Morphometric study of adult human gall bladder in a cadaver and its clinical importance

Extrahepatic biliary apparatus comprises of gall bladder, cystic duct, hepatic ducts and common bile duct. Gall Bladder is a pear shaped hollow organ, which are situated in contact with the under surface of right lobe of liver. In adult the length is between 7-10 cm, maximum breadth being 3 cm and with a maximum capacity of 50 ml. The morphological and morphometric variations of gall bladder are common. These variations are well studied and documented by the earlier studies but its precise morphological types and its incidence are utmost important during diagnostic and therapeutic procedures. Hence, comprehensive knowledge of variations of gall bladder will be important to avoid complications during surgical procedures and radiological interventions. The study was carried on 50 liver with Gallbladder specimens obtained from 10% formalin fixed cadavers of age group 50-60 years in the department of Anatomy. The gall bladder was observed, dissected carefully and studied for its parameters i.e. length and breadth using Vernier calipers. The variations in shape, its external morphological features and its position were also noted.52% of the gall bladder specimens had length ranging between 7 – 10cms. 68% of the specimens had transverse diameter ranging between 3 – 5cms. Various shapes observed were Pear shape, Hourglass shape, Retort shape, Cylindrical shape and Flask or Irregular shaped. The commonest shape observed and recorded in this study was Pear shaped in 26 specimens (52%). Folded fundus (Phrygian cap) of gall bladder was found in 2 out of 50 specimens (4%) and Hartmann’s pouch was found in 7 out of 50 specimens (14%).The precise knowledge of the various morphological and morphometric variants of the gall bladder is important for the operating Surgeons and Radiologists. The preoperative diagnosis of these variations helps to reduce the complications like bleeding and biliary leaks.

On the question of peristaltic movement of the uterus during normal labor

The name of peristaltic movement is understood as a change in shape visible to the eye, detected during operation by each hollow organ of the human body, the wall of which is built of smooth muscle fibers. This movement is due to the location of muscle bundles characteristic of smooth muscle organs and the sequential spread of contraction from one segment of the organ to another.

Сryoablation technology for bone metastases

Puncture cryoablation of tumor lesions was performed as a part of complex palliative treatment of 32 patients with the fourth stage of the disease with bone metastases. Each patient, depending on the extent of the lesion, underwent from one to eight procedures. New domestic nitrogen equipment with reusable instruments was used. Cryoablation procedures were performed in the room for Computed Tomography (CT) using robotic navigation, as well as in the operating room under ultrasound monitoring. The indications for the procedure were severe pain syndrome, disease progression, prevention of pathological fractures, and the impossibility of performing the surgical treatment in patients with comorbidities. When performing cryoablation, the number and diameter of cryoprobes, the length of the needle and cryoprobe tip, the direction of insertion, and their mutual positioning were determined depending on the size and shape of the tumor lesion. The technique of puncture approaches and monitoring rules are described in detail. It is recommended to avoid the destruction of the pelvic ring, hip joint, to be careful in cases of tumor localization in the body and arches of the vertebrae, in the lateral parts of the sacrum, in the places where the nerve trunks adhere to the bone. The cryoablation procedure cannot be planned if the skin, the wall of a hollow organ, and the spinal cord are involved in the tumor process. There is a high risk of fracture after performing total cryoablation of metastasis if it covers more than a third of the diameter of the tubular bone.

Advances in Endoscopic Photoacoustic Imaging

Photoacoustic (PA) imaging is able to provide extremely high molecular contrast while maintaining the superior imaging depth of ultrasound (US) imaging. Conventional microscopic PA imaging has limited access to deeper tissue due to strong light scattering and attenuation. Endoscopic PA technology enables direct delivery of excitation light into the interior of a hollow organ or cavity of the body for functional and molecular PA imaging of target tissue. Various endoscopic PA probes have been developed for different applications, including the intravascular imaging of lipids in atherosclerotic plaque and endoscopic imaging of colon cancer. In this paper, the authors review representative probe configurations and corresponding preclinical applications. In addition, the potential challenges and future directions of endoscopic PA imaging are discussed.

Visceral pressure stimulator for exploring hollow organ pain: a pilot study

Background The regulation and control of pressure stimuli is useful for many studies of pain and nociception especially those in the visceral pain field. In many in vivo experiments, distinct air and liquid stimuli at varying pressures are delivered to hollow organs such as the bladder, vagina, and colon. These stimuli are coupled with behavioral, molecular, or physiological read-outs of the response to the stimulus. Care must be taken to deliver precise timed stimuli during experimentation. For example, stimuli signals can be used online to precisely time-lock the stimulus with a physiological output. Such precision requires the development of specialized hardware to control the stimulus (e.g., air) while providing a precise read-out of pressure and stimulus signal markers. Methods In this study, we designed a timed pressure regulator [termed visceral pressure stimulator (VPS)] to control air flow, measure pressure (in mmHg), and send stimuli markers to online software. The device was built using a simple circuit and primarily off-the-shelf parts. A separate custom inline analog-to-digital pressure converter was used to validate the real pressure output of the VPS. Results Using commercial physiological software (Spike2, CED), we were able to measure mouse bladder pressure continuously during delivery of unique air stimulus trials in a mouse while simultaneously recording an electromyogram (EMG) of the overlying abdominal muscles. Conclusions This device will be useful for those who need to (1) deliver distinct pressure stimuli while (2) measuring the pressure in real-time and (3) monitoring stimulus on–off using physiological software.

Nanomagnetic Actuation of Hybrid Stents for Hyperthermia Treatment of Hollow Organ Tumors

This paper describes a magnetic nanotechnology that locally enables hyperthermia treatment of hollow organ tumors by using polymer hybrid stents with incorporated magnetic nanoparticles (MNP). The hybrid stents are implanted and activated in an alternating magnetic field to generate therapeutically effective heat, thereby destroying the tumor. Here, we demonstrate the feasibility of nanomagnetic actuation of three prototype hybrid stents for hyperthermia treatment of hollow organ tumors. The results show that the heating efficiency of stent filaments increases with frequency from approximately 60 W/gFe (95 kHz) to approximately 250 W/gFe (270 kHz). The same trend is observed for the variation of magnetic field amplitude; however, heating efficiency saturates at approximately 30 kA/m. MNP immobilization strongly influences heating efficiency showing a relative difference in heating output of up to 60% compared to that of freely dispersed MNP. The stents showed uniformly distributed heat on their surface reaching therapeutically effective temperatures of 43 °C and were tested in an explanted pig bile duct for their biological safety. Nanomagnetic actuation of hybrid stents opens new possibilities in cancer treatment of hollow organ tumors.

Clinical variants of abdominal surgical pathology in premature infants

Introduction. In the majority of cases, acute abdominal pathology in premature newborns masks as necrotizing enterocolitis and, if there are no signs of intestinal perforation, conservative therapy is prescribed. The article discusses rare forms of acute surgical pathology in premature newborns.Clinical observations. In the first clinical case, a premature baby had an initial air leak syndrome (pneumothorax and pneumoperitoneum). The Meckel’s diverticulitis with perforation without peritonitis was found during surgery. In the second case, a newborn child with body weight 1160 grams on the 21st day of his life developed ileoileal intussusception. In the third case, a newborn child had the duodenal membrane which was excised on the 5th day of life. On the 11th postoperative day, a picture of perforated hollow organ in the abdominal cavity developed. Destructive appendicitis was found intra-operatively. All patients clinically recovered.Conclusion. Ultrasound examination, as an early diagnostic option, can help to suspect a surgical pathology at an early stage. The described clinical cases are rare in pediatric surgeon’s practice but they require a cautious approach from both narrow clinical specialists and diagnostic specialists.

A Deep Learning Method for Alerting Emergency Physicians about the Presence of Subphrenic Free Air on Chest Radiographs

Hollow organ perforation can precipitate a life-threatening emergency due to peritonitis followed by fulminant sepsis and fatal circulatory collapse. Pneumoperitoneum is typically detected as subphrenic free air on frontal chest X-ray images; however, treatment is reliant on accurate interpretation of radiographs in a timely manner. Unfortunately, it is not uncommon to have misdiagnoses made by emergency physicians who have insufficient experience or who are too busy and overloaded by multitasking. It is essential to develop an automated method for reviewing frontal chest X-ray images to alert emergency physicians in a timely manner about the life-threatening condition of hollow organ perforation that mandates an immediate second look. In this study, a deep learning-based approach making use of convolutional neural networks for the detection of subphrenic free air is proposed. A total of 667 chest X-ray images were collected at a local hospital, where 587 images (positive/negative: 267/400) were used for training and 80 images (40/40) for testing. This method achieved 0.875, 0.825, and 0.889 in sensitivity, specificity, and AUC score, respectively. It may provide a sensitive adjunctive screening tool to detect pneumoperitoneum on images read by emergency physicians who have insufficient clinical experience or who are too busy and overloaded by multitasking.

Novel endoscopic optical diagnostic technologies in medical trial research: recent advancements and future prospects

Novel endoscopic biophotonic diagnostic technologies have the potential to non-invasively detect the interior of a hollow organ or cavity of the human body with subcellular resolution or to obtain biochemical information about tissue in real time. With the capability to visualize or analyze the diagnostic target in vivo, these techniques gradually developed as potential candidates to challenge histopathology which remains the gold standard for diagnosis. Consequently, many innovative endoscopic diagnostic techniques have succeeded in detection, characterization, and confirmation: the three critical steps for routine endoscopic diagnosis. In this review, we mainly summarize researches on emerging endoscopic optical diagnostic techniques, with emphasis on recent advances. We also introduce the fundamental principles and the development of those techniques and compare their characteristics. Especially, we shed light on the merit of novel endoscopic imaging technologies in medical research. For example, hyperspectral imaging and Raman spectroscopy provide direct molecular information, while optical coherence tomography and multi-photo endomicroscopy offer a more extensive detection range and excellent spatial–temporal resolution. Furthermore, we summarize the unexplored application fields of these endoscopic optical techniques in major hospital departments for biomedical researchers. Finally, we provide a brief overview of the future perspectives, as well as bottlenecks of those endoscopic optical diagnostic technologies. We believe all these efforts will enrich the diagnostic toolbox for endoscopists, enhance diagnostic efficiency, and reduce the rate of missed diagnosis and misdiagnosis.