1 %) patients. Among them, most often there were suppurations of the cyst — in 13 (17,1 %); a break of the cyst in the free abdominal cavity — in 1 (1,3 %), in the pleural cavity — 1 (1,3 %), in the biliary tract — in 1 (1,3 %). In 20 (26,3 %) cases, the operation was performed from the upper median access, in 46 (60,5%) — from oblique hypochondriac accesses by Kocher or by Fedorov. Pericystectomy was performed in 52 (68,4 %) patients, in 8 (10,5 %) patients had resections of liver segments with an echinococcal cyst, in 4 (5,3 %) — cyst opening with removal of contents and treatment of its cavity. Laparoscopic echinococectomy was used in 12 (15,8 %) patients. In the postoperative period, complications were observed in 16 (21,1 %) patients. The use of the welding electrocoagulator EK-300M «Swarmed» in the thermal rehabilitation of the walls of the residual cavity after echinococectomy allowed to reduce blood loss from (2200 ± 210) to (250 ± 50) ml, recurrences – with 2,8 up to 0 %. Before and after operation was performed antireсedive antiparasitic therapy with albendazole (Vormil) in two cycles of 28 days, separated by a 14-day break. The dose at body weight over 60 kg was 400 mg 2 times a day, and for less than 60 kg the drug was prescribed at a rate of 15 mg/kg/day. Results. With the use of laparoscopic echinococectomy, intraoperative blood loss was reduced by 9 times (р=0,0001); duration of operation — 2 times (р>0,05), stay in hospital - 3,3 times (р=0,002). There were no fatal outcomes. Conclusions. Pericystectomy is an effective operation for complete recovery and does not give recurrence of the disease. The use of a welding electrocoagulator and laparoscopic echinococectomy significantly improve the results of treatment of patients with parasitic liver cysts.

scholarly journals Diagnosis and surgical treatment of liver echinococcosis

2021 ◽  
Vol 26 (4) ◽  
pp. 113-117
Author(s):  
V.O. Shaprinskyi  ◽  
O.O. Vorovskyi ◽  
O.A. Kaminskyi ◽  
Ya.M. Pashynskyi
Keyword(s):  
Blood Loss ◽  
Pleural Cavity ◽  
Abdominal Cavity ◽  
Diagnostic Value ◽  
Results Of Treatment ◽  
Before And After ◽  
Residual Cavity ◽  
Right Lobe ◽  
The Right ◽  
Duration Of Operation

The results of treatment of 72 patients with echinococcosis of the liver were analyzed, women – 62 (86.2%), men – 10 (13.8%). Primary echinococcosis was detected in 69 (95.8%) patients, secondary – in 3 (4.2%). Among instrumental research methods, ultrasound and computed tomography examination were of diagnostic value. Single liver cysts were found in 63 (87.5%) patients, multiple – in 9 (12.5%). Among patients with solitary cysts, the right lobe was more often affected than the left – 48 (66.7%) vs 24 (33.3%) cases. Echinococcosis of central localization was less common and was noted in 8 (11.1%) cases. Echinococcosis complications were observed in 16 (22.2%) patients. Among them, most often there were suppurations of the cyst – in 13 (18.1%); a bursting of the cyst into the free abdominal cavity – in 1 (1.4%), in the pleural cavity – 1 (1.4%), in the biliary tract – in 1 (1.4%). Partial or complete liming of the hand was observed in 12 (16.7%) patients. In 20 (27.8%) cases, the operation was performed from the upper median access, in 42 (58.3%) – from oblique hypochondria accesses by Kocher or by Fedorov. Pericystectomy was performed in 48 (66.7%) patients, in 8 (11.1%) patients underwent resections of liver segments with an echinococcal cyst, in 4 (5.6%) – cyst opening with removal of contents and treatment of its cavity. Laparoscopic echinococectomy was used in 12 (16.7%) patients. In the postoperative period complications were observed in 16 (22.2%) patients. The use of the welding electrocoagulator EK-300M "Swarmed" in the thermal rehabilitation of the walls of the residual cavity after echinococectomy allowed to reduce blood loss from 2200±210 ml to 250±50 ml. With the use of laparoscopic echinococectomy, intraoperative blood loss was reduced by 9 times (р=0.0001); duration of operation – 2 times (р<0.05), stay in hospital – 3.3 times (р=0.002). There were no fatal outcomes. Before and after operation antirelapse antiparasitic therapy with albendazole (Vormil) was performed in two cycles of 28 days, separated by a 14-day break. The dose at body weight over 60 kg was 400 mg 2 times a day, and for less than 60 kg the drug was calculated at a rate of 15 mg/kg/day. There were 2 (2.8%) cases of relapse, there was no mortality.

