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Sample records for omentum

  1. The omentum

    Institute of Scientific and Technical Information of China (English)

    Cameron Platell; Deborah Cooper; John M. Papadimitriou; John C. Hall

    2000-01-01

    @@INTRODUCTION The word omentum derives from the ancient Egyptians who, when embalming human bodies, used to assess their "omens" by looking at the variations in what we recognise today as the omentum[1] Galen(128 - 199 AD)thought that the role of the omentum was to warm the intestines.This was on the basis of a gladiator who had an omental resection after a stab injury and suffered greatly from cold for the rest of his life[2] A more conventional view of the omentum is that it plays a central role in peritoneal defence by adhering to sites of inflammation, absorbing bacteria and other contaminants, and providing leukocytes for a local immune response[3]. This review details current knowledge on the origins, structure, and function of the omentum, and discusses its role in the peritoneal cavity during various disease states.

  2. A rare case of benign omentum teratoma

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    Sforza Marcos

    2012-01-01

    Full Text Available Introduction. Mature teratomas (benign cystic teratomas or dermoid cysts are among the most common ovarian tumours; however, teratomas of the omentum and mesentery are extremely rare. Teratoma in the intraperitoneal cavity is uncommon and atypical, and it is even more uncommon in adulthood. Case Outline. An 82-year-old female was admitted to our department with clinical signs of abdominal tumour. The ultrasound scan and preoperative laboratory tests were done. Explorative laparotomy revealed tumour with torsion on its pedicle at the greater omentum. After removal of the mass and the incision a tooth and hair were found, characteristics of teratoma. Conclusion. The excision was very effective and also definitive treatment for this case. The patient recovered well and was discharged 3 days later. The patient probably carried the tumour all her life asymptomatically until admission.

  3. Greater omentum in reconstruction of refractory wounds

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    沈余明; 沈祖尧

    2003-01-01

    Objective: To evaluate the clinical efficacy of greater omentum in reconstruction of refractory wounds. Methods: From August 1988 to May 2001, 20 patients with refractory wound underwent pedicle or microvascular free transfer of the greater omentum. Indications of surgery were electrical injury of the wrist and hand in 9 patients, electrical injury of the scalp and cranial bones in 3, avulsion injury of the scalp in 2, radiation-related ulcer of the chest wall in 2, ulcer and osteomyelitis following resection of the sternum sarcoma in 1, electrical injury of the abdomen in 1, bone and soft tissue defects following compound fracture of the leg in 1, and extensive scar and ulcer of the leg and footdrop following trauma in 1. Severe infection and extensive tissue necrosis were present prior to surgical operation in 12 patients. Eleven patients were treated with pedicled omental flaps, and 9 patients with free omental flaps. The size of the omental flaps ranged from 20 cm×12 cm to 38 cm×23 cm. Results: All the omental flaps survived. Healing at the first intention of the wounds was achieved in 17 cases. The on-top skin grafts resulted in partial necrosis of lipid liquefaction developed in the omentum and healed with dressing change in 2 cases. A sinus tract of osteomyelitis occurred in one case and healed after delayed excision of the necrosed bone. Follow-up study of all cases from 3 to 24 months showed no recurrent wounds and post-operative abdominal complication. Recovery with acceptable appearance and restoration of function was satisfactory. Conclusions: Greater omentum provides a well-vascularized tissue with lymphatic ducts for wound coverage. It has strong resistance against infection. It is very malleable and can be molded easily. Therefore it is an ideal tissue in filling cavities and repairing defects, especially in covering large and irregular defects that can not be treated with skin or muscle flaps.

  4. Post-irradiation angiosarcoma of the greater omentum

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    Westenberg, A.H.; Wiggers, T.; Henzen-Logmans, S.C.; Verweij, J.; Meerwaldt, J.A.; Geel, A.N. van (Dr Daniel den Hoed Cancer Center, Rotterdam (Netherlands))

    1989-04-01

    A case of angiosarcoma of the greater omentum is reported. This angiosarcoma developed 8 years after irradiation for cervical carcinoma and presented with an intra-abdominal hemorrhage. The authors describe her clinical course, treatment and follow-up. Although several other locations of irradiation-induced sarcomas have been published, this is the first report in literature of a postirradiation angiosarcoma in the greater omentum. (author).

  5. Post-irradiation angiosarcoma of the greater omentum.

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    Westenberg, A H; Wiggers, T; Henzen-Logmans, S C; Verweij, J; Meerwaldt, J A; van Geel, A N

    1989-04-01

    A case of angiosarcoma of the greater omentum is reported. This angiosarcoma developed 8 years after irradiation for cervical carcinoma and presented with an intra-abdominal hemorrhage. We describe her clinical course, treatment and follow-up. Although several other locations of irradiation-induced sarcomas have been published, this is the first report in literature of a postirradiation angiosarcoma in the greater omentum.

  6. Segmental Infarction of Omentum –A Case Report

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    SA Jalali

    2001-09-01

    Full Text Available Idiopathic or spontaneous segmental infarction of omentum is a rare disease producing acute abdominal emergency. This rare entity is in a small group of abdominal emergencies with circulatory compromise. Infarction could be caused by omental torsion which could be due to adhesion of a previouse surgery or it could be spontaneous. Less than 150 cases of idiopathic segmental infarction of omentum has been reported since it was first reported about hundred years ago. The importance of this abdominal emergency lies ion differential diagnosis of acute appendecitis because its defenitive diagnosis is made only after laparotomy. In these cases the appendix is normal and besides an amount of serosanguinous fluid in the peritoneal cavity, a segment of omentum is infarcted. A case of idiopathic segmental infarction is reported in a 37-year-old heavy weigh male. The suggested procedure is appendectomy and segmental resection of the necrotic piece of omentum. In this case no adhesion or torsion of omentum was present.

  7. Demographics and frequency of the intermittently upturned omentum at CT

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    Penn, Alex; Wang, Wilbur; Wang, Zhen Jane; Yee, Judy; Webb, Emily M.; Yeh, Benjamin M., E-mail: ben.yeh@ucsf.edu

    2013-11-01

    Objectives: To describe the demographics and frequency of the intermittently upturned omentum at CT. Methods: We retrospectively reviewed abdominal CT scans of 336 consecutive patients (189 men and 147 women) who were imaged between June 1 and June 17, 2010 and who had prior comparison scans. Readers recorded the presence or absence of an intermittently upturned omentum, defined as a thick rind of fat interposed between the liver and the anterior abdominal wall seen on one but not the other scan. At chart review, we recorded patient demographics and other clinical characteristics (prior surgical history, presence of cirrhosis). Results: An intermittently upturned omentum was found in 10 of 336 (3.0%) patients. An intermittently upturned omentum was seen more commonly in men than in women (9 of 189 men, or 4.8% versus 1 of 147 women, or 0.7%, p = 0.047) and in cirrhotics (4 of 37 cirrhotics, or 10.8% versus 6 of 299 non-cirrhotics, or 2.0%, p = 0.023). In a sub-analysis of patients without prior abdominal surgery, this finding was again seen more commonly in men than women (7 of 163 men, or 4.3% versus 0 of 134 women, or 0%, p = 0.018) and in cirrhotics (3 of 33 cirrhotics, or 9.1% versus 4 of 264 non-cirrhotics, or 1.5%, p = 0.032). Conclusions: An intermittently upturned omentum is not uncommon and is more frequently seen in men and in patients with cirrhosis who may have a larger anterior hepatic space.

  8. Torsion of the greater omentum: treatment by laparoscopy.

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    Sánchez, Javier; Rosado, Rafael; Ramírez, Diego; Medina, Pedro; Mezquita, Susana; Gallardo, Andrés

    2002-12-01

    Four new cases of necrosis of the omentum secondary to torsion are reported. We review the associated signs and symptoms, which are usually those of an acute inflammatory condition in the right lower quadrant (RLQ), very similar to acute appendicitis. Because of acute abdominal pain in the RLQ, along with an uncertain diagnosis, laparoscopic surgery was performed in these cases. Laparoscopy demonstrated the existence of the omental infarction and allowed for complete treatment of the condition without the need for laparotomy.

  9. Intrauterine contraceptive device embedded in the omentum – case report

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    Zolnierczyk P

    2015-12-01

    Full Text Available Piotr Zolnierczyk, Krzysztof Cendrowski, Wlodzimierz Sawicki Department of Obstetrics, Gynecology and Oncology, 2nd Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland Abstract: This report describes the case of a 29-year-old patient, female (nulliparous who had an intrauterine device (IUD inserted in 2010 and who has had no gynecological control since then (for 4 years. After this time, the asymptomatic patient had a gynecological appointment, during which a doctor did not find the strings of IUD in the speculum. Ultrasound examination did not reveal the presence of the IUD in the uterine cavity, which led to the suspicion of its presence outside the uterus. The patient was referred to a hospital, where she underwent ultrasound and X-ray examination of the pelvis that confirmed the presence of the IUD outside the uterus. Laparoscopy was performed during which the IUD was localized as being embedded in the omentum. It was removed by performing a resection of a part of the omentum with inflammatory infiltration. The patient was discharged home on the second postoperative day in a good condition. This case confirms the need for gynecological control and ultrasound examination shortly after insertion. An ultrasound or/and X-ray is mandatory in any case of absence of IUD strings previously visible in the vagina, if the patient did not observe its expulsion. Keywords: intrauterine device, myometrium, IUD threads, uterine cavity, ultrasound examination

  10. Solitary fibrous tumor of the greater omentum mimicking an ovarian tumor in a young woman

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    Elisabet Rodriguez Tarrega

    2016-08-01

    Full Text Available We report a case of solitary fibrous tumor (SFT of greater omentum in a young woman. SFT arising from the greater omentum can mimic a gynecologic neoplasm. SFTs are generally benign but some of them are malignant and have uncertain prognosis. An adequate follow-up is essential in these patients.

  11. Adrenal Rest Tumor from the Greater Omentum Mimicking Exophytic Hepatocellular Carcinoma (HCC): A Case Report

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    Yoon, Hyung Jo; Kim, Seong Hoon; Shin, Hyun Woong [Daegu Fatima Hospital, Daegu (Korea, Republic of); Park, Jae Bok [Catholic University of Daegu, Gyeongsan (Korea, Republic of); Jo, Hyun Chul; Son, Mi Young; Kim, Tae Bong [Daegu Veterans Hospital, Daegu (Korea, Republic of)

    2010-02-15

    Adrenal rest tumors are aberrant adrenocortical tissue which has been most commonly described in abdominal and pelvic sites. To our knowledge, there has been no previous description of an adrenal rest tumor of the greater omentum. We present a case of a pathologically confirmed adrenal rest tumor of the greater omentum in a 76-year- old man

  12. Primary Yolk Sac Tumor of the Omentum: Case Report

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    Baek, Chang Kyu; Oh, Young Taik; Jung, Dae Chul [Dept. of Radiology, Research Institue of Radiological Science, Yensei University College of Medicine, Seoul (Korea, Republic of); Bae, Yoon Sung [Dept. of Pathology, Yensei University College of Medicine, Seoul (Korea, Republic of)

    2012-01-15

    A 32-year-old woman had been referred to our hospital for lower abdominal pain. Pelvic ultrasonography and magnetic resonance imaging revealed a huge solid mass with an internal cystic portion. The patient underwent a staging laparotomy and subsequent total abdominal hysterectomy with bilateral salpingo-oophorectomy, bilateral pelvic lymph nodes sampling, and total omentectomy. At staging laparotomy, a large omental mass was found. The tumor displayed the typical histological patterns observed in the yolk sac tumor. The alpha-fetoprotein (AFP) serum value on the 10th day after surgery was 11,576.67 IU/mL and decreased to 6.46 IU/mL after chemotherapy. At the end of the treatment, all the findings, including the AFP level, were normal. We report a case of primary yolk sac tumor of the omentum in a 32-year-old woman.

  13. Effect of omentum graft on esophageal anastomosis in dogs

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    A. K. Mahdi

    2011-01-01

    Full Text Available The aim of this study was to evaluate the complications and final function outcome of wrapping nonvascularized omentum graft around the suture line of esophageal anastomosis. Twelve adult local breed dogs were used in this study. The animals were divided into two equal groups (control and treated, all animal induced into general anesthesia by injection of atropen sulphate in a dose 0.04 mg/kg B.W, intramuscularly then after 15 minute given mixture of ketamine hydrochloride and xylazine hydrochloride in doses 15 mg/kg and 5 mg/kg B.W intramuscularly respectively. An oblique resection of about 1cm of the esophageal length and anastomosis by double layer of simple interrupted pattern by 2.0 cat gut suture (control group, same procedure was done in treated group except the wrapping the anastomosis site with patch of omentum tissue after lapratomy operation in the left flank region procedure. The clinical signs of treated animal revealed signs of dysphagia and regurgitation in treated group while this signs disappear in the control group. Radiological and histopathological examination of the anastomosis site performed at 15 and 30 days post operation. Radiological study recorded high degree of stenosis in the anastomosis site in treated group at 15 and 30 days post operation in compared with animals in control group that record mean degree of stenosis in treated group at 15 day (57.61±0.2 and at 30 day (55.78±0.2 while it recorded in control group at 15 day (39.34±1.04 and at 30 day (36.0.6 ±0.9, histopathological results recorded enhanced healing of anastomosis site in treated animals more than control animals. In conclusion we found that non vascularized omental graft prevent leak when used around the anastomosis line in esophageal and enhanced healing of anastomosis line but it increase the stenosis, fibrosis and adhesion of anastomosis site with surrounding muscle and this interferes with the swallowing as well as dysphagia and regurgitation

  14. CCR1 antagonism attenuates T cell trafficking to omentum and liver in obesity-associated cancer.

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    Conroy, Melissa J; Galvin, Karen C; Kavanagh, Maria E; Mongan, Ann Marie; Doyle, Suzanne L; Gilmartin, Niamh; O'Farrelly, Cliona; Reynolds, John V; Lysaght, Joanne

    2016-07-01

    Obesity is a global health problem presenting serious risk of disease fuelled by chronic inflammation, including type 2 diabetes mellitus, cardiovascular disease, liver disease and cancer. Visceral fat, in particular the omentum and liver of obese individuals are sites of excessive inflammation. We propose that chemokine-mediated trafficking of pro-inflammatory cells to the omentum and liver contributes to local and subsequent systemic inflammation. Oesophagogastric adenocarcinoma (OAC) is an exemplar model of obesity and inflammation driven cancer. We have demonstrated that T cells actively migrate to the secreted factors from the omentum and liver of OAC patients and that both CD4(+) and CD8(+) T cells bearing the chemokine receptor CCR5 are significantly more prevalent in these tissues compared to matched blood. The CCR5 ligand and inflammatory chemokine MIP-1α is also secreted at significantly higher concentrations in the omentum and liver of our OAC patient cohort compared to matched serum. Furthermore, we report that MIP-1α receptor antagonism can significantly reduce T cell migration to the secreted factors from OAC omentum and liver. These novel data suggest that chemokine receptor antagonism may have therapeutic potential to reduce inflammatory T cell infiltration to the omentum and liver and in doing so, may ameliorate pathological inflammation in obesity and obesity-associated cancer.

  15. Giant solitary fibrous tumor arising from greater omentum

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    Liang Zong; Ping Chen; Guang-Yao Wang; Qun-Shan Zhu

    2012-01-01

    Extrathoracic solitary fibrous tumors (SFTs) have been described at almost every anatomic location of human body,but reports of SFT in the abdominal cavity are rare.We herein present a rare case of SFT originating from greater omentum.Computed tomography revealed a 15.8 cm x 21.0 cm solid mass located at superior aspect of stomach.Open laparotomy confirmed its mesenchymal origin.Microscopically,its tissue was composed of non-organized and spindle-shaped cells exhibiting atypical nuclei,which were divided up by branching vessel and collagen bundles.Immunohistochemical staining showed that this tumor was negative for CD117,CD99,CD68,cytokeratin,calretinin,desmin,epithelial membrane antigen,F8 and S-100,but positive for CD34,bcl-2,α-smooth muscle actin and vimentin.The patient presented no evidence of recurrence during follow-up.SFT arising from abdominal cavity can be diagnosed by histological findings and immunohistochemical markers,especially for CD34 and bcl-2 positive cases.