scholarly journals The Functional Relevance of Diffusion Tensor Imaging in Patients with Degenerative Cervical Myelopathy

2020 ◽  
Vol 9 (6) ◽  
pp. 1828 ◽  
Author(s):  
Stefania d’Avanzo ◽  
Marco Ciavarro ◽  
Luigi Pavone ◽  
Gabriele Pasqua ◽  
Francesco Ricciardi ◽  
...  
Keyword(s):  
Diffusion Tensor Imaging ◽  
Cervical Myelopathy ◽  
Diffusion Tensor ◽  
Diagnostic Value ◽  
Hand Strength ◽  
Predictive Tool ◽  
Left Hand ◽  
Before And After ◽  
The Right ◽  
Degenerative Cervical Myelopathy

(1) Background: In addition to conventional magnetic resonance imaging (MRI), diffusion tensor imaging (DTI) has been investigated as a potential diagnostic and predictive tool for patients with degenerative cervical myelopathy (DCM). In this preliminary study, we evaluated the use of quantitative DTI in the clinical practice as a possible measure to correlate with upper limbs function. (2) Methods: A total of 11 patients were enrolled in this prospective observational study. Fractional anisotropy (FA) values was extracted from DTI data before and after surgery using a GE Signa 1.5 T MRI scanner. The Nine-Hole Peg Test and a digital dynamometer were used to measure dexterity and hand strength, respectively. (3) Results: We found a significant increase of FA values after surgery, in particular below the most compressed level (p = 0.044) as well as an improvement in postoperative dexterity and hand strength. Postoperative FA values moderately correlate with hand dexterity (r = 0.4272, R2 = 0.0735, p = 0.19 for the right hand; r = 0.2087, R2 = 0.2265, p = 0.53 for the left hand). (4) Conclusion: FA may be used as a marker of myelopathy and could represent a promising diagnostic value in patients affected by DCM. Surgical decompression can improve the clinical outcome of these patients, especially in terms of the control of finger-hand coordination and dexterity.

scholarly journals Results of the Controlled Clinical Test of Intraoperative Blood Reinfusion Hardware, Assembled From the Abdominal Cavity in Conditions of Slow and Fast Modes

2020 ◽  
Vol 6 (2) ◽  
pp. 111-117
Author(s):  
Sh. Abdurakhmanov ◽  
Zh. Chyngysheva ◽  
B. Musaliev ◽  
E. Tilekov
Keyword(s):  
Experimental Data ◽  
Clinical Trials ◽  
Blood Loss ◽  
Abdominal Cavity ◽  
Clinical Test ◽  
Controlled Clinical Trials ◽  
Experimental Control ◽  
Clinical Control ◽  
Before And After ◽  
Comparative Description

Conducting parallel clinical and experimental control on the basis of controlled clinical trials was necessitated by, on the whole, a more thorough assessment of the effectiveness of intraoperative blood reinfusion hardware with the establishment of the possibility of ‘transfer’ of experimental data on modeling cavity blood loss to a clinical platform. Objective: a comparative description of the results of the following studies performed in the context of controlled clinical trials: 1) experimental control — a study of blood collected from the pleural and abdominal cavities before and after intraoperative blood reinfusion hardware under simulation conditions in animal injuries of the abdomen and chest with the formation, respectively, of hemothorax and hemoperitoneum; 2) clinical control — a study of blood collected from the abdominal and thoracic cavities before and after intraoperative blood reinfusion hardware in patients with injuries and injuries of the chest and abdomen with the corresponding formation of hemothorax and hemoperitoneum.

scholarly journals Diagnostic program and tactical approaches to treatment of patients with obturative colonic obstruction of tumor genesis

2012 ◽  
Vol 93 (3) ◽  
pp. 426-431
Author(s):  
I S Malkov ◽  
M M Toltoev
Keyword(s):  
Bowel Obstruction ◽  
Surgical Intervention ◽  
Primary Anastomosis ◽  
Colonic Obstruction ◽  
Abdominal Cavity ◽  
Digital Rectal Examination ◽  
Postoperative Mortality ◽  
Diagnostic Procedures ◽  
Results Of Treatment ◽  
The Right

Aim. To determine the value of ultrasound investigations, colonoscopy and laparoscopy in the complex diagnosis of acute obturative colonic obstruction of tumor genesis and in selecting the optimal treatment strategy. Methods. Conducted was an anlysis of results of treatment of 112 patients with obturative colonic obstruction of tumor genesis. A set of diagnostic procedures was carried out for every admitted patient: digital rectal examination, radiography of the abdomen, ultrasound examination, fiber colonoscopy, and laboratory studies. Results. Based on the clinical and radiographic the diagnosis of obturative colonic obstruction was established in 64.3%, ultrasound investigation revealed the presence of bowel obstruction without specifying its location in 92% of the cases. Emergency colonoscopy was informative only in 55.5% of cases due to inadequate prior preparation of the colon. Using the developed methodology of preparing the colon, it was possible to perform colonoscopy up to the level of the tumor in 26 patients (92.9%) out of 28 patients. In the 32 cases minimal surgical intervention were performed by way of formation of an ileotransverse anastomosis by-pass, double-barreled ileostomy or colostomy. 80 patients underwent resection of the bowel with the tumor, including operations with the formation of a primary anastomosis, which were performed in 20 patients when the tumor was located in the right segments of the colon. In 22 patients an intraoperative colonic lavage was performed. Postoperative complications were recorded in 30 (26.8%) patients. Postoperative mortality was 24.1% (27 patients). Conclusion. Based on the radiographic and ultrasound investigations of the abdominal cavity it is possible to establish the presence of bowel obstruction without specifying the localization of the obstruction zone; in order to determine the cause of the obturative colonic obstruction it is necessary to perform an emergency colonoscopy with rigorous preparation of the colon according to the developed technique, while the volume of surgical intervention should be determined in each case individually.

scholarly journals Carotid chemodectoma in the otorhinolaryngological practice: a clinical case

2020 ◽  
Vol 27 (2) ◽  
pp. 135-143
Author(s):  
A. N. Vachev ◽  
O. V. Dmitriev ◽  
O. V. Zeleva ◽  
P. M. Zelter
Keyword(s):  
Computed Tomography ◽  
Surgical Treatment ◽  
Carotid Artery ◽  
Blood Loss ◽  
Clinical Case ◽  
Interdisciplinary Approach ◽  
Complete Recovery ◽  
Peritonsillar Abscess ◽  
Surgical Removal ◽  
The Right

Aim. To describe a clinical case of carotid chemodectoma in a patient seeking treatment from an otorhinolaryngologist.Results. A 79-year-old woman complained of sore throat and difficulty swallowing. Mesopharyngoscopy revealed a significant asymmetry of the pharynx on the right with a sagging soft palate. Computed tomography revealed the asymmetry of the pharynx on the right due to compression from outside. An irregularly shaped formation intensely accumulating contrast medium was detected in the periopharyngeal space on the right, near the bifurcation of the carotid artery. Carotid chemodectoma was suspected. The patient underwent surgical removal of the chemodectoma followed by the autoarterial reconstruction of the carotid artery on the right. The postoperative period was uneventful.Conclusion. The management of patients with carotid chemodectoma requires an interdisciplinary approach with participation of vascular surgeons, otorhinolaryngologists and radiologists. This approach ensures timely surgical treatment leading to complete recovery without neurological consequences and profuse blood loss. The disease can be mistaken for a peritonsillar abscess with the possibility of serious complications during surgical treatment.

Comparative Arterial Antithrombotic Activity of Clopidogrel and Acetyl Salicylic Acid in the Pig

1992 ◽  
Vol 68 (05) ◽  
pp. 500-505 ◽  
Author(s):  
Ch M Samama ◽  
Ph Bonnin ◽  
M Bonneau ◽  
G Pignaud ◽  
E Mazoyer ◽  
...  
Keyword(s):  
Platelet Aggregation ◽  
Femoral Artery ◽  
Bleeding Time ◽  
Ex Vivo ◽  
Flow Reduction ◽  
Cyclic Flow ◽  
Left Femoral Artery ◽  
Before And After ◽  
The Right ◽  
Induced Aggregation

SummaryWe investigated the comparative antithrombotic properties of clopidogrel, an analogue of ticlopidine, and aspirin, using the Folts' model on femoral arteries in 22 pigs. On each animal, clopidogrel or aspirin were used to treat the thrombotic process on the left femoral artery and to prevent this process on the right femoral artery. Sequentially: an injury and stenosis were carried out on the left femoral artery; the thrombotic process was monitored with a Doppler during a 30-min observation period for cyclic flow reductions or permanent cessation of flow; after the first cyclic flow reduction occurred, clopidogrel (5 mg kg-1) or aspirin (2.5, 5, 100 mg kg-1) were injected intravenously; if cyclic flow reductions were abolished, epinephrine (0.4 µg kg-1 min-1) was injected to try to restore cyclic flow reductions and/or permanent cessation of flow; then injury and stenosis were applied on the right femoral artery. Before and after injection of clopidogrel or aspirin, ear immersion bleeding times and ex-vivo platelet aggregation were performed. Clopidogrel (n = 7) abolished cyclic flow reductions in all animals and epinephrine did not restore any cyclic flow reduction. On the right femoral artery, cyclic flow reductions were efficiently prevented, even for two injuries. Basal bleeding time (5 min 28) was lengthened (>15 min, 30 min after clopidogrel and remained prolonged even after 24 h). ADP-induced platelet aggregation was inhibited (more than 78%). Comparatively, aspirin had a moderate and no dose-dependent effect. Aspirin 2.5 mg kg-1 (n = 6) abolished cyclic flow reductions in 2 animals, CFR reoccurred spontaneously in one animal and epinephrine restored it in a second animal. Aspirin 5 mg kg-1 (n = 6) abolished cyclic flow reductions in only 3 animals and epinephrine always restored it. Aspirin 100 mg kg-1 (n = 3) was unable to abolish cyclic flow reductions. On the right femoral artery, aspirin did not significantly prevent cyclic flow reductions which occurred in all animals after one (n = 14) or two injuries (n = 1), except for one animal. Basal bleeding time was lengthened but it shortened rapidly, reaching its basal value after 24 h. ADP-induced aggregation was not significantly inhibited, whereas arachidonic acid induced aggregation was always inhibited. Clopidogrel appears as a more potent antithrombotic drug than aspirin in this model, in treating and preventing spontaneous or epinephrine-induced cyclic flow reductions and lengthening bleeding time.

Closure of Secundum Atrial Septal Defect with Autologous Right Atrial Patch: Case Report

2005 ◽  
Vol 8 (2) ◽  
pp. 96 ◽  
Author(s):  
Osman Tansel Dar�in ◽  
Alper Sami Kunt ◽  
Mehmet Halit Andac
Keyword(s):  
Atrial Septal Defect ◽  
Right Atrium ◽  
Septal Defect ◽  
Complete Recovery ◽  
Interatrial Septum ◽  
Right Atrial ◽  
Atrial Wall ◽  
Residual Shunt ◽  
Asd Closure ◽  
The Right

Background: Although various synthetic materials and pericardium have been used for atrial septal defect (ASD) closure, investigators are continuing to search for an ideal material for this procedure. We report and evaluate a case in which autologous right atrial wall tissue was used for ASD closure. Case: In this case, we closed a secundum ASD of a 22-year-old woman who also had right atrial enlargement due to the defect. After establishing standard bicaval cannulation and total cardiopulmonary bypass, we opened the right atrium with an oblique incision in a superior position to a standard incision. After examining the secundum ASD, we created a flap on the inferior rim of the atrial wall. A stay suture was stitched between the tip of the flap and the superior rim of the defect, and suturing was continued in a clockwise direction thereafter. Considering the size and shape of the defect, we incised the inferior attachment of the flap, and suturing was completed. Remnants of the flap on the inferior rim were resected, and the right atrium was closed in a similar fashion. Results: During an echocardiographic examination, neither a residual shunt nor perigraft thrombosis was seen on the interatrial septum. The patient was discharged with complete recovery. Conclusion: Autologous right atrial patch is an ideal material for ASD closure, especially in patients having a large right atrium. A complete coaptation was achieved because of the muscular nature of the right atrial tissue and its thickness, which is a closer match to the atrial septum than other materials.

EFEKTIVITAS METODE DEMONSTRASI DALAM MENINGKATKAN HASIL BELAJAR SISWA SEKOLAH MENENGAH KEJURUAN PADA PENGAJARAN SISTEM KOLOID

2013 ◽  
Vol 19 (1) ◽  
pp. 28
Author(s):  
Hamda Situmorang ◽  
Manihar Situmorang
Keyword(s):  
High School ◽  
High School Students ◽  
Abstract Concept ◽  
Vocational High School ◽  
School Students ◽  
Lecture Method ◽  
Colloid System ◽  
Before And After ◽  
The Right ◽  
And Control

Abstract Implementation of demonstration method in the teaching of chemistry is assigned as the right strategy to improve students’ achievement as it is proved that the method can bring an abstract concept to reality in the class. The study is conducted to vocational high school students in SMKN1 Pargetteng getteng Sengkut Pakfak Barat at accademic year 2013. The teaching has been carried out three cycles on the teaching of chemistry topic of colloid system. In the study, the class is divided into two class, experiment class and control class. The demontration method is used to teach students in experimental class while the teaching in control class is conducted with lecture method. Both are evaluated by using multiple choise tests before and after the teaching procedures, and the ability of students to answer the problems are assigned as students’ achievements. The results showed that demonstration method improved students’ achievement in chemistry. The students in experimental class who are taughed with demonstration method (M=19.08±0.74) have higher achievements compare with control class (M=12.91±2.52), and both are significantly different (tcalculation 22.85 > ttable 1.66). The effectivity of demostration method in experimental class (97%) is found higer compare to conventional method in control class (91%).

Sign in / Sign up

Export Citation Format

Share Document