  16. Malignant peripheral nerve sheath tumor arising from the greater omentum: Case report

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    Tokunaga Masakazu

    2011-03-01

    Full Text Available Abstract Malignant peripheral nerve sheath tumors (MPNSTs are rare soft tissue tumors that arise from a peripheral nerve or exhibit nerve sheath differentiation. Most of these tumors arise on the trunk, extremities, or head and neck regions; they are very rarely located in the abdominal cavity. The patient was a 71-year-old man who was referred to our hospital for a mass and pain in the right lower abdomen. Abdominal computed tomography revealed a large (9 × 9 cm, well-circumscribed, lobulated, heterogeneously enhanced mass in the pelvis. Exploratory laparotomy revealed a large mass in the greater omentum, and the tumor was completely excised. Histopathological analysis revealed that the tumor was composed of spindle cells with high mitotic activity. On staining the tumor, positive results were obtained for S-100 but negative results were obtained for c-kit, cluster of differentiation (CD34, α-smooth muscle actin, and desmin. These findings strongly supported a diagnosis of MPNST primarily arising from the greater omentum. To the best of our knowledge, this is the first reported case of an MPNST arising from the greater omentum. In this report, we have described the case of a patient with an MPNST arising from the greater omentum and have discussed the clinical characteristics and management of MPNSTs.

  17. Secondary Malignant Peritoneal Mesothelioma of the Greater Omentum after Therapy for Primary Pleural Mesothelioma

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    Andreas Gutzeit

    2013-04-01

    Full Text Available Mesothelioma is the most common malignant primary tumor of the pleura and usually associated with inhalation of asbestos fibers. In contrast, peritoneal mesothelioma is a rare entity whose pathomechanism is not yet fully understood. The coexistence of pleural mesothelioma with secondary involvement of the abdominal cavity has not been addressed in the literature. In this case report, we describe secondary malignant mesothelioma of the greater omentum. A 69-year-old man with histologically proven pleural mesothelioma on the right side and no past medical history of asbestos exposure received palliative treatment consisting of a talc pleurodesis. After a 6-month interval of stable disease, a local progressive tumor of the right pleura was seen on a CT scan. Eleven months later, during follow-up, the patient presented at our emergency department with a sudden onset of diffuse abdominal pain. Abdominal ultrasound revealed a mass within the greater omentum and the coexistence of free fluid. Subsequent abdominal CT scans demonstrated tumor infiltration from the right pleura by a transdiaphragmatic route into the abdomen, where diffuse infiltration of the greater omentum was observed. Aspiration of the ascites and the biopsy of the greater omentum confirmed the diagnosis of secondary malignant mesothelioma of the peritoneum. In conclusion, we present the extremely rare diagnosis of secondary malignant mesothelioma of the abdomen, which arose as a result of local progression from the right pleura into the abdomen.

  18. Capillary haemangioma of the greater omentum in a 5-month-old female infant: a case report

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    Chateil, J.F. [Hopital Pellegrin, 33 - Bordeaux (France). Service de Neuro-Radiologie; Unite de Radiopediatrie, Hopital Pellegrin, Bordeaux (France); Saragne-Feuga, C.; Brun, M.; Diard, F. [Hopital Pellegrin, 33 - Bordeaux (France). Service de Neuro-Radiologie; Perel, Y. [Service de Pediatrie A, Hopital Pellegrin, Bordeaux (France); Neuenschwander, S. [Service de Radiologie, Institut Curie, Paris (France); Vergnes, P. [Service de Chirurgie Pediatrique, Hopital Pellegrin, Bordeaux (France)

    2000-12-01

    Capillary haemangiomas are frequent benign tumours in infancy. The authors report a case of capillary haemangioma of the greater omentum, discovered in a child of 5 months of age and studied with US, CT and MRI. The localization of such a lesion in the greater omentum is exceptional. Abdominal US revealed a heterogeneous, multinodular intraperitoneal mass. Doppler study demonstrated hypervascularity of the lesion. CT localized the mass to the greater omentum. The mass was hypodense on the unenhanced scan and enhanced massively after injection. The infant suffered a reaction to contrast medium during the CT. MRI demonstrated a mass which was hypointense on T1-weighted images and hyperintense on T2-weighted images. Laparotomy confirmed the location of the mass within the greater omentum and allowed resection of the tumour. (orig.)

  19. Omentum in the Pediatric Umbilical Hernia: Is It a Potential Alarm for the Appearance of Complications?

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    Xenophon Sinopidis

    2012-01-01

    Full Text Available Umbilical hernia is a common benign condition which resolves spontaneously during the first five years of life. However, in certain cases there are some characteristics which may be indicative of a different prognostic approach, as they increase the possibility of complications. The two cases of umbilical hernia that we describe here were treated operatively and revealed the presence of strangulated and adhered omentum, respectively. Reflecting on the adhesive properties of the omentum, we hypothesized that this may occur more often than it is believed, especially in those cases that are described as recurrent symptomatic herniations. In such cases, there should be increased alert for the possibility of complications during the period of the conservative expectance for resolution.

  20. Omentum in the pediatric umbilical hernia: is it a potential alarm for the appearance of complications?

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    Sinopidis, Xenophon; Panagidis, Antonios; Alexopoulos, Vasileios; Karatza, Ageliki; Mitropoulou, Konstantina; Varvarigou, Anastasia; Georgiou, George

    2012-01-01

    Umbilical hernia is a common benign condition which resolves spontaneously during the first five years of life. However, in certain cases there are some characteristics which may be indicative of a different prognostic approach, as they increase the possibility of complications. The two cases of umbilical hernia that we describe here were treated operatively and revealed the presence of strangulated and adhered omentum, respectively. Reflecting on the adhesive properties of the omentum, we hypothesized that this may occur more often than it is believed, especially in those cases that are described as recurrent symptomatic herniations. In such cases, there should be increased alert for the possibility of complications during the period of the conservative expectance for resolution.

  1. Reconstrucción de cuero cabelludo con colgajo libre de omentum Reconstruction of the scalp with a free flap of omentum

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    C. Navarro Cuellar

    2004-08-01

    Full Text Available Los defectos de cuero cabelludo pueden tener una etiología diversa. Resecciones oncológicas, lesiones postraumáticas e infecciosas pueden dar lugar a diferentes defectos en cuanto a tamaño y extensión. Para su reconstrucción disponemos de múltiples técnicas quirúrgicas como colgajos locales, regionales y expansores titulares. No obstante, para defectos extensos los colgajos libres son la única posibilidad reconstructiva. Presentamos el caso de un paciente con carcinomas epidermoides multicéntricos en cuero cabelludo tratado previamente con radioterapia en el que se realizó una resección amplia del cuero cabelludo y fue reconstruído con un colgajo libre de omentum.Scalp defects may have different etiologies. Oncologic resections, postraumatic lesions and infectious wounds may lead to a great variety of defects in size and extension. In order to accomplish the reconstruction we have different surgical techniques such as local and regional flaps and tissue expanders. Nevertheless, for more extensive defects free flaps are the only reconstructive possibility. We present the case of a patient with multicentric squamous cell carcinomas previously with radiotherapy. He underwent wide resection and was reconstructed with an omentum free flap.

  2. Isolated Primary Hydatid Disease of Omentum; Report of a Case and Review of the Literature

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    Ali Ghafouri

    2010-09-01

    Full Text Available Hydatid disease, most commonly caused by the larval stage ofEchinococcus granulosus, affects mainly human liver andlung, and rarely other parts of the body. It is prevalent in mostsheep-raising Mediterranean Countries including Iran. Peritonealhydatid cyst, either primary or secondary, represents anuncommon but significant manifestation of the disease. Thepresent case report describes a case of primary isolated hydatiddisease of omentum, which to our knowledge constitutesthe first case of this kind in Iran.

  3. [Autotransplantation of the greater omentum in patients with radiation injuries of the integumentary tissues].

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    Milanov, N O; Bardyshev, M S; Shilov, B L; Trofimov, E I

    1989-05-01

    The treatment of radiation damages of the integumentary tissues is a complicated problem of reconstructive plastic surgery. The condition of the tissues in the irradiated zone do not allow wide application of the traditional methods. Microsurgical autotransplantation of the greater omentum provides the possibility for adequate closure of the radiation ulcers. Operations were conducted on 9 patients with such ulcers of various localization; the cosmetic and functional result was good in 7 of them.

  4. CT appearances of involvement of the peritoneum, mesentery and omentum in Wilms` tumor

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    Slasky, B.S. [Dept. of Radiology, Hadassah Univ. Hospital, Jerusalem (Israel); Bar-Ziv, J. [Dept. of Radiology, Hadassah Univ. Hospital, Jerusalem (Israel); Freeman, A.I. [Dept. of Pediatric Hematology/Oncology, Hadassah Univ. Hospital, Jerusalem (Israel); Peylan-Ramu, N. [Dept. of Pediatric Hematology/Oncology, Hadassah Univ. Hospital, Jerusalem (Israel)

    1997-01-01

    Background. Peritoneal involvement by Wilms` tumor indicates stage III disease. CT is the single preferred modality in determining the extent and staging of Wilms` tumor; however, the CT appearances of Wilms` tumor involvement of the peritoneum have not been specifically addressed in the literature. Objective. The objective of this study was to demonstrate the CT manifestations when there is involvement of the peritoneum, mesentery and/or omentum in Wilms` tumor. Materials and methods. Four cases of Wilms` tumor form the basis of this report. They were examined on Elscint CT scanners. Results. Masses (``dropped metastases``) in the pelvis were present in all four patients. Three patients had masses in the mesentery of the small bowel and sigmoid colon. Infiltration of the greater omentum was identified in two patients as a mantle of tumor separating bowel from the anterior abdominal wall. Ascites was present in two patients. In one patient broad-based solid masses of varying sizes were noted on the parietal and on the visceral surfaces of the peritoneum, and in a different patient a discrete mass was noted in the lesser omentum. Conclusion. The peritoneal spaces, recesses, ligaments and folds are invisible unless invaded by disease which is well demonstrated on CT. (orig.). With 6 figs., 1 tab.

  5. Primary Yolk Sac Tumor of the Omentum: A Case Report and Literature Review

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    Kenichi Harano

    2012-12-01

    Full Text Available Yolk sac tumor (YST is a rare malignant tumor originating from germ cells. YST normally originates from the gonads, rarely occurring in extragonadal sites. We report a 35-year-old man with YST arising in the omentum, which is the first reported case of a primary YST of the omentum in an adult male. The patient presented to the community hospital with abdominal distension. A CT scan showed thickening of the omentum with ascites. The patient underwent open biopsy of the omental mass. The Pathology Department of the hospital could not make a definitive diagnosis at that time, and the tumor was considered a cancer of unknown primary (CUP origin with features of primary colorectal cancer based on the immunohistochemistry (IHC findings of the biopsy specimen (CK7–/CK20+ and CDX-2+. He was then referred to our hospital. We found that serum α-fetoprotein was abnormally elevated to 7,144 ng/ml (normal <10.0, and reevaluation of the biopsy specimen revealed microcystic or reticular patterns of tumor cells with Schiller-Duval bodies typical of YST. The present case suggests that IHC is a very useful diagnostic tool for subtyping CUP but should be interpreted in the context of clinical and morphological findings.

  6. Primary multiple extragastrointestinal stromal tumors of the omentum with different mutations of c-kit gene

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    2008-01-01

    The author reports a very rare case of sporadic primary multiple extragastrointestinal stromal tumors (EGISTs) of the omentum associated with different mutations of the exon 11 of the c-kit gene in a 75-year-old man with gastric cancer. During an operation for the cancer, two solid tumors (10 mm and 8 ram) were found in the omentum. Both tumors consisted of cellular spindle cells. Mitotic figures were two and three per 50 high power fields. The tumor cells were positive for KIT, CD34 and vimentin, but negative for desmin, S100 protein, α-smooth muscle actin and p53 protein. Ki67 labeling was 2% and 3%. The larger EGIST showed a deletion of codons 552-558 of exon 11 of the c-kit gene, while the smaller EGIST had a point mutation at codon 559 (GTT→GAT) in exon 11 of the c-kit gene. Exons 9, 13, and 17 of the c-kit gene, and exons 12 and 18 of the platelet derived growth factor receptor α genes showed no mutations. The case shows that sporadic multiple EGISTs can occur in the omentum.

  7. Ultrasonographic and clinical findings of inguinal hernia containing the ovary or omentum in girls

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    Shin, Su Mi; Chai, Jee Won [Dept. of Radiology, SMG-SNU Boramae Medical Center, Seoul (Korea, Republic of)

    2016-09-15

    To characterize the ultrasonographic and clinical findings of inguinal hernia containing the ovary or omentum in girls. We studied 46 girls (49 cases) who were diagnosed with inguinal hernia on ultrasonography between March 2009 and December 2015. The ultrasonographic findings were retrospectively analyzed with respect to location, age at detection, contents of hernia, diameter of the canal of Nuck, and incidence of reducibility, incarceration and strangulation. The clinical findings included the number of cases that underwent operation, contents of hernia discovered during operation, and duration between ultrasonographic diagnosis and operation. The two groups in which inguinal hernia contained the ovary and omentum were statistically compared. Of the 49 cases, the contents of hernia were the ovary or tube in 14 cases, omentum in 32 cases, and bowel in 3 cases. The ovarian herniation group was significantly younger (10.1 months vs. 4.9 years, p < 0.001), had a lower incidence of reducibility (n = 3 vs. n = 29, p < 0.001), higher incidence of incarceration (n = 4 vs. n = 0, p = 0.006), and a shorter duration between ultrasonographic diagnosis and operation (5.7 days vs. 55.8 days, p = 0.032) than the omental herniation group. The ovarian herniation group was younger, had a lower incidence of reducibility, higher incidence of incarceration, and a shorter duration between ultrasonographic diagnosis and operation.

  8. Wrapped omentum with periosteum concurrent with adipose derived adult stem cells for bone tissue engineering in dog model.

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    Sadegh, Amin Bigham; Basiri, Ehsan; Oryan, Ahmad; Mirshokraei, Pezhman

    2014-03-01

    Adipose derived adult stem cells (ASCs) are multipotent cells that are able to differentiate into osteoblasts in presence of certain factors. The histological characteristics of periosteum makes it a specific tissue with a unique capacity to be engineered. Higher flexibility of the greater omentum is useful for reconstructive surgery. These criteria make it suitable for tissue engineering. The present study was designed to evaluate bone tissue engineering with periosteal free graft concurrent with ASCs and pedicle omentum in dog model. Twelve young female indigenous dogs were used in this experiment. In omental group (n = 4), end of omentum was wrapped by periosteum of the radial bone in abdomen of each dog. In omental-autogenously ASCs group (n = 4), 1 ml of ASCs was injected into the wrapped omentum with periosteum while in omental-allogenously ASCs group (n = 4), 1 ml of allogenous ASCs was injected. Lateral view radiographs were taken from the abdominal cavity postoperatively at the 2nd, 4th, 6th and 8th weeks post-surgery. Eight weeks after operation the dogs were re-anesthetized and the wrapped omenum by periosteum in all groups was found and removed for histopathological evaluation. Our results showed that omentum-periosteum, omental-periosteum-autogenous ASCs and omental-periosteum-allogenous ASCs groups demonstrated bone tissue formation in the abdominal cavity in dog model. The radiological, macroscopical and histological findings of the present study by the end of 8 weeks post-surgery indicate bone tissue engineering in all three groups in an equal level. The present study has shown that the wrapped omentum with periosteum concurrent with ASCs (autogenous or allogenous ASCs) lead to a favorable bone tissue formation. We suggested that it may be useful when pedicle graft omentum used concurrent with periosteum in the bone defect reconstruction, and this phenomenon should be studied in future.

  9. Ultrasound-guided biopsy of greater omentum: An effective method to trace the origin of unclear ascites

    Energy Technology Data Exchange (ETDEWEB)

    Que Yanhong [Department of Ultrasound, First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001 (China)], E-mail: quebaobao@yahoo.com.cn; Wang Xuemei [Department of Ultrasound, First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001 (China)], E-mail: wxmlmt@yahoo.com.cn; Liu Yanjun [Department of Ultrasound, First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001 (China)], E-mail: lyj7512@sina.com; Li Ping [Department of Ultrasound, First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001 (China)], E-mail: liping7213@sina.com; Ou Guocheng [Department of Ultrasound, First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001 (China)], E-mail: yang9951@126.com; Zhao Wenjing [Department of Ultrasound, First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001 (China)], E-mail: awk999@163.com

    2009-05-15

    Objectives: Thickened greater omentum is encountered with high frequency in patients with ascites. The purpose of our study was to assess the utility of greater omentum biopsy under the guidance of ultrasound (US) in tracing the origin of unclear ascites and differentiating benign and malignant ascites. Materials and methods: We retrospectively reviewed our institutional database for all records of greater omentum biopsy cases. One hundred and ninety-four patients with unclear ascites and thickened greater omentum were included in the study. The sonograms of greater omentum were evaluated before undergoing the ultrasound-guided biopsy and a biopsy was considered successful if a specific benign or malignant diagnosis was rendered by the pathologist. Results: Successful biopsy was rendered for 182 biopsy procedures (93.8%, 182/194) including tuberculosis (n = 114), chronic inflammation (n = 3), metastases (n = 58), malignant mesothelioma (n = 6) and pseudomyxoma peritonei (n = 1). Twelve biopsies were non-diagnostic. According to the results of biopsy and follow-up, the sensitivity and specificity of biopsy in distinguishing malignant ascites from benign ascities were respectively 95.6% (65/68) and 92.9% (117/126). The greater omentum of 84 cases of tuberculous peritonitis showed 'cerebral fissure' sign and was well seen as an omental cake infiltrated with irregular nodules when involved by carcinomatosis. No 'cerebral fissure' sign was observed in peritoneal carcinomatosis. The sensitivity and specificity of this sign in indicating the existence of tuberculous peritonitis were 73.5% (89/121) and 100% (73/73). Moreover, if the specific 'cerebral fissure' sign was combined with the biopsy results, the specificity of biopsy in distinguishing malignant ascites from benign ascits increased to 96.8% (122/126). Conclusion: Ultrasound-guided biopsy of greater omentum is an important and effective method to diagnose the unclear ascites for

  10. Umbilical hernia rupture with evisceration of omentum from massive ascites: a case report

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    Neary Paul C

    2011-05-01

    Full Text Available Abstract Introduction The incidence of hernias is increased in patients with alcoholic liver disease with ascites. To the best of our knowledge, this is the first report of an acute rise in intra-abdominal pressure from straining for stool as the cause of a ruptured umbilical hernia. Case presentation An 81-year-old Caucasian man with a history of alcoholic liver disease presented to our emergency department with an erythematous umbilical hernia and clear, yellow discharge from the umbilicus. On straining for stool, after initial clinical assessment, our patient noted a gush of fluid and evisceration of omentum from the umbilical hernia. An urgent laparotomy was performed with excision of the umbilicus and devitalized omentum. Conclusion We report the case of a patient with a history of alcoholic liver disease with ascites. Ascites causes a chronic increase in intra-abdominal pressure. A sudden increase in intra-abdominal pressure, such as coughing, vomiting, gastroscopy or, as in this case, straining for stool can cause rupture of an umbilical hernia. The presence of discoloration, ulceration or a rapid increase in size of the umbilical hernia signals impending rupture and should prompt the physician to reduce the intra-abdominal pressure.

  11. Umbilical hernia rupture with evisceration of omentum from massive ascites: a case report

    LENUS (Irish Health Repository)

    Good, Daniel W

    2011-05-03

    Abstract Introduction The incidence of hernias is increased in patients with alcoholic liver disease with ascites. To the best of our knowledge, this is the first report of an acute rise in intra-abdominal pressure from straining for stool as the cause of a ruptured umbilical hernia. Case presentation An 81-year-old Caucasian man with a history of alcoholic liver disease presented to our emergency department with an erythematous umbilical hernia and clear, yellow discharge from the umbilicus. On straining for stool, after initial clinical assessment, our patient noted a gush of fluid and evisceration of omentum from the umbilical hernia. An urgent laparotomy was performed with excision of the umbilicus and devitalized omentum. Conclusion We report the case of a patient with a history of alcoholic liver disease with ascites. Ascites causes a chronic increase in intra-abdominal pressure. A sudden increase in intra-abdominal pressure, such as coughing, vomiting, gastroscopy or, as in this case, straining for stool can cause rupture of an umbilical hernia. The presence of discoloration, ulceration or a rapid increase in size of the umbilical hernia signals impending rupture and should prompt the physician to reduce the intra-abdominal pressure.

  12. Inflammatory pseudotumor in the liver and right omentum caused by pelvic inflammatory disease: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Byun, Hyuk Jun; Kim, Seong Hoon [Dept. of Radiology, Daegu Fatima Hospital, Daegu (Korea, Republic of)

    2015-08-15

    Inflammatory pseudotumor can develop in any part of the human body. It is one of the most important tumor-mimicking lesions that require differential diagnosis. There are various causes of inflammatory pseudotumor, one of which is infection and its resultant inflammation. Pelvic inflammatory disease (PID) often causes perihepatitis, which is called Fitz-Hugh-Curtis syndrome. In Fitz-Hugh-Curtis syndrome, bacteria spread along the right paracolic gutter, causing inflammation of the right upper quadrant peritoneal surfaces and the right lobe of the liver. We experienced a case of PID with accompanying inflammatory pseudotumor in the liver and the right omentum. This case identically correlates with the known intraperitoneal spreading pathway involved in Fitz-Hugh-Curtis syndrome, and hence, we present this case report.

  13. Lymphangioma torsion of the omentum in a child: A case report

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    Johann Paulo S. Guzman, MD

    2017-03-01

    Full Text Available Lymphangiomas rarely present as intra-abdominal masses. These lymphatic malformations can arise in the mesentery, retroperitoneum and omentum. Omental cysts are usually benign and asymptomatic. We present an omental cyst with torsion in a pediatric patient presenting with abdominal pain and vomiting a few days before admission to our institution. Physical examination shows soft globular abdomen with a palpable tender mass in the mid abdomen. This patient was worked-up with an initial pre-op CT scan with IV contrast of the abdomen showing multiple intraabdominal cystic masses. Patient underwent laparotomy and complete excision of the omental cystic masses. Surgery mandates complete surgical excision to prevent recurrence. Patient was discharged without any untoward post-operative complications.

  14. Simultaneous Occurrence of Early Gastric Carcinoma and Mucosa-Associated Lymphoid Tissue Lymphoma of the Omentum

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    Tomohiro Murakami

    2014-03-01

    Full Text Available The simultaneous association of gastric carcinoma with omental mucosa-associated lymphoid tissue (MALT lymphoma is a rare event that has not been reported previously. We focused on the hypothetic pathogenetic mechanisms, diagnosis and treatment of this rare condition. A 55-year-old woman with Helicobacter pylori infection underwent distal gastrectomy in our hospital. Three independent early gastric cancers and a mass near the cecum were diagnosed preoperatively. Pathological review of the resected stomach showed three independent early signet ring cell gastric carcinomas, and the mass in the omentum near the cecum was shown to be omental MALT lymphoma. Due to the nature of the patient's disease, she was started on medical eradication of H. pylori. Synchronous gastric adenocarcinoma and omental MALT lymphoma is a rare event. Special attention given to H. pylori-associated gastric cancer patients can avoid misdiagnosis and lead to adequate treatment.

  15. Omentum: An unusual site for distant metastasis for post-surgery radiotherapy treated squamous cell carcinoma larynx

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    Tamalika Kundu

    2016-01-01

    Full Text Available Squamous cell carcinoma of the larynx is the most common histologic type, accounting for up to 90% of cancers with more predilections to spread locoregionally to the cervical lymph nodes. Distant metastasis, usually to lungs, bone, and liver is seen much less frequently, with an overall incidence of 6.5–7.3%. A case of 55-year-old male with the previous history of surgery and radiotherapy treated squamous cell carcinoma of the larynx, presenting with a chief complaint of pain abdomen is hereby reported for its unusual diagnosis of metastatic deposits of squamous cell carcinoma in the omentum. Though there are reference available for peritoneum as the distant metastatic site for hypopharyngeal carcinoma, reference for laryngeal carcinoma metastasizing to omentum were not found even with an extensive search of literature. Awareness of unusual sites of distant metastasis such as omentum must be kept in mind for treated laryngeal carcinoma patients presenting with non-specific symptoms like pain abdomen. And also, chances of involvement of unusual site of the distant metastasis increases with advanced tumor-node-metastasis stage and nodal status.

  16. Omentum and bone marrow: how adipocyte-rich organs create tumour microenvironments conducive for metastatic progression

    Science.gov (United States)

    Gusky, H. Chkourko; Diedrich, J.; MacDougald, O. A.; Podgorski, I.

    2016-01-01

    Summary A number of clinical studies have linked adiposity with increased cancer incidence, progression and metastasis, and adipose tissue is now being credited with both systemic and local effects on tumour development and survival. Adipocytes, a major component of benign adipose tissue, represent a significant source of lipids, cytokines and adipokines, and their presence in the tumour microenvironment substantially affects cellular trafficking, signalling and metabolism. Cancers that have a high predisposition to metastasize to the adipocyte-rich host organs are likely to be particularly affected by the presence of adipocytes. Although our understanding of how adipocytes influence tumour progression has grown significantly over the last several years, the mechanisms by which adipocytes regulate the meta-static niche are not well-understood. In this review, we focus on the omentum, a visceral white adipose tissue depot, and the bone, a depot for marrow adipose tissue, as two distinct adipocyte-rich organs that share common characteristic: they are both sites of significant metastatic growth. We highlight major differences in origin and function of each of these adipose depots and reveal potential common characteristics that make them environments that are attractive and conducive to secondary tumour growth. Special attention is given to how omental and marrow adipocytes modulate the tumour microenvironment by promoting angiogenesis, affecting immune cells and altering metabolism to support growth and survival of metastatic cancer cells. PMID:27432523

  17. Decellularized omentum as novel biologic scaffold for reconstructive surgery and regenerative medicine

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    A. Porzionato

    2013-01-01

    Full Text Available Homologous tissues, such as adipose tissue, may be an interesting source of acellular scaffolds, maintaining a complex physiological three-dimensional (3D structure, to be recellularized with autologous cells. The aim of the present work is to evaluate the possibility of obtaining homologous acellular scaffolds from decellularization of the omentum, which is known to have a complex vascular network. Adult rat and human omenta were treated with an adapted decellularization protocol involving mechanical rupture (freeze-thaw cycles, enzymatic digestion (trypsin, lipase, deoxyribonuclease, ribonuclease and lipid extraction (2-propanol. Histological staining confirmed the effectiveness of decellularization, resulting in cell-free scaffolds with no residual cells in the matrix. The complex 3D networks of collagen (azan-Mallory, elastic fibers (Van Gieson, reticular fibers and glycosaminoglycans (PAS were maintained, whereas Oil Red and Sudan stains showed the loss of lipids in the decellularized tissue. The vascular structures in the tissue were still visible, with preservation of collagen and elastic wall components and loss of endothelial (anti-CD31 and -CD34 immunohistochemistry and smooth muscle (anti-alpha smooth muscle actin cells. Fat-rich and well vascularized omental tissue may be decellularized to obtain complex 3D scaffolds preserving tissue architecture potentially suitable for recellularization. Further analyses are necessary to verify the possibility of recolonization of the scaffold by adipose-derived stem cells in vitro and then in vivo after re-implantation, as already known for homologus implants in regenerative processes.

  18. PRELIMINARY STUDY OF OMENTUM TRANSPOSITION TO BRAIN FOR TREATMENT OF ALZHEIMER'S DISEASE

    Institute of Scientific and Technical Information of China (English)

    ZHONG Jun; WU Wei-lie; Harry Goldsmith

    2007-01-01

    Objective To learn the effect of omemtum transposition to the brain of patients with Alzheimer's disease. Methods Ten consecutive patients, aged 58 - 81 years old, underwent graft of their elongated pedicled omentum onto their left frontal-temperal-parietal cerebral cortex. Those patients, who had more than five years of dementia with low mini mental-state examination (MMSE) scores of 2 -15, were diagnosed by a neurologist. All subjects underwent single photon evoked computer tomography (SPECT) pre- and post-operatively.SPECT results were analyzed semi-quantitatively by calculation of the left/right radioactivity counts symmetry index (Si). The patients were followed up to one year. The outcome was evaluated by the neurologist with a modified scale of activities of daily living (mADL) as well as the MMSE. Results Three months following the surgery,the Si of SPECT increased from ( 98. 7 ± 1.9) % to ( 103. 9 ± 2.3 ) % ( P = 0. 0307). The neurological and neuropsychological testing scores increased insignificantly during the follow-up period. By the one year, the MMSE score rose from 8. 7 ± 1.4 to 10. 7 ± 1.8 ( P > 0. 05 ), while the mADL from 13.3 ± 1.8 to 16. 9 ± 2. 0 ( P > 0. 05 ). One of the patients suffered a heart attack, two had epileptic episodes postoperatively. Conclusion We believe that omental transposition to the brain augments cerebral blood flow, which might be helpful to decelerate the processing of Alzheimer's disease. However, it is still a potentially risky procedure for the elderly.

  19. Complicated sternal dehiscence treated with the strasbourg thoracic osteosyntheses system (STRATOS and the transposition of greater omentum: a case report

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    Casablanca Giuseppe

    2010-06-01

    Full Text Available Abstract Sternal dehiscence is a serious complication after cardiac surgery. Sternal refixation, performed by simple rewiring or techniqual modification of rewiring as described by Robicsek, can fail, overall when the bone quality is poor or the sternum is completely destroyed. The sternal closure systems, consisting of plates, screws or rib clips and titanium bars, have been recently introduced to treat the complicated sternal dehiscence. We describe for the first time the use of the Strasbourg Thoracic Osteosyntheses System (STRATOS and the greater omentum, to treat a complicated sternal dehiscence, causing chest pain and respiratory failure.

  20. Multipotency and cardiomyogenic potential of human adipose-derived stem cells from epicardium, pericardium, and omentum.

    Science.gov (United States)

    Wystrychowski, Wojciech; Patlolla, Bhagat; Zhuge, Yan; Neofytou, Evgenios; Robbins, Robert C; Beygui, Ramin E

    2016-06-13

    Acute myocardial infarction (MI) leads to an irreversible loss of proper cardiac function. Application of stem cell therapy is an attractive option for MI treatment. Adipose tissue has proven to serve as a rich source of stem cells (ADSCs). Taking into account the different morphogenesis, anatomy, and physiology of adipose tissue, we hypothesized that ADSCs from different adipose tissue depots may exert a diverse multipotency and cardiogenic potential. The omental, pericardial, and epicardial adipose tissue samples were obtained from organ donors and patients undergoing heart transplantation at our institution. Human foreskin fibroblasts were used as the control group. Isolated ADSCs were analyzed for adipogenic and osteogenic differentiation capacity and proliferation potential. The immunophenotype and constitutive gene expression of alkaline phosphatase (ALP), GATA4, Nanog, and OCT4 were analyzed. DNA methylation inhibitor 5-azacytidine was exposed to the cells to stimulate the cardiogenesis. Finally, reprogramming towards cardiomyocytes was initiated with exogenous overexpression of seven transcription factors (ESRRG, GATA4, MEF2C, MESP1, MYOCD, TBX5, ZFPM2) previously applied successfully for fibroblast transdifferentiation toward cardiomyocytes. Expression of cardiac troponin T (cTNT) and alpha-actinin (Actn2) was analyzed 3 weeks after initiation of the cardiac differentiation. The multipotent properties of isolated plastic adherent cells were confirmed with expression of CD29, CD44, CD90, and CD105, as well as successful differentiation toward adipocytes and osteocytes; with the highest osteogenic and adipogenic potential for the epicardial and omental ADSCs, respectively. Epicardial ADSCs demonstrated a lower doubling time as compared with the pericardium and omentum-derived cells. Furthermore, epicardial ADSCs revealed higher constitutive expression of ALP and GATA4. Increased Actn2 and cTNT expression was observed after the transduction of seven

  1. Surgical management of a large peritoneal pseudocyst causing acute kidney injury secondary to abdominal compartment syndrome in a rare case of congenital absence of omentum during pregnancy.

    Science.gov (United States)

    Jones, Benjamin P; Hunjan, Tia; Terry, Jayne

    2016-09-01

    Complete congenital absence of the omentum is very rare with only one previously reported case. We present a unique case of the management of a pregnant woman with a large pelvic pseudocyst caused by complications related to congenital absence of omentum, resulting in acute kidney injury, likely secondary to acute compartment syndrome. This case highlights the importance of considering acute compartment syndrome in critically unwell pregnant women and reiterates the need to measure intra-abdominal pressure when clinically indicated. Given that pregnancy is in itself a state of intra-abdominal hypertension, obstetricians should maintain a high index of suspicion in the context of additional risk factors.

  2. Implante Autólogo Ovariano no Omento Maior: Estudo Experimental Ovarian Autotransplantation to the Greater Omentum: Experimental Model

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    Luiz Ronaldo Alberti

    2002-01-01

    Full Text Available Objetivos: avaliar os aspectos morfofuncionais de ovários implantados no omento maior, bem como a melhor técnica para implantação do ovário: se íntegro ou fatiado. Métodos: foram divididas aleatoriamente 40 ratas Wistar com ciclos estrais normais em quatro grupos: Grupo I (n = 5, controle - laparotomia; Grupo II (n = 5, ooforectomia total bilateral; Grupo III (n = 15, implante autólogo íntegro no omento maior e Grupo IV (n = 15, implante autólogo fatiado no omento maior. Realizaram-se esfregaços vaginais nos 3º e 6º mes pós-operatório e estudos histológicos dos implantes ovarianos, avaliando-se: degeneração, fibrose, reação inflamatória, angiogênese, cistos foliculares, desenvolvimento folicular e corpos lúteos. Resultados: os animais do Grupo I ciclaram normalmente. As ratas do Grupo II não apresentaram ciclo, permanecendo em diestro. No Grupo III, 11 ratas permaneceram em diestro, três apresentaram ciclos incompletos e apenas uma ciclou normalmente. No Grupo IV, três animais não ciclaram, oito tiveram esfregaços vaginais incompletos e quatro ciclaram normalmente. Os achados histológicos dos animais pertencentes ao Grupo III evidenciaram histoarquitetura normal em dez ratas, porém nas outras cinco, houve degeneração ovariana. No Grupo IV, 14 ratas tiveram ovários com histoarquitetura preservada e em apenas uma houve sinais de degeneração. Conclusões: o implante autólogo ovariano no omento maior foi viável, obtendo-se melhor preservação morfofuncional com a implantação de fatias.Purpose: in order to maintain the gonadal function after oophorectomy, morphofunctional aspects of ovarian autotransplantation to the greater omentum and the best kind of implantation, intact or sliced, were investigated. Methods: forty cycling female Wistar rats were randomly divided into four groups: Group I (n = 5, control - laparotomy; Group II (n = 5, bilateral oophorectomy; Group III (n = 10, intact ovarian

  3. A case of spontaneous transdiaphragmatic intercostal hernia of bowel loops and omentum with herniation of lung – A very rare entity

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    Arnab Sit

    2016-04-01

    Full Text Available Herein we report a case of spontaneous transdiaphragmatic intercostal hernia of bowel loops and omentum with lung herniation in an elderly gentleman with Chronic Obstructive Pulmonary Disease (COPD. Initially he presented with severe cough followed by pain and small fluctuating swelling over the right chest wall. In-patient investigations were suggestive of hemothorax without any chest wall abnormality. Later the swelling gradually increased to a significant size for which he was further evaluated. Detailed imaging studies revealed it was a case of spontaneous intercostal hernia of bowel loops and omentum with herniation of lung. The patient is kept under regular follow up for optimization for his obstructive airway component for the required surgical repair of the parietal defect.

  4. Solid tumors of the peritoneum, omentum, and mesentery in children: radiologic-pathologic correlation: from the radiologic pathology archives.

    Science.gov (United States)

    Chung, Ellen M; Biko, David M; Arzamendi, Aaron M; Meldrum, Jaren T; Stocker, J Thomas

    2015-01-01

    Intraperitoneal solid tumors are far less common in children than in adults, and the histologic spectrum of neoplasms of the peritoneum and its specialized folds in young patients differs from that in older patients. Localized masses may be caused by inflammatory myofibroblastic tumor, Castleman disease, mesenteric fibromatosis, or other mesenchymal masses. Inflammatory myofibroblastic tumor is a mesenchymal tumor of borderline biologic potential that appears as a solitary circumscribed mass, possibly with central calcification. Castleman disease is an idiopathic lymphoproliferative disorder that appears as a circumscribed, intensely enhancing mass in the mesentery. Mesenteric fibromatosis, or intra-abdominal desmoid tumor, is a benign tumor of mesenchymal origin associated with familial adenomatous polyposis. Mesenteric fibromatosis appears as a mildly enhancing, circumscribed solitary mass without metastases. Diffuse peritoneal disease may be due to desmoplastic small round cell tumor (DSRCT), non-Hodgkin lymphoma, or rhabdomyosarcoma. DSRCT is a rare member of the small round blue cell tumor family that causes diffuse peritoneal masses without a visible primary tumor. A dominant mass is typically found in the retrovesical space. Burkitt lymphoma is a pediatric tumor that manifests with extensive disease because of its short doubling time. The bowel and adjacent mesentery are commonly involved. Rhabdomyosarcoma may arise as a primary tumor of the omentum or may spread from a primary tumor in the bladder, prostate, or scrotum. Knowledge of this spectrum of disease allows the radiologist to provide an appropriate differential diagnosis and suggest proper patient management.

  5. Interposition of the omentum and/or the peritoneum in the emergency repair of large ventral hernias with polypropylene mesh.

    Science.gov (United States)

    Sorour, Magdy A

    2014-01-01

    Ventral and incisional hernias are common surgical problems and their repairs are among the common surgeries done by a general surgeon. Repair of a large ventral hernia is still associated with high postoperative morbidity and recurrence rates. No single approach to ventral hernia repair will be the best choice for all patients. Large ventral hernias are often better approached with open surgery but may still be problematic when the defect is too wide for primary fascial closure to be achieved, as this leaves mesh exposed, bridging the gap. Techniques for incisional hernia repair have evolved over many years, and the use of mesh has reduced recurrence rates dramatically. The use of polypropylene mesh is reported to be associated with long-term complications such as severe adhesions and enterocutaneous fistula, which occur more commonly if the mesh is applied intraperitoneally with direct contact of the serosal surface of the intestine. Composite meshes containing expanded polytetrafluoroethylene (ePTFE) have been used recently; their major drawbacks lie in their high cost, inferior handling characteristics, and poor incorporation into the tissues. Although several studies have clearly demonstrated the safety and efficacy of prosthetic mesh repair in the emergency management of the incarcerated and/or strangulated inguinal and ventral hernias, however, surgeons remained reluctant to use prosthetics in such settings. The aim of this work was to evaluate the effectiveness and safety of placing the omentum and/or the peritoneum of the hernia sac as a protective layer over the viscera in the emergency repair of large ventral hernias using on-lay polypropylene mesh whenever complete tension-free closure of the abdominal wall was impossible. This study was carried out on all patients with large ventral hernia presented to the Gastrointestinal Surgery Unit, Main Alexandria University Hospital in an emergency situation during the period from October 2005 till October 2012

  6. Reconstruction of the abdominal wall by using a combination of the human acellular dermal matrix implant and an interpositional omentum flap after extensive tumor resection in patients with abdominal wall neoplasm:A preliminary result

    Institute of Scientific and Technical Information of China (English)

    Yan Gu; Rui Tang; Ding-Quan Gong; Yun-Liang Qian

    2008-01-01

    AIM:To present our trial using a combination of the human acellular dermal matrix (HADM) implant and an interpositional omentum flap to repair giant abdominal wall defects after extensive tumor resection.METHODS:Between February and October of 2007,three patients with giant defects of the abdominal wall after extensive tumor resection underwent reconstruction with a combination of HADM and omentum flap.Postoperative morbidities and signs of herniation were monitored.RESULTS:The abdominal wall reconstruction was successful in these three patients,there was no severe morbidity and no signs of herniation in the follow-up period.CONCLUSION:The combination of HADM and omentum flap offers a new,safe and effective alternative to traditional forms in the repair of giant abdominal wall defects.Further analysis of the long-term outcome and more cases are needed to assess the reliability of this technique.

  7. Safety of implanting sustained-release 5-fluorouracil into hepatic cross-section and omentum majus after primary liver cancer resection.

    Science.gov (United States)

    Chen, Jiangtao; Zhang, Junjie; Wang, Chenyu; Yao, Kunhou; Hua, Long; Zhang, Liping; Ren, Xuequn

    2016-09-01

    This study was designed to evaluate the short-term safety of implanting sustained-release 5-fluorouracil (5-FU) into hepatic cross-section and omentum majus after primary liver cancer resection and its impact on related indexes of liver. Forty patients were selected and divided into an implantation group (n = 20) and a control group (n = 20). On the first day after admission, first week after surgery, and first month after surgery, fasting venous blood was extracted from patients for measuring hematological indexes. The reduction rate of alpha fetoprotein (AFP) on the first week and first month after surgery was calculated, and moreover, drainage volume of the abdominal cavity drainage tube, length of stay after surgery, and wound healing condition were recorded. We found that levels of alanine aminotransferase, aspartate amino transferase, blood urea nitrogen, creatinine, total bilirubin, albumin, and white blood cells measured on the first week and first month after surgery, length of stay, and wound healing of patients in the two groups had no significant difference (P >0.05). Drainage volume and reduction rate of AFP of two groups were significantly different on the first week and first month after surgery (P <0.05). Implanting sustained-release 5-FU into hepatic cross-section and omentum majus after primary liver cancer resection is proved to be safe as it has little impact on related indexes.

  8. Invariant NKT cells and CD1d(+) cells amass in human omentum and are depleted in patients with cancer and obesity.

    LENUS (Irish Health Repository)

    Lynch, Lydia

    2012-02-01

    Invariant NKT (iNKT) cells recognize lipid antigens presented by CD1d and respond rapidly by killing tumor cells and release cytokines that activate and regulate adaptive immune responses. They are essential for tumor rejection in various mouse models, but clinical trials in humans involving iNKT cells have been less successful, partly due to their rarity in humans compared with mice. Here we describe an accumulation of functional iNKT cells in human omentum, a migratory organ with healing properties. Analysis of 39 omental samples revealed that T cells are the predominant lymphoid cell type and of these, 10% expressed the invariant Valpha24Jalpha18 TCR chain, found on iNKT cells, higher than in any other human organ tested to date. About 15% of omental hematopoietic cells expressed CD1d, compared with 1% in blood (p<0.001). Enriched omental iNKT cells killed CD1d(+) targets and released IFN-gamma and IL-4 upon activation. Omental iNKT-cell frequencies were lower in patients with severe obesity (p=0.005), and with colorectal carcinoma (p=0.004) compared with lean healthy subjects. These data suggest a novel role for the omentum in immune regulation and tumor immunity and identify it as a potential source of iNKT cells for therapeutic use.

  9. Long-term function of islets encapsulated in a re-designed alginate microcapsule construct in omentum pouches of immune-competent diabetic rats

    Science.gov (United States)

    Pareta, Rajesh; McQuilling, John P; Sittadjody, Sivanandane; Jenkins, Randy; Bowden, Stephen; Orlando, Giuseppe; Farney, Alan C; Brey, Eric M; Opara, Emmanuel C

    2014-01-01

    Objectives Our study aim was to determine encapsulated islet graft viability in an omentum pouch and the effect of FGF-1 released from our redesigned alginate microcapsules on the function of the graft. Methods Isolated rat islets were encapsulated in an inner core made with 1.5% low-viscosity high-mannuronic acid (LVM) alginate followed by an external layer made with 1.25% low-viscosity high-guluronic acid (LVG) alginate with or without FGF-1, in microcapsules measuring 300 – 400 μm in diameter. The two alginate layers were separated by a perm-selective membrane made with 0.1 % Poly-L-Ornithine (PLO), and the inner LVM core was partially chelated using 55 mM sodium citrate for 2 min. Results A marginal mass of encapsulated islet allografts (~2000 islets/kg) in Streptozotocin-diabetic Lewis rats caused significant reduction in blood glucose levels similar to the effect observed with encapsulated islet isografts. Transplantation of allo-islets co-encapsulated with FGF-1 did not result in better glycemic control, but induced greater body weight maintenance in transplant recipients compared to those that received only allo-islets. Histological examination of the retrieved tissue demonstrated morphologically and functionally intact islets in the microcapsules, with no signs of fibrosis. Conclusion We conclude that the omentum is a viable site for encapsulated islet transplantation. PMID:24681880

  10. Combined transplantation of bone marrow mesenchymal stem cells and pedicled greater omentum promotes locomotor function and regeneration of axons after spinal cord injury in rats

    Institute of Scientific and Technical Information of China (English)

    Liang Li; Zhiying Zhang; Haiyan Lin; Congli Ren; Chuansen Zhang

    2008-01-01

    BACKGROUND: According to previous studies, the neuroprotective effect of the pedicled greater omentum may be attributed to the secretion of neurotrophic factors and stimulation of angiogenesis. The neurotrophic factors released from the pedicled greater omentum, such as brain-derived neurotrophic factor and neurotrophin 3/4/5 could exert a neuroprotective effect on the damaged host neural and glial cells, and also could induce the transdifferentiation of transplanted bone marrow mesenchymal stem cells (BMSCs) into neural cells. OBJECTIVE: Based on the functions of the omentum of neuro-protection and vascularization, we hypothesize that the transplantation of BMSCs and pedicled greater omentum into injured rat spinal cord might improve the survival rate and neural differentiation of transplanted BMSCs and consequently gain a better functional outcome. DESIGN, TIME AND SETTING: A randomized, controlled animal experiment. The experiments were carried out at the Department of Anatomy, the Secondary Military Medical University of Chinese PLA between June 2005 and June 2007.MATERIALS: Fifteen male inbred Wistar rats, weighing (200±20) g, provided by the Experimental Animal Center of the Secondary Military Medical University of Chinese PLA were used and met the animal ethical standards. Mouse anti-BrdU and mouse anti-NF200 monoclonal antibody were purchased from Boster, China. METHODS: Cell culture: We used inbred Sprague-Dawley rats to harvest bone marrow for culture of BMSCs and transplantation to avoid possible immune rejection. BMSCs were cultured via total bone marrow adherence. Experimental grouping and intervention: The rats were randomly divided into a control group, cell group and combined group, five rats per group. Rats in the control group underwent spinal cord injury (SCI) only, during which an artery clamp with pressure force of 30 g was employed to compress the spinal cord at the T10 level for 30 seconds to produce the SCI model. 5 μL PBS containing 105

  11. Perbedaan Efek Infusa Bubuk Kedelai (Glycine max, Jamur Tiram (Pleurotus ostreatus, dan Campuran Keduanya terhadap Kadar Kolesterol LDL, Ekspresi Gen Reseptor LDL Hati, dan Berat Omentum Majus Mencit Model Hiperlipidemia

    Directory of Open Access Journals (Sweden)

    Rizky Suganda Prawiradilaga

    2016-07-01

    Full Text Available Abstrak Angka kejadian dislipidemia di Indonesia semakin meningkat. Dislipidemia dan obesitas abdominal merupakan faktor risiko penyakit kardiovaskular. Diperlukan solusi yang efektif dengan bahan alami seperti kedelai dan jamur tiram. Tujuan penelitian ini melihat efektivitas infusa bubuk kedelai, jamur tiram, dan campuran keduanya terhadap kadar kolesterol LDL, ekspresi gen LDLR hati, dan berat omentum majus mencit percobaan. Penelitian eksperimental di Laboratorium Farmakologi RSUP Dr. Hasan Sadikin Bandung tahun 2010 memakai rancangan postes kelompok kontrol. Mencit jantan sebanyak 20 ekor dibagi 5 kelompok perlakuan, yaitu A pakan standar, B induksi kolesterol, C infusa kedelai dengan induksi kolesterol, D infusa jamur tiram dengan induksi kolesterol, dan E infusa campuran dengan induksi kolesterol. Pada akhir penelitian mencit dikorbankan lalu dibedah untuk diambil darah jantung, juga sedikit bagian hati dan omentum majus. Kolesterol LDL darah kelompok E (12±5,48 mg/dL sama dengan kelompok D (12±6,06 mg/dL, tetapi lebih rendah daripada kelompok C (15±5,35 mg/dL dan kelompok B (13,5±5,45 mg/dL, namun tidak signifikan. Didapatkan ekspresi gen LDLR yang sedang pada kelompok A dan C, ekspresi gen LDLR yang lemah pada kelompok B, dan tidak terekspresi pada kelompok D dan E. Berat basah omentum majus kelompok E (0,40±0,07 g lebih rendah bermakna dibanding kelompok A (0,55±0,07 g, B (0,8±0,49 g, C (1,28±0,28 g, D (0,74±0,11 g (p<0,05. Berat kering omentum majus kelompok E (0,16±0,03 g lebih rendah bermakna daripada kelompok B (0,27±0,25 g, C (0,39±0,06 g, dan D (0,31±0,07 g (p=0,025. Simpulan, infusa kedelai 100 mg/hari meningkatkan kadar kolesterol LDL darah dan berat omentum majus, tetapi jamur tiram 75 mg/hari sebaliknya, menurunkan kadar kolesterol LDL darah dan berat omentum majus mencit.

  12. Effect of adipose tissue extract of greater omentum on human fibroblasts in vitro%大网膜脂肪组织提取液对成纤维细胞作用的研究

    Institute of Scientific and Technical Information of China (English)

    张小文; 吴涛; 邹浩; 王琨; 黄松泉

    2011-01-01

    Objective To study effect of the adipose tissue extract of greater omentum on human fibroblasts. Method The effect of the adipose tissue extract of greater omentum on human fibroblasts was observed by inverted microscope, MTT, flow cytometry, transmission electron microscope. Results The growth of fibroblasts was inhibited by the adipose tissue extract of greater omenturn. The apoptosis of fibroblasts was not inhibited, and the cell function of fibroblasts was inhibited and the mitosis of fibroblasts was affected. Conclusions The growth of fibroblasts can be inhibited by the adipose tissue extract of greater omentum. The formation and development of biliary cicatricial constriction may be affected by the adipose tissue extract of greater omentum.%目的 探讨大网膜脂肪组织提取液对成纤维细胞的作用.方法 应用倒置显微镜、MTT法、流式细胞仪、透射电镜观测提取液对成纤维细胞生长、增殖、凋亡以及细胞超微结构的影响.结果 大网膜脂肪组织提取液对成纤维细胞的生长增殖有抑制作用;抑制细胞凋亡,并影响细胞的有丝分裂,并使细胞功能受到抑制.结论 大网膜脂肪组织提取液可以抑制成纤维细胞的生长,有可能影响胆管瘢痕狭窄的形成和发展.

  13. 带蒂大网膜移位修补膀胱阴道瘘的围手术期护理%The perioperative nursing of pedicled greater omentum displacement for the repair of vesicovaginal fistulas

    Institute of Scientific and Technical Information of China (English)

    孔桃红; 张巧珍; 凌冬兰; 苏美霞; 熊穗清

    2011-01-01

    Objective To investigate the therapeutic effects of which pedicled greater omentum displacement for the repair of vesicovaginal fistulas and perioperative care elements.Methods Twenty eight cases of vesicovaginal fistulas patients, with pedicled greater omentum displacement which covered the wound repaired between bladder and vesicovaginal fistula,and through improving the perioperative nursing, promoting fistula healing and increasing the cure rate.Results All the operations were successfully completed fully recouered.Conclusions The pedicled greater omentum displacement for the repair of vesicovaginal fistulas,which can improve the success rate of operation. Intensive perioperative care,with particular attention to preoperative psychological counseling after partial cleaning and properly handle the various drainage tubes,etc,which are help to reduce perioperative complications.%目的 探讨带蒂大网膜移植修补膀胱阴道瘘病人的临床疗效及围手术期的护理要点.方法 对28例膀胱阴道瘘病人采用移位带蒂大网膜覆盖于膀胱和阴道瘘口修补后的创口之间,并通过改进围手术期的护理方法,有效地促进了瘘口愈合.结果 所有病人手术均获成功并痊愈出院.结论 带蒂大网膜移位修补膀胱阴道瘘,手术成功率高;加强围手术期的护理,尤其是重视术前心理疏导、局部清洁及术后妥善处理好各种引流管等,有助于减少膀胱阴道瘘病人围手术期并发症的发生.

  14. Clinical value of ultrasonography in the differentia diagnosis of benign and malignant lesions in greater omentum%超声对大网膜良恶性病变的诊断价值

    Institute of Scientific and Technical Information of China (English)

    赵志华; 詹宏伟

    2012-01-01

    Objective To evaluate the clinical value of ultrasonography in the differentia diagnosis of benign and malignant lesions in greater omentum.Methods The ultrasonography features of thickened omentum in 62 patients with abdominal distention and ascites of unknown origin were retrospectively analyzed and their pathology results by ultrasound-guided biopsy were contrasted. Results Among 62 patients with thickened omentum , there were 36 cases of tuberculous peritonitis, 5 cases of pseudomyxoma peritonei, 18 cases of metastatic adenocarcinoma, 2 cases of malignant mesothelioma and 1 case of non-Hodgkin's lymphoma.Benign lesions mainly appeared as hyperechogenicity,massive thickening and grade 0 of blood flow, while malignant lesions were shown as hypoechogenicity, nodules and grade Ⅲ of blood flow.The differences were statistically significant (P< 0.05).Conclusion Ultrasonographic features of benign and malignant lesions in greater omentum are significantly different. Ultrasonography is beneficial to differential them and has significant clinical value.%目的 探讨超声对大网膜良恶性病变的诊断价值.方法 观察62例大网膜增厚患者的超声表现,与超声引导下穿刺活检结果进行对比分析.结果 62例患者中,结核性腹膜炎36例,腹膜假性黏液瘤5例,转移性腺癌18例,恶性间皮瘤2例,非霍奇金淋巴瘤1例.增厚大网膜良性病变表现以高回声、块状增厚及0级血流为主,恶性病变以低回声、结节状及Ⅲ级血流为主,二者比较差异均有统计学意义(P<0.05).结论 大网膜良恶性病变声像图特点存在明显差异,超声检查有助于二者的鉴别诊断,具有重要临床价值.

  15. Quistes del mesenterio y epiplón en niños: Estudio de 20 años Cysts of the mesentery and omentum in children: A 20-year study

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    Vivian Vialat Soto

    2004-09-01

    Full Text Available Se realiza un estudio de 8 casos operados con diagnóstico de quistes de epiplón o mesenterio en el período de enero de 1982 a diciembre de 2001, en el Hospital Pediátrico universitario Centro Habana. Estas son lesiones intraabdominales raras, que con frecuencia evolucionan como una tumoración asintomática, pero en ocasiones pueden ser causas de abdomen agudo en el niño. Más frecuente en el sexo femenino y todos menores de 10 años de edad. Las radiografías simple de abdomen y el ultrasonido abdominal aportan gran positividad en el diagnostico de estas afecciones. En todos los casos se realizo exéresis total de la lesión tumoral benigna; 3 casos eran quistes del mesenterio del intestino delgado y 5 casos linfangiomas quísticos del epiplón mayor. En 2 pacientes fue necesario realizar resección intestinal para la exéresis del tumor. No hubo complicaciones en nuestros casos.A study of 8 cases operated on with diagnosis of omentum or mesentery cysts from January 1982 to December 2001 at "Centro Habana" Teaching Pediatric Hospital was conducted. These are rare intraabdominal lesions that frequently evolve as an asymptomatic tumor, but on ocassions may be causes of acute abdomen in the child. They were more common among females and all the affected were under 10. The simple X-rays of the abdomen and the abdominal ultrasound showed great positivity in the diagnosis of these affections. Total exeresis of the benign tumoral lesion was performed in all cases. 3 cases were cysts of the mesentery of the small intestine and 5 were cystic lymphangiomas of the greater omentum . In 2 patients, it was necessary to perform intestinal resection for the tumor exeresis. There were no complications.

  16. Repairing effect of pedicle omentum in severe ureteral injury%带蒂大网膜修复严重输尿管损伤及其机制的实验研究

    Institute of Scientific and Technical Information of China (English)

    蔡育彬; 湛海伦; 缪斌; 何丹; 司徒杰; 高新

    2009-01-01

    目的 探讨带蒂大网膜修复严重输尿管损伤的作用机制. 方法 20只健康成年杂种犬随机分为实验组及对照组,每组10只,均建立严重输尿管损伤动物模型,端端吻合输尿管后实验组采用带蒂大网膜包裹损伤输尿管,对照组未采用大网膜包裹.术后不定期观察有无尿瘘及输尿管坏死.术后12周观察术侧输尿管损伤愈合情况,取吻合口及周围组织行病理学检查,镜下观察血管再生情况,免疫组化检测血管内皮生长因子(VEGF)及其受体KDR的表达. 结果 术后实验组无尿瘘,对照组2只因尿瘘反复腹腔感染死亡.术后12周实验组输尿管吻合口处黏膜及平滑肌层完全再生,血管再生现象明显,VEGF及KDR表达阳性细胞密度分别为(12.65±0.02)%和(10.23±0.03)%.对照组吻合口愈合不良并狭窄,思侧肾严重积液(脓),无明显血管再生,VEGF及KDR表达阳性细胞密度仅为(1.54±0.03)%、(2.65±0.04)%,明显低于实验组(均P<0.05). 结论 带蒂大网膜有促进严重输尿管损伤修复作用,可能通过VEGF及KDR表达升高促进血管再生而实现.%Objective To evaluate the repairing effect of pedicle omentum on severe ureteral in-jury. Methods Twenty healthy dogs were randomized into the experiment group and the control group. Firstly the model of severe ureteral injury was made. In experimental group, the pedicle omen-turn were used to wrap up the severe injured ureter, but which was no done in control group. Urinary fistula and ureteral necrosis were observed. At 12 weeks postoperatively,the models were re-operated to investigate whether the severe injured ureters had healed. Angiogenesis, VEGF and its receptor KDR were also examined in stoma and surrounding tissue histopathologically. Results No urinary fistula was observed in experimental group, but 2 cases in control group were dead because of recurrent abdominal cavity infection after the formation of urinary fistula. The mucosa and smooth

  17. Combination of poly L-lactic acid nanofiber scaffold with omentum graft for bone healing in experimental defect in tibia of rabbits Combinação de poli L-ácido láctico nanofibras com enxerto de omento para reparo ósseo em defeito experimental em tíbia de coelhos

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    Amir Sotoudeh

    2012-10-01

    Full Text Available PURPOSE: To investigate the osteoconductive properties and biological performance of Poly L-lactic acid (PLLA with omentum in bone defects. METHODS: PLLA nanofiber scaffolds were prepared via electrospinning technique. Forty four New Zealand white female rabbits randomly divided into three groups of 18 rabbits each. Created defects in right tibias were filled in group I with omentum, in group II with PLLA nanofiber scaffold and in group III with combination of the omentum and PLLA. The same defects were created in left tibia of all groups but did not receive any treatment (control group. Histological and histomorphometric evaluations were performed at two, four and six weeks after the implantation. RESULTS: Histological changes on all groups along with the time course were scored and statistical analysis showed that the average scores in group III were significantly higher than the other groups. CONCLUSION: Histomorphometric analysis of bone healing was shown to be significantly improved by the combined PLLA with omentum compared with the other groups, suggesting this biomaterial promote the healing of cortical bone, presumably by acting as an osteoconductive scaffold.OBJETIVO: Investigar as propriedades de osteocondução e desempenho biológico do ácido L láctico-Poly (PLLA com omento em defeitos ósseos. MÉTODOS: Andaimes PLLA nanofibras foram preparados via eletrofiação técnica. Cinquenta e quatro coelhos fêmeas Nova Zelândia brancos foram distribuídos aleatoriamente em três grupos de 18 coelhos cada. Defeitos criados em tíbias direitas foram preenchidos no grupo I com omento, no grupo II com PLLA nanofibras e no grupo III com a combinação do omento e PLLA. Os mesmos defeitos foram criados na tíbia esquerda de todos os grupos, mas não receberam qualquer tratamento (grupo controle. As avaliações histológicas e histomorfométricas foram realizadas em duas, quatro e seis semanas após a implantação. RESULTADOS: As altera

  18. Identification and comparison between omental type Ⅰ and type Ⅱ milky spots of the greater omentum in rat%大鼠大网膜Ⅰ型和Ⅱ型乳斑的确定及对比

    Institute of Scientific and Technical Information of China (English)

    李尚胜; 黄允宁

    2011-01-01

    Objective: To identify the type of milky spots, and investigate the similarities and differences between type Ⅰ and type Ⅱ milky spots in number, area and cell composition. Methods: Double-labeling of rat omental milky spots with activated carbon and H-E staining were used to measure the number and the area of type Ⅰ and type Ⅱ milky spots by Image-Pro plus software, and the differences in ultrastructure between type Ⅰ and type Ⅱ milky sports were observed under an electron microscope. Results: In physiological conditions, the number of the type Ⅱ milky spots was more significant than that of the type Ⅰ milky spots [(9. 153±0. 818)per cm2 vs (1. 913±0. 851)per cm2 , P<0. 01], and the area of the type Ⅱ milky spots was significantly larger than that of the type Ⅰ milky spots [(0. 421±0.136)mm2 vs (0. 102±0.041)mm2 , P <0. 01]. Two types of milk spots were mainly composed of macrophages, lymphocytes, mast cells, monocytes, plasma cells, eosinophils, reticular cells and stromal cells; vessel, lymph vessel and adipocyte were observed in type Ⅱ milky spots.Activated carbon particles were observed in macrophages of two types milky spots. Conclusion: Both activated carbon and H-E staining can mark milky spots; Omental milky spots can be classified into two types: type Ⅰ and type Ⅱ (type Ⅰ milky spots are located in the thin serous membrane of the omentum and no blood vessels or adipose tissues are found in the surrounding area; type Ⅱ milky spots are distributed close to vascular networks and adipose tissues, curved vessel can be observed in this milky spots). Two types of the milky spots in the tissue cell composition are different due to the distribution; Macrophages in both types of milky spots have the immune function of phagocytizing foreign particles.%目的:对乳斑的分型进行确定,并探讨Ⅰ型乳斑和Ⅱ型乳斑数量、面积及细胞构成的异同.方法:微粒子活性炭及H-E染色双重标

  19. 老年腹膜透析患者改良腹透置管术在预防大网膜包裹中的应用%Clinical efficiency of application of improved drain tube insertion in the prevention of greater omentum package in elderly patients with peritoneal dialysis

    Institute of Scientific and Technical Information of China (English)

    雷红英; 周盛起; 徐妙娟; 蒋苗芳; 郑雪俭

    2016-01-01

    Objective To investigate the effects of improved dialysis catheter in the prevention of omental wrap in patients with postoperative dialysis catheter.Methods A total of 72 patients were divided into experimental group(37 cases)and control group(35 cases).The experimental group was treated by an improved dialysis catheter combined with traditional dialysis catheter.22 patients with a great quantity of greater omentum in experimental group were treated with improved dialysis catheter,namely,tying 3 to 5 knots with 7th line on the large greater omentum to draw the omentum.The control group was treated with traditional dialysis catheter.The routine dialysate measurement,blood routine,serum creatinine,urea nitrogen,C-reactive protein were compared between two groups,and complications such as omental wrapping,perioperative peritonitis,ileus,and peritoneal fluid leakage were observed.Results Compared with the control group,the incidence of greater omental wrap in the experimental group was significantly reduced(P<0.05).No significant differences in other parameters were found,including WBC,hemoglobin,Scr,BUN,hs-CRP,karyocyte count of peritoneal dialysate,over flow discharge of peritoneal dialysis.Conclusions For elderly peritoneal dialysis patients with a great quantity of greater omentum,the improved dialysis catheter can effectively prevent the occurrence of postoperative complication of omental wrapping.And it is simple to operate,which is of great clinical application value.%目的 通过改良腹透置管术观察术后大网膜包裹情况,探讨老年腹膜透析患者改良腹透置管术在预防大网膜包裹中的作用. 方法 72例患者分成试验组(37例)和对照组(35例),试验组在传统腹透置管术基础上,对于术中可见到大量大网膜的22例患者,进行改良腹透置管术,即在其大网膜上予7号线打结3~5个以吸引大网膜;对照组进行传统腹透置管术;比较两组腹透液常规、血常规、血肌酐、尿

  20. Pseudocyst in Omentum caused by Abdominal Tuberculosis : Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, So Yeon; Kim, Hyun Jin; Park, Soo Youn; Choi, Hyun Joo; Hwang, Seong Su; Cha, Eun Suk; Park, Young Ha [Catholic University of Korea, St.Vincent' s Hospital, Suwon (Korea, Republic of)

    2006-06-15

    A 25-year-old woman presented with abdominal discomfort and weight loss. Sonography demonstrated a well defined, anechoic, cystic mass with posterior acoustic enhancement, internal thin septations, and a peripheral hypoechoic solid portion that had no increased blood flow on Doppler ultrasound. Contrast-enhanced CT revealed a cystic omental mass with internal thin septations and an enhancing solid portion which appeared as the hypoechoic solid portion on ultrasonography. A pathologic specimen demonstrated a pseudocyst containing serous fluid with gelatinous material. The solid component at the peripheral portion of the pseudocyst indicated caseous necrosis with multinucleated giant cells. This histologic finding was consistent with tuberculosis and supported the final diagnosis of omental pseudocyst caused by tuberculous peritonitis. Therefore, intraperitoneal pseudocyst with tuberculosis should be considered in the differential diagnosis of an intraperitoneal cystic mass in a young adult

  1. Nitric oxide monocyte production levels in patients with the hepatosplenic form of Scistosoma mansoni infection who underwent splenectomy, ligature of the left gastric vein and auto implantation of spleen tissue in the major omentum Níveis de óxido nítrico produzidos por monócitos em portadores de esquistossomose hepatoesplênica que se submeteram a esplenectomia, ligadura da veia gástrica esquerda e auto-implante de tecido esplênico no omento maior

    Directory of Open Access Journals (Sweden)

    Carlos Teixeira Brandt

    2006-10-01

    Full Text Available PURPOSE: To measure the levels of NO production by monocytes in patients with the hepatosplenic form of schistosomiasis mansoni who underwent splenectomy, ligature of the left gastric vein and auto implantation of spleen tissue in the major omentum. METHODS: Four groups of volunteers were enrolled in the investigation: G1 - 12 patients with S. mansoni infection in its hepatosplenic form without any kind of treatment (SMH; G2 - 13 SMH patients who underwent medical treatment and portal hypertension decompression splenectomy and ligature of the left gastric vein (SMH/SLGV; G3 - 19 patients similar to the later group, but additionally received auto implantation of spleen morsels in the major omentum (SMH/SLGV/AI; and G4 - 15 individuals with no S. mansoni infection coming from the same geographical area and presenting similar socio economical status (CG. Nitrite production by monocytes was determined by a standard Griess reaction adapted to microplates. The results were presented by mean ± SD for each group. Significant differences in NO production by monocytes were determined by Tukey-Kramer multicomparisons test. Probability values of 0.05 were considered significant. RESULTS: Patients from G1 (SMH showed lower level of NO production by monocytes (5.28 ± 1.28µmol/ml. Patients from G2 (SMH/SLGV showed similar results (6.67 ± 0.44µmol/ml - q = 2.681 p > 0.05. Individuals of G4 (CG showed higher level of NO production by monocytes (8.19 ± 2.74µmol/ml. Patients from G3 (SMH/SGLV/AI showed similar NO production by PBMC as compared to individuals of G4 (CG - (7.41 ± 1.65µmol/ml - q = 1.615 p > 0.05. The volunteers from G4 (CG and G3 (SMH/SLGV/AI showed significantly greater levels of NO production by monocytes as compared to those from G1 (SMH - (q = 5.837 p OBJETIVO: Mensurar os níveis de produção de ON por monócitos do sangue periférico (MSP em portadores de esquistossomose na forma hepatoesplênica que tinham se submetido a

  2. Reconstrucción de cuero cabelludo con colgajo libre de omentum Reconstruction of the scalp with a free flap of omentum

    OpenAIRE

    Navarro Cuellar, C.; F. Riba García; B. Guerra Martínez; R. Pujol Romanya; H. Herencia Nieto; C. Navvarro Vila

    2004-01-01

    Los defectos de cuero cabelludo pueden tener una etiología diversa. Resecciones oncológicas, lesiones postraumáticas e infecciosas pueden dar lugar a diferentes defectos en cuanto a tamaño y extensión. Para su reconstrucción disponemos de múltiples técnicas quirúrgicas como colgajos locales, regionales y expansores titulares. No obstante, para defectos extensos los colgajos libres son la única posibilidad reconstructiva. Presentamos el caso de un paciente con carcinomas epidermoides multicént...

  3. A Case of Castleman's Disease Arising from the Greater Omentum

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Eun Ju [Dept. of Radiology, Donga University College of Medicine, Pusan (Korea, Republic of)

    2011-09-15

    Castleman's disease is a rare benign lymphoproliferative disorder of unknown etiology with about 70% of cases occurring in the thorax. However, the disorder can also occur in an extrathoracic site where lymphoid tissue is present. We report here a rare case of omental Castleman's disease in a 69-year-old female patient, imaged by three cross-sectional modalities: US, CT, and MRI with gadolinium.

  4. Use of greater omentum in the surgical treatment of a synovial cyst in a cat.

    Science.gov (United States)

    Stegen, L; Van Goethem, B; Beerden, C; Grussendorf, C; de Rooster, H

    2015-01-01

    A 13-year-old cat was diagnosed with a synovial cyst originating from the glenohumeral joint. The cat presented with severe front limb lameness and a non-painful fluctuating swelling on the medial aspect of the humerus. Radiographic examination showed severe bilateral shoulder osteoarthritis with osteophyte formation. The mass was surgically resected and histopathology confirmed the diagnosis of a synovial cyst. Three weeks postoperatively the cyst recurred. Surgical resection was repeated followed by omentalisation of the defect. Throughout the following 3 months the cyst did not recur. Unfortunately, for reasons unrelated to the presented disease, the cat was euthanized shortly afterwards, therefore making a long-term follow-up impossible.

  5. Umbilical hernia rupture with evisceration of omentum from massive ascites: a case report.

    LENUS (Irish Health Repository)

    Good, Daniel W

    2011-01-01

    The incidence of hernias is increased in patients with alcoholic liver disease with ascites. To the best of our knowledge, this is the first report of an acute rise in intra-abdominal pressure from straining for stool as the cause of a ruptured umbilical hernia.

  6. A levonorgestrel-releasing intrauterine system embedded in the omentum in a woman with abdominal pain: a case report

    Science.gov (United States)

    2009-01-01

    Introduction The Mirena intrauterine system has been licensed as a contraceptive in the United Kingdom since May 1995. The use of an intrauterine system as a primary method of contraception among women has been slowly increasing over the last few years and they now account for about 3% of contraceptive use in England. The Mirena intrauterine system now also has a license for the management of idiopathic menorrhagia. Women may be informed that the rate of uterine perforation associated with intrauterine contraceptive use is low (0-2.3 per 1000 insertions). The rate of perforation reported with the Mirena intrauterine system in a large observational cohort study was 0.9 per 1000 insertions. Case presentation In this case report, the diagnosis of an intraperitoneal Mirena intrauterine system was noted nearly four years after its insertion, despite the patient having had a vaginal hysterectomy and admissions to hospital in the interim with complaints of abdominal pain. Conclusion This case report demonstrates clearly that whenever there is a question of a intrauterine system having fallen out following an ultrasound scan report showing an empty uterus, clinicians should also perform an abdominal X-ray. PMID:20062790

  7. A levonorgestrel-releasing intrauterine system embedded in the omentum in a woman with abdominal pain: a case report

    Directory of Open Access Journals (Sweden)

    Phillips Kevin

    2009-11-01

    Full Text Available Abstract Introduction The Mirena intrauterine system has been licensed as a contraceptive in the United Kingdom since May 1995. The use of an intrauterine system as a primary method of contraception among women has been slowly increasing over the last few years and they now account for about 3% of contraceptive use in England. The Mirena intrauterine system now also has a license for the management of idiopathic menorrhagia. Women may be informed that the rate of uterine perforation associated with intrauterine contraceptive use is low (0-2.3 per 1000 insertions. The rate of perforation reported with the Mirena intrauterine system in a large observational cohort study was 0.9 per 1000 insertions. Case presentation In this case report, the diagnosis of an intraperitoneal Mirena intrauterine system was noted nearly four years after its insertion, despite the patient having had a vaginal hysterectomy and admissions to hospital in the interim with complaints of abdominal pain. Conclusion This case report demonstrates clearly that whenever there is a question of a intrauterine system having fallen out following an ultrasound scan report showing an empty uterus, clinicians should also perform an abdominal X-ray.

  8. Surgical Treatment for Greater Omentum Umbilical Hernia Caused by Porcine Abscess%猪脓肿引发大网膜脐疝的手术治疗

    Institute of Scientific and Technical Information of China (English)

    鞠险峰

    2008-01-01

    2006年5月,贵州省余庆县白泥镇子营社区草坪三组张某饲养的1头60kg重架子猪脐部脓肿,请人用针穿刺两次,均有血脓流出,未见好转,求诊,笔者决定手术摘除,现报告如下。

  9. The omentum-polypropylene sandwich technique: an attractive method to repair large abdominal-wall defects in the presence of contamination or infection.

    NARCIS (Netherlands)

    Bleichrodt, R.P.; Malyar, A.W.; Vries Reilingh, T.S. de; Buyne, O.R.; Bonenkamp, J.J.; Goor, H. van

    2007-01-01

    BACKGROUND: Repair of abdominal wall defects in the presence of contamination or infection continues to be a significant problem for surgeons. The loss of tissue warrants reinforcement of the abdominal wall, preferably by autologous material. However, autologous repair often requires extensive

  10. The omentum-polypropylene sandwich technique: an attractive method to repair large abdominal-wall defects in the presence of contamination or infection.

    NARCIS (Netherlands)

    Bleichrodt, R.P.; Malyar, A.W.; Vries Reilingh, T.S. de; Buyne, O.R.; Bonenkamp, J.J.; Goor, H. van

    2007-01-01

    BACKGROUND: Repair of abdominal wall defects in the presence of contamination or infection continues to be a significant problem for surgeons. The loss of tissue warrants reinforcement of the abdominal wall, preferably by autologous material. However, autologous repair often requires extensive opera

  11. CT findings of benign omental lesions following abdominal cancer surgery

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Yun; Kim, Dong Won; Cho, Jin Han; Kwon, Hee Jin; Ha, Dong Ho; Oh, Jong Young [Diagnostic Radiology, Dong-A University College of Medicine, Busan (Korea, Republic of)

    2016-07-15

    The greater omentum is the largest peritoneal fold and can be the origin of primary pathologic conditions, as well as a boundary and conduit for disease processes. Most diseases involving the omentum manifest with nonspecific and overlapping features on computed tomography (CT). In particular, varying benign disease processes of traumatic, inflammatory, vascular, or systemic origin can occur in the omentum during the follow-up period after surgery for intra-abdominal malignancy. It can be challenging for radiologists due to various spectrum of CT findings. Thus, we reviewed the CT findings of various benign omental lesions after surgery for intra-abdominal malignancy.

  12. Left-sided omental torsion: CT appearance

    Energy Technology Data Exchange (ETDEWEB)

    Aoun, N.; Haddad-Zebouni, S.; Slaba, S.; Ghossain, M. [Hotel-Dieu de France Hospital, Beirut (Lebanon). Dept. of Radiology; Noun, R. [Hotel-Dieu de France Hospital, Beirut (Lebanon). Dept. of General Surgery

    2001-01-01

    A 34-year-old male presented with exquisite left flank pain. Computed tomography showed a hyperdense vascular structure surrounded by whirling linear streaks situated in the greater omentum under the splenic flexure of the colon. Omental stranding extended caudally into the pelvis where part of the inflamed omentum entered a left inguinal hernia sac. Surgery revealed left-sided torsion of the greater omentum. Left-sided omental torsion is infrequent and pre-operative diagnosis is rarely established. The CT findings of an omental fatty mass with a whirling pattern is characteristic of omental torsion. Preoperative diagnosis is important because conservative management has been suggested. (orig.)

  13. Umbilical hernia (image)

    Science.gov (United States)

    An umbilical hernia is a protrusion of the peritoneum and fluid, omentum, or a portion of abdominal organ(s) through the ... spontaneously without treatment by age 1 or 2. Umbilical hernias are usually painless and are common in infants.

  14. Pedunculated uterine leiomyoma associated with pseudo-Meigs' syndrome and elevated CA-125 level: CT features

    Energy Technology Data Exchange (ETDEWEB)

    Kebapci, Mahmut; Aslan, Ozgur; Kaya, Tamer [Department of Radiology, Osmangazi University School of Medicine, Meselik, 26480 Eskisehir (Turkey); Yalcin, Omer T.; Ozalp, Sinan [Department of Obstetrics and Gynecology, Osmangazi University School of Medicine, Meselik, 26480 Eskisehir (Turkey)

    2002-07-01

    A 38-year-old woman presented with a 1-week history of low back pain, distension, weakness, and loss of appetite. Laboratory studies showed a serum CA-125 level of 281 U/ml (normal value 1.2-32 U/ml). Abdominopelvic sonography revealed massive ascites, left pleural effusion, and a heterogeneous, hypoechogenic, and smoothly outlined solid mass. The mass had a close proximity and to the anterior side of the right ovary. Doppler sonography showed that the mass was hypervascularized. Computed tomography demonstrated numerous, tortuous vascular structures around the mass and along the omentum indicating its auxiliary vascularization from the omentum. Exploratory laparotomy and histopathological examination revealed pedunculated leiomyoma with parasitized blood supply from the omentum. Ascites and pleural effusion disappeared 6 months after surgery. We present the clinical and CT features of a parasitic leiomyoma adhering to the omentum. (orig.)

  15. Role of pelvic lymphadenectomy in stage 1A endometrial carcinoma ...

    African Journals Online (AJOL)

    Hossam Hassan Aly Hassan El Sokkary

    2013-10-31

    Oct 31, 2013 ... Abstract Introduction: Endometrial cancer is the commonest ... tubes, ovaries, omentum and cytology of peritoneal wash were done for surgical staging, in addition ... Endogenous risk factors include obesity, early menarche,.

  16. Rapid pre-operative diagnosis of ileal hernia through the foramen of ...

    African Journals Online (AJOL)

    We report a case of IHFW in which multi-detector computed tomography ... of blood tests and biochemical investigations were normal. A plain abdominal ... lesser omentum (containing the hepatic artery, portal vein and bile duct), caudal to the ...

  17. Left-sided omental torsion with inguinal hernia

    Institute of Scientific and Technical Information of China (English)

    Yasumitsu Hirano; Kaeko Oyama; Hiroshi Nozawa; Takuo Hara; Koichi Nakada; Masahiro Hada; Takeshi Takagi; Makoto Hirano

    2006-01-01

    We report a case of surgically proved left-sided torsion of the greater omentum that caused secondary by untreated inguinal hernia. Case A 36-year-old man presented to our hospital with abdominal pain. He had been diagnosed with a left inguinal hernia, but he had not received any treatments. Contrast-enhanced computed tomography (CT) of the abdomen showed a large fat density mass below the Sigmoid colon and left inguinal hernia with incarcerated fat. Exploratory laparotomy revealed torsion of the greater omentum with small bloody ascites. The greater omentum was twisted into one and a half circles and entered into a left inguinal hernia. An omentectomy with a repair of left inguinal hernia was performed. A resected omentum was submitted for pathological examination, which showed hemorrhagic infarction. Omental torsion is a rare cause of acute abdominal pain but should be included in the differential diagnoses of acute abdomen, especially in patients with untreated inguinal hernia.

  18. Peritoneal Mesothelioma

    Science.gov (United States)

    ... abdomen, on the surface of the omentum and visceral organs. Because of its relation to the abdomen, ... abdomen. Other symptoms related to abdominal mesothelioma include: Pain in the abdomen Weight loss and loss of ...

  19. New draft.cdr

    African Journals Online (AJOL)

    HP USER

    Infection was recorded in several visceral organs with omentum having the highest prevalence (35.29%) and the lungs ... which pass out in the faeces of the host and are ingested by ... pain, colic, loss of appetite, emaciation and unthriftiness.

  20. Gallstone ileus in an ‘asymptomatic’ parastomal hernia

    Science.gov (United States)

    Jayamanne, H; Brown, J

    2016-01-01

    Parastomal hernias are common and often asymptomatic. We report the first known case in which later, acute symptoms developed owing to gallstone ileus in a sac containing both omentum and small bowel. Urgent computed tomography established the diagnosis. PMID:27241611

  1. Gallstone ileus in an 'asymptomatic' parastomal hernia.

    Science.gov (United States)

    Jayamanne, H; Brown, J; Stephenson, B M

    2016-09-01

    Parastomal hernias are common and often asymptomatic. We report the first known case in which later, acute symptoms developed owing to gallstone ileus in a sac containing both omentum and small bowel. Urgent computed tomography established the diagnosis.

  2. Huge, irreducible femoral hernia interpreted as a preperitoneal lipoma in radiological findings

    Directory of Open Access Journals (Sweden)

    Paweł Osemek

    2010-03-01

    Full Text Available Occurrence of pathological masses in the inguinal region, mimicking hernias, is an important surgical and radiologicalproblem. Presence of a hernial sac is the determining factor. Herein, we present a case of irreducible femoral herniawith the greater omentum in its sac, interpreted as a preperitoneal lipoma in ultrasonography and computedtomography depictions. The patient underwent Rutkow tension-free hernioplasty with sac revision and dissectionof the greater omentum.

  3. The Putative Role of Human Peritoneal Adipocytes in the Fight against Bacteria: Synthesis of the Antimicrobial Active Peptide DEFA1-3

    OpenAIRE

    2010-01-01

    Background: Spontaneous peritonitis is a rather rare event, even in peritoneal dialysis (PD). As defensins are natural antimicrobial peptides, we hypothesized that adipocytes as the major constituents of the omentum could play an important role in protecting against infection by generating defensin (DEFA1-3). Methods: We isolated adipocytes from the omentum majus and conducted qualitative and quantitative RT-PCR and immunohistochemical analyses. Results: For the first time described, we were ...

  4. Primary omental malignant mixed Müllerian tumor in a 67-year-old woman

    Institute of Scientific and Technical Information of China (English)

    魏丽惠; 王建六; 张岫屏; 崔恒; 沈丹华; 钱和年

    2002-01-01

    @@Malignant mixed Müllerian tumors (MMMTs) are highly aggressive neoplasms composed of sarcomatous and carcinomatous elements commonly encountered in the female genital tract and rarely occur in extragenital sites. Most of extragenital MMMTs develop from the peritoneum. To our knowledge, only 25 cases have been described in the literature. Among them, only 2 cases have arised in the major omentum.1 Here we report a case of a 67-year-old female with primary MMMT of the major omentum.

  5. Parallel Profiles of Inflammatory and Effector Memory T Cells in Visceral Fat and Liver of Obesity-Associated Cancer Patients.

    Science.gov (United States)

    Conroy, Melissa J; Galvin, Karen C; Doyle, Suzanne L; Kavanagh, Maria E; Mongan, Ann-Marie; Cannon, Aoife; Moore, Gillian Y; Reynolds, John V; Lysaght, Joanne

    2016-10-01

    In the midst of a worsening obesity epidemic, the incidence of obesity-associated morbidities, including cancer, diabetes, cardiac and liver disease is increasing. Insights into mechanisms underlying pathological obesity-associated inflammation are lacking. Both the omentum, the principal component of visceral fat, and liver of obese individuals are sites of excessive inflammation, but to date the T cell profiles of both compartments have not been assessed or compared in a patient cohort with obesity-associated disease. We have previously identified that omentum is enriched with inflammatory cytokines, chemokines and T cells. Here, we compared the inflammatory profile of T cells in the omentum and liver of patients with the obesity-associated malignancy oesophageal adenocarcinoma (OAC). Furthermore, we assessed the secreted cytokine profile in OAC patient serum, omentum and liver to assess systemic and local inflammation. We observed parallel T cell cytokine profiles and phenotypes in the omentum and liver of OAC patients, in particular CD69(+) and inflammatory effector memory T cells. This study reflects similar processes of inflammation and T cell activation in the omentum and liver, and may suggest common targets to modulate pathological inflammation at these sites.

  6. The use of an anterior abdominal wall peritoneal flap in the laparoscopic repair of vesicouterine fistula.

    Science.gov (United States)

    Tasdemir, Nicel; Abali, Remzi; Celik, Cem; Yazici, Cenk Murat; Akkus, Didem

    2014-01-01

    Vesicouterine fistula (VUF) is a rare type of genitourinary fistula. Lower-segment cesarean section is the leading cause of VUF. Patients mostly present with the classical triad of menouria, amenorrhea, and urinary incontinence, with the history of a previous cesarean section. Conservative management with catheterization and open, laparoscopic, and robotic surgeries are the prescribed treatment options. We present the case of a 35-year-old woman who presented with cyclical menouria and urinary incontinence. After diagnosis of VUF by cystoscopy, the laparoscopic approach was chosen. During the procedure, we used anterior abdominal wall peritoneum and adjacent adipose tissue interposition for the first time, instead of omental interposition, because of the unavailability of omentum. The postoperative period was uneventful, and the procedure was successful. In conclusion, the laparoscopic approach is feasible and the anterior abdominal wall peritoneal flap can be used instead of omentum for tissue interposition when the omentum is not available.

  7. Primary Teratoma of the Lesser Sac: Lesser Sac Teratoma

    Directory of Open Access Journals (Sweden)

    Brandon M. Hardesty

    2012-01-01

    Full Text Available Germ cell tumors predominantly involve the gonads but may rarely be found outside of the gonads, primarily in midline structures. We describe the case of a 27-year-old male with an asymptomatic 8 cm teratoma located within the lesser sac of his omentum. This is the fourth case of a teratoma located within the lesser sac of the omentum, which provides the opportunity to make some comparisons. Finally, we discuss some of the etiologic theories behind extragonadal germ cell tumors and how they relate to teratomas in the lesser sac.

  8. Femoral hernia containing strangulated ileum along with the uterus and both ovaries: a first case report.

    Science.gov (United States)

    Ay, A; Agac Ay, A; Kaptanoglu, B; Ozer, S; Akalin, C

    2012-06-01

    Strangulated femoral hernia is a common surgical emergency. The contents of the hernial sac commonly include omentum and small bowel, but, occasionally, strangulation of other organs such as Meckel's diverticulum, stomach, ovary, or appendix may occur, resulting in unusual clinical presentations. We report of a case with strangulated femoral hernia containing the uterus and both ovaries, and this is the first report of such a case. We believe that it is important to take into consideration herniation of the uterus and ovaries with omentum or small bowel into the femoral canal to prevent various complications related to the reproductive functions of the patient.

  9. Early Monitoring of the Viability of the Buried Intrathoracic Omental Flap: A Feasibility Study

    NARCIS (Netherlands)

    J.J. van Wingerden; J.M.P. Collins; E.H. Coret; P.J.J. Schröder

    2010-01-01

    Purpose. The value of mobile, high-resolution gray-scale and color Doppler ultrasonography (US) in the immediate postoperative, intensive care setting for monitoring the buried flap and vascular pedicle of the laparoscopic or transdiaphragmatic harvested omentum for intrathoracic reconstruction was

  10. Laparoscopic repair of strangulated Morgagni hernia

    OpenAIRE

    2007-01-01

    Abstract A 73 year old man presented with vomiting and pain due to a strangulated Morgagni hernia containing a gastric volvulus. Laparoscopic operation allowed reduction of the contents, excision of necrotic omentum and the sac, with mesh closure of the large defect. A brief review of the condition is presented along with discussion of the technique used.

  11. Laparoscopic repair of strangulated Morgagni hernia

    Directory of Open Access Journals (Sweden)

    Kelly Michael D

    2007-10-01

    Full Text Available Abstract A 73 year old man presented with vomiting and pain due to a strangulated Morgagni hernia containing a gastric volvulus. Laparoscopic operation allowed reduction of the contents, excision of necrotic omentum and the sac, with mesh closure of the large defect. A brief review of the condition is presented along with discussion of the technique used.

  12. Omental Approach to Functional Recovery After Cerebrovascular Disease

    NARCIS (Netherlands)

    Konieczny, Marek J.; Ri, Song-Jin; Georgiadis, Janniko R.

    OBJECTIVE: To review and synthesize the clinical literature regarding risks and benefits of omentum transplantation and transposition surgery in patients with ischemic stroke of other etiology (non-MMD) and Moyamoya disease (MMD), and to evaluate the evidence for biological underpinnings of the

  13. Intraperitoneal granulomatous foreign body reaction after accidental perforation of the abdominal wall. Case report

    DEFF Research Database (Denmark)

    Lanng, C; Winther-Nielsen, H; Hougen, H P

    2013-01-01

    After an accidental perforation by a wooden stake of the abdominal wall and distal ileum a 28-year-old man developed an aggressive granulomatous foreign body reaction of the greater omentum with high fever and abdominal pain. The patient was cured by omental resection and prednisone treatment....

  14. Hydrophobicity of peritoneal tissues in the rat

    NARCIS (Netherlands)

    Gomez-Suarez, C; Bruinsma, GM; Rakhorst, G; van der Mei, HC; Busscher, HJ

    2002-01-01

    In this study, an inventory of the hydrophobicity of peritoneal tissues in the living rat was made. Peritoneal tissues were divided into mesentery (i.e., omentum) and parietal and visceral peritoneum and their hydrophobicity was determined by the sessile drop method. All peritoneal tissues were hydr

  15. Strangulated umbilical hernia in a child.

    OpenAIRE

    1983-01-01

    We describe a case of strangulated umbilical hernia in a girl aged 5 years. She presented with an acute inflammatory lesion at the umbilicus which was initially thought to be due to cellulitis with possible abscess formation. Exploration revealed an umbilical hernia containing necrotic greater omentum.

  16. Parathymic lymph nodes during growth and rejection of intraperitoneally inoculated tumor cells

    NARCIS (Netherlands)

    Dullens, H F; Rademakers, L H; Cluistra, S; Van Os, R; Dux, K; Den Besten, P J; Den Otter, W

    1991-01-01

    The omental lymphoid organ (OLO) is a part of the greater omentum composed of vascularized milky spots situated between fat cells and containing lymphocytes, plasma cells and macrophages. We analysed the disappearance of intraperitoneally injected tumor cells from the peritoneal cavity and their

  17. The Role of the Omental Microenvironment in Ovarian Cancer Metastatic Colonization

    Science.gov (United States)

    2012-08-01

    allowed us to rule out a requirement for B cells, T cells, or NK cells for ovarian cancer cell lodging within milky spots, confirming and expanding...Anatomy, embryology , and surgical applications. Surg Clin North Am 2000, 80:275–93–xii. 9. Collins D, Hogan AM, O’Shea D, Winter DC: The omentum

  18. Omental Lipid-Coated Mesh

    Science.gov (United States)

    2011-06-16

    civilian medicine. REFERENCES: 1. Takada T, Kamei Y, Iwata T, et al. Effect of Omental Lipid Fraction on Enhancement of Skin Flap Survival. Annals of...Characterization of Feline Omentum Lipids. Lipids, 1987; 22:229-235. 7. Nottebaert M, Lane J, Juhn A, et al. Omental Angiogenic Lipid Fraction and

  19. Desmoplastic small round cell tumor of the lung:case report

    Institute of Scientific and Technical Information of China (English)

    WANG Zhao-ming; XIAO Wen-bo; ZHENG Shu-sen

    2007-01-01

    @@ Desmoplastic small round cell tumor(DSRCT)is a clinically and morphologically well-defined neoplasm.1 This highly aggressive malignant small cell neoplasm tends to affect adolescents and young adults and occurs predominantly in the abdomen,pelvis,and omentum.1,2 DSRCT in the lung is extremely rare.

  20. The microenvironment of visceral adipose tissue and liver alter natural killer cell viability and function.

    Science.gov (United States)

    Conroy, Melissa J; Fitzgerald, Vivienne; Doyle, Suzanne L; Channon, Shauna; Useckaite, Zivile; Gilmartin, Niamh; O'Farrelly, Cliona; Ravi, Narayanasamy; Reynolds, John V; Lysaght, Joanne

    2016-12-01

    The role of NK cells in visceral adipose tissue (VAT) and liver inflammation in obesity is not fully understood. This study investigated the frequency, cytokine expression, chemokine receptor, and cytotoxicity receptor profile of NK cells in the blood, omentum, and liver of patients with the obesity-associated cancer, oesophageal adenocarcinoma (OAC). The effect of chronically inflamed tissue microenvironments on NK cell viability and function was also examined. We identified significantly lower NK cell frequencies in the liver of OAC patients compared with healthy controls and within the omentum and liver of OAC patients compared with blood, whereas IL-10-producing populations were significantly higher. Interestingly, our data suggest that reduced frequencies of NK cells in omentum and liver of OAC patients are not a result of impaired NK cell chemotaxis to these tissues. In fact, our functional data revealed that secreted factors from omentum and liver of OAC patients induce significant levels of NK cell death and lead to reduced percentages of TNF-α(+) and NKP46(+) NK cells and higher frequencies of IL-10-producing NK cells. Together, these data suggest that the omental and hepatic microenvironments of OAC patients alter the NK cell phenotype to a more anti-inflammatory homeostatic role. © Society for Leukocyte Biology.

  1. The Impact of Radiation on an Unusual Case of Omental Epithelioid Angiosarcoma

    Directory of Open Access Journals (Sweden)

    Sumana Narayanan

    2015-01-01

    Full Text Available Epithelioid angiosarcoma is a rare high-grade tumor with irregular vascular morphology. We report an unusual case of intra-abdominal epithelioid angiosarcoma affecting the omentum and peritoneal surfaces resulting in significant hemorrhagic and inflammatory changes. As in other cases of this tumor this patient had previously undergone radiation treatment for a history of cervical cancer.

  2. Download this PDF file

    African Journals Online (AJOL)

    de France (IF), SA Mutton Merino (SAMM), Dohne Merino (DM), FM and Merino as sire .... for slaughter at respectively 22, 31, 40 or 49 kg live ma5.sin .... 0,856. Slomach & intest (kg). 3,44. 0,431. 12,56. 0,720. Omentum fat (kg) .... LS Mean ::!

  3. Aktueller Stand der plastisch-rekonstruktiven Chirurgie aus der Sicht der Thoraxchirurgie

    Directory of Open Access Journals (Sweden)

    Rupprecht, Holger

    2012-12-01

    Full Text Available Bronchoplastic techniques: Plastic-reconstructive techniques in thoracic surgery have led to significant reductions of morbidity and mortality. Particulary the so-called sleeve resections are now commonplace in non-small cell carcinoma in stage I–IIIA, with rather similar five-year survival as conventional resections. Even with infiltration of large vessels (T4-stage, this technique can be applied even in the curative approach, e.g., replacement of the pulmonary artery by a vascular prosthesis (“double sleeve resection”.Extended resection of the anterior and lateral chest wall: Malignant tumors of the chest wall are caused by infiltration of the so-called T3-carcinoma of the lung, by primary bone tumors (e.g., chondrosarcoma or by osseous metastases from extrathoracic malignancies (e.g., breast cancer. After “en bloc-resection” of the chest wall including the surrounding lung parenchyma, the large defect is covered by a muscle rotation flap (M. latissimus dorsi. Sometimes these muscle flaps can not be used, for example in cachexia. In these cases, the bony thoracic defect is reconstructed by a Goretex-patch (Goretex Dualmesh. Then the patient undergoes laparotomy or laparoscopy and dissection of the omentum of the great curvature of the stomach while preserving the right epiploic artery. Through a subcutaneous tunnel, the omentum is displaced to the thoracic wall to cover the Goretex-patch. To accelerate the wound healing, the omentum is covered with a polyurethane sponge, which is pressed with a suction of 125 mm Hg (vacuum therapy. At about 4 weeks, the healed omentum can be covered with a split skin graft.Intrathoracic infections: Severe thoracic infections (empyema, lung abscess are usually caused by a pneumonia (80% or are the consequence of operative complications (e.g., bronchial stump insufficiency.The infection is not curable with the conventional irrigation drains. Often the muscle rotation flaps fail, too. The combination of

  4. A Case of Morgagni Hernia Resulting with Respiratory Arrest

    Directory of Open Access Journals (Sweden)

    Cavit Çöl

    2011-05-01

    Full Text Available Morgagni’s hernia is seen at a rate of 3-4% among all diaphragmatic hernias. It develops from a defect in the pleuroperitoneal membrane. Herniation of the omentum is seen most commonly, that of the colon frequently, and herniation of small bowel and stomach is seen rarely. When being examined due to anemia and dyspnea, a 53-year-old male patient suffered from a respiratory arrest and was hence intubated and placed under treatment at the intensive care unit. On radiological examination, a giant diaphragmatic hernia was observed bilaterally, more marked on the right side. On laparotomy, especially on the right side, the caecum, the ascending colon, the transverse colon, the appendix, the omentum and part of the small bowel was seen to be herniated. Primary diaphragmatic repair + right hemicolectomy + end-to-end ileo-transversostomy was performed. We have reported this case because it was a giant hernia which caused respiratory arrest.

  5. The laparoscopic repair of a morgagni hernia in a child.

    Science.gov (United States)

    Ra, Yong Joon; Huh, Up; Lee, Sang-Gwon; Je, Hyung Gon

    2011-02-01

    A 12-year-old female presented with the abnormal findings on the chest PA. The chest CT revealed a retrosternal defect of the diaphragm and a fatty opacity in the pleural cavity, resulting in a diagnosis of Morgagni hernia. It was decided to undergo a laparoscopic surgery. The retrosternal defect of the diaphragm measuring 3.5 cm in diameter was found, through which a portion of the greater omentum and the fatty tissue connected with the falciform ligament were herniated into the pleural cavity. The greater omentum was pushed back into the peritoneal cavity and the fatty tissue connected with falciform ligament was excised. The mediastinal pleura was plicated and the defect of the diaphragm was repaired primarily. Immediately after the operation, the patient developed a right pneumothorax for which a chest tube was inserted. She was discharged at the post-operative third day without any further complications.

  6. Morgagni hernia: A rare case report and review of literature.

    Science.gov (United States)

    Pattnaik, Manoj Kumar; Sahoo, Sarada Prasanna; Panigrahy, Sameer Kumar; Nayak, Kalyani Bala

    2016-01-01

    Morgagni hernias (MHs) are rare and constitute about 2% of all diaphragmatic hernias. Although uncommon, it has potential for considerable morbidity if the diagnosis is missed. An elderly woman with known history of chronic asthma and constipation presented to us with vague right-sided chest pain. General physical examination was unremarkable and coincidentally diagnosed to have diabetes mellitus. Chest roentgenogram posteroanterior view revealed a right paracardiac opacity and right lateral view showed the opacity in the peridiaphragmatic area of anterior mediastinum. Computed tomographic scan of the chest and abdomen revealed a right-sided MH containing omental fat. Standard right posterolateral thoracotomy was done, and there was a rent at the medial end of the xiphoid process with hernia sac containing the omentum, which was compressing adjacent lungs and heart. The sac was opened; redundant omentum was resected, and rent closed with intercostal muscle with prolene. MH being rare must be addressed with appropriate investigation to prevent unnecessary morbidity and mortality.

  7. Small bowel obstruction- a surprise.

    Science.gov (United States)

    Mathew, Jeffrey Daniel; Cp, Ganesh Babu; M, Balachandar; M, Ramanathan

    2015-01-01

    Trans - omental hernia is very rare, accounting to 1-4% of all internal hernias which is an unusual cause of small bowel obstruction. Here we present a case report of a small bowel obstruction in a female due to trans - omental hernia presenting with central abdominal pain, distension and bilious vomiting. She had no previous history of trauma, surgery. Plain X-ray abdomen erect showed multiple air fluid levels with dilated small bowel loops. Emergency laparotomy revealed a segment of congested small bowel loop (ileum) through a defect in greater omentum. On table the herniated bowel loop was reduced and the defect in greater omentum was closed primarily. There was no necessity for bowel resection as it regained normal colour after reduction. Postoperative period was uneventful with complete resolution of symptoms. This case is presented for its rarity and its importance in clinical differential diagnosis of acute abdomen due to small bowel obstruction.

  8. Banda gástrica ajustável laparoscópica: alternativa técnica

    Directory of Open Access Journals (Sweden)

    Pablo Roberto Miguel

    Full Text Available In these paper we are presenting a technical alternative to laparoscopic adjustable gastric banding. From January 1999 to April 2000, 60 patients with mean body mass index (BMI of 40,7 kg/m2 underwent laparoscopic adjustable gastric banding. The new technique is performed in two steps. In the first step, an isolation instrument (laparoscopic finger is inserted through the lesser sac, next to the junction of diaphragmatic crura, including the lesser omentum in order to pull the band catheter. The second step separates the lesser omentum from the right side of the stomach.There was no mortality and the morbidity was 11,6% (1 slippage of the band and 6 trocar port seroma. The new technique was performed in all patients with no conversion to open procedure. We didn't have respiratory complications. This technical alternative is safe and easily performed, helping to prevent transoperative perforations.

  9. Autobuttressing of colorectal anastomoses using a mesenteric flap.

    LENUS (Irish Health Repository)

    Mohan, H M

    2013-12-01

    Anastomotic leakage is a common and dreaded complication of colorectal surgery. Many different approaches have been tried to attempt to reduce leakage and associated morbidity. The concept of reinforcement of an anastomosis by buttressing is well established. Techniques described include using sutures, native omentum, animal or synthetic material. We report a technique for buttressing using a mesenteric flap to envelope the anastomosis. The primary rationale is to reduce clinical sequelae of anastomotic leakage by promoting local containment, as well as providing a scaffold for healing. Using autologous tissue provides a safe, time-efficient and cost-effective buttress without the risks of infection or reaction associated with foreign material. A mesenteric flap is particularly useful in patients in whom omentum is not available due to previous surgery, or to fill the dead space posterior to a low anastomosis within the pelvis.

  10. Pedicle omental graft created by laparoscopic surgery for filling a radiation-induced ulcer in a woman with breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Ida, Katsuya [Kosai General Hospital, Shizuoka (Japan)

    2002-06-01

    In patients with advanced or recurrent breast cancer, it is difficult to reconstruct chest wall ulcers due to postoperative irradiation, which is often infected. We present a laparoscopic technique for creating and mobilizing an omental flap. A 63-year-old woman diagnosed with parasternal lymph node metastases from left breast cancer 11 months after standard radical mastectomy underwent lymph node resection with radiation therapy. She developed ulceration of the irradiated chest wall 3 years and 10 months later. An omental flap obtained by laparoscopy was used to fill the space after the radiation-induced ulcer was resected and covered with a free skin graft. The skin graft adapted to the omentum. This laparoscopic procedure is more cosmetrically acceptable and less invasive than laparotomy in obtaining the omentum while yielding equivalent results in chest wall reconstruction. (author)

  11. Adenocarcinoma arising in an ileal duplication cyst with peritoneal seeding: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Suk; Hong, Sung Hwan; Park, Hong Suk; Lee, Eil Seong; Kang, Ik Won [Hallym Univ. College of Medicine, Chunchon (Korea, Republic of)

    2001-05-01

    We report a case in which mucinous adenocarcinoma arose in a duplication cyst at the distal ileum with intraperitoneal seeding. A thirty-three-year-old male patient presented with abdominal distension. Ultrasonography, CT and MR imaging revealed a dumbbell-shaped cystic mass adherent to the small intestine. The wall of the mass was thickened in two areas and contained inhomogeneous materials. A large amount of ascites with irregular masses along the greater omentum were seen present. Surgery revealed a duplication cyst adherent to the ileum. Pathologic examination proved that the thickened portions of the wall of the mass were mucinous adenocarcinoma, and that the nodules on the greater omentum were metastatic adenocarcinoma.

  12. Banda gástrica ajustável laparoscópica: alternativa técnica Laparoscopic adjustable gastric banding: technical alternative

    Directory of Open Access Journals (Sweden)

    Pablo Roberto Miguel

    2001-06-01

    Full Text Available In these paper we are presenting a technical alternative to laparoscopic adjustable gastric banding. From January 1999 to April 2000, 60 patients with mean body mass index (BMI of 40,7 kg/m2 underwent laparoscopic adjustable gastric banding. The new technique is performed in two steps. In the first step, an isolation instrument (laparoscopic finger is inserted through the lesser sac, next to the junction of diaphragmatic crura, including the lesser omentum in order to pull the band catheter. The second step separates the lesser omentum from the right side of the stomach.There was no mortality and the morbidity was 11,6% (1 slippage of the band and 6 trocar port seroma. The new technique was performed in all patients with no conversion to open procedure. We didn't have respiratory complications. This technical alternative is safe and easily performed, helping to prevent transoperative perforations.

  13. [Multicystic peritoneal mesothelioma].

    Science.gov (United States)

    Horling, E W; Albert, C; Bassermann, R; Stiegler, H

    1996-01-01

    We report on a 31-year-old man with a 29 x 15 x 15 cm large abdominal tumor who came to surgery under suspicion of echinococcus cyst of the liver. Histologically, the neoplasm could identified as multicystic peritoneal mesothelioma (synonyma: benign cystic mesothelioma). Additionally some cysts were located in the greater omentum and mesocolon. In contrast to our case the benign cystic mesotheliomas most commonly occur in young women, localized in the pelvis and abdomen and often complicated by postoperative local recurrence. We performed a resection of the right hemicolon and the omentum. Postoperatively no further therapy was necessary because of the benign appearance of the lesion. Close follow-up is required in these patients due to the disposition for recurrences.

  14. MORGAGNİ HERNİSİ: NADİR BİR AKUT BATIN NEDENİ

    OpenAIRE

    2005-01-01

    Morgagni hernia is a rare congenital diaphragmatic disease that is usually asymptomatic and discovered by chance during routine diagnostic tests performed for other pathologies. Here we present a case of strangulated Morgagni hernia in a 27 year-old man admitted with sign and symptoms of an acute abdomen. A CT scan confirmed the presence of the stomach, omentum, splenic flexura of colon and spleen in the left pleural cavity. An emergency laparotomy permitted reduction of the herniation an...

  15. Non-intubated laparoscopic repair of giant Morgagni’s hernia for a young man

    Science.gov (United States)

    Zhang, Miao; Wang, Heng; Liu, Dong; Pan, Xuefeng; Wu, Wenbin; Hu, Zhengqun

    2016-01-01

    An asymptomatic patient was admitted as his chest photograph and computed tomography scans showed a giant Morgagni’s hernia (MH). And it was repaired by laparoscopic approach under epidural anesthesia without endotracheal intubation. The hernia content of omentum was repositioned back into the abdominal cavity, and the diaphragmatic defect was repaired with composite mesh. Which indicated that non-intubated laparoscopic mesh repair via epidural anesthesia is reliable and satisfactory for MH. PMID:27621903

  16. Xanthogranulomatous pseudotumor of stomach induced by perforated peptic ulcer mimicking a stromal tumor.

    Science.gov (United States)

    Lai, Hsin-Yi; Chen, Jeon-Hor; Chen, Chi-Kuan; Chen, Yung-Fang; Ho, Yung-Jen; Yang, Mei-Due; Shen, Wu-Chung

    2006-10-01

    Perforation is a serious complication of peptic ulcer disease occurring in 5% of such patients. Occasionally, the perforation may be sealed off by the omentum or the adjacent organs. Sealed perforated ulcer with pseudotumor formation is very rarely encountered. Here we present a case of gastric pseudotumor induced by perforation of a peptic ulcer. The imaging features in a barium sulfate study and computed tomography mimic an intramural tumor of the stomach.

  17. UNILOCULAR OMENTAL CYST IN ADULT FEMALE PRESENTING AS HUGE ABDOMINAL LUMP: A RARE CASE REPORT

    Directory of Open Access Journals (Sweden)

    Himansu

    2015-05-01

    Full Text Available Omental cysts are rare entity with a prevalence of 1: 1,000,000 in adults and in 1: 20, 000 in children. We are reporting a case of a 30 year female patient with abdominal lump over epigastrium and left hypochondrium for 6 months; diagnosed on laparotomy as uniloculated omental cyst originating from lesser omentum. Omental cyst is a challenging diagnostic entity with varied presentations and a wide range of differential diagnosis has to be kept in mind.

  18. Multiplicity of Sites for Extrathymic T-cell Differentiation

    OpenAIRE

    Abo, Toru; Watanabe, Hisami; Sekikawa, Hiroho

    1993-01-01

    In addition to an intrathymic pathway of T-cell differentiation, extrathymic pathways of T-cell differentiation have been found to exist at multiple sites in the living bodies of both mice and humans. Such sites include the sinusoids in the liver, intraepithelial sites in the intestine, the splenic red pulp, the thymic medulla, the decidua in the uterus, and the omentum in the peritoneal cavity. Although extrathymic pathways are minimal in youth, they become predominant with aging and under c...

  19. Experimental study of the diagnostic potentialities of bioimpedance measurement in acute intestinal obstruction.

    Science.gov (United States)

    Rodin, A V; Pleshkov, V G; Leonov, S D; Bazhenov, S M

    2013-10-01

    The dynamics of impedance values of the small and large intestine, parietal peritoneum, and greater omentum was analyzed during different periods of experimental acute intestinal obstruction. The impedance was below the normal, which indicated progressive microcirculatory disorders and necrosis of the intestinal wall. The histomorphological picture of healing of anastomoses created after resection of the intestine with consideration for bioimpedance values and of anastomoses created after resection of the intestine in a priori viable tissues virtually did not differ.

  20. A rare presentation of an acute appendicitis

    Science.gov (United States)

    Kordzadeh, Ali; Lorenzi, Bruno; Kalyan, Jiten P.; Hanif, Muhammad A.; Charalabopoulos, Alexandros

    2017-01-01

    Paraumbilical hernia sac usually contains omentum, bowel loop and rarely appendicular epiploicae, metastatic deposits and vermiform appendix. Presentation of acute appendicitis in a paraumbilical hernia is rare and limited to few case reports in the literature. Herein, we would like to report a case of a successfully treated acute appendicitis presenting in a paraumbilical hernia in an 84-year-old lady with 6-month follow-up. PMID:28096326

  1. The Role of the Omental Microenvironment in Ovarian Cancer Metastatic Colonization

    Science.gov (United States)

    2013-08-01

    eBioscience, San Diego, CA) according to the manufacturer’s instructions. Transwell Migration Assay All migration assays used the same physical setup, with 1...colonization of omental milky spots. Another possible source of the chemotactic properties of the omentum is the abundance of endothelial cells found...ALLIANCE Intergroup Trial: A211102 Role: PI Title: Role of metformin in inhibition of Akt/IL6 signaling during initiation of TNBC. Completed Support

  2. Multicystic mesothelioma with endometriosis.

    Science.gov (United States)

    Groisman, G M; Kerner, H

    1992-12-01

    A multicystic mesothelioma of the omentum in a 36 year old woman consisted of a multicystic mass with foci of typical endometriosis and 'necrotic pseudoxanthomatous nodules'. The presence of endometriosis within multicystic mesothelioma has never been reported. Our findings support the hypothesis that endometriosis plays a rôle in the pathogenesis of multicystic mesothelioma and that this is a reactive rather than a neoplastic lesion.

  3. A Rare Case of Benign Multicystic Peritoneal Mesothelioma: A Clinical Dilemma

    OpenAIRE

    Gupta, Ashish; Rao, Harish K.; Pande, Raghav; Gupta, Soumya

    2011-01-01

    A middle aged housewife presented with an anterior abdominal wall mass which was slowly growing over a period of 1 years over the midline scar of previous caesarean section with cystic degeneration in a part of the tumor. Fine needle aspiration cytology revealed a papillary serous cystadenoma. At exploratory laparotomy tumor was seen arising from the ventral surface of the parietal peritoneum with normal viscera, omentum and ovaries. The pathologist reported the tumor as Benign Multicystic Pe...

  4. Omental fibroma: CT and US findings

    Energy Technology Data Exchange (ETDEWEB)

    Paksoy, Y.; Acikgoezoglu, S.; Oedev, K. [Department of Radiology, Selcuk Univ., Konya (Turkey); Sahin, M. [Department of General Surgery, Selcuk Univ., Konya (Turkey); Oemeroglu, E. [Department of Pathology, Selcuk Univ., Konya (Turkey)

    1998-10-01

    The US, CT, and X-ray findings in a patient with omental fibroma of the lesser omentum are described. Ultrasound showed a solid mass with cystic areas in the central region. At CT the lesion showed peripheral enhancement and central hypodensity. On X-ray studies with barium, there was border distortion in the lesser curvature of the stomach. The mass was resected surgically. A pathologic diagnosis of fibroma was confirmed. (orig.) (orig.) With 5 figs., 8 refs.

  5. Peritoneal Lavage in the Diagnosis of Acute Surgical Abdomen Following Thermal Injury.

    Science.gov (United States)

    1995-01-01

    disease, others6𔄂-15 have confirmed his Sepsis syndrome 13 findings. Hoffman16 reviewed the literature on the use of Abdominal distension 11 Ileus 7 DPL...developed sepsis, ileus , and abdominal distention 98 Fourteen of the 17 patients died, a mortality rate of 82%. days following injury. Lavage fluid...the greater omentum. The difficulty in diag- whelming pulmonary sepsis or multisystem organ failure, nosing biliary disease with DPL has been

  6. [A case of gallstone ileus which the cholecystoduodenal fistula closed spontaneously after laparoscopic-assisted simple enterolithotomy].

    Science.gov (United States)

    Okubo, Hitoshi; Nogawa, Tatsuhiko; Jibiki, Masaaki

    2006-10-01

    A 47-year-old woman complaining of diarrhea and vomiting was admitted on the suspicion of gallstone ileus 4 days after onset. Upper gastrointestinal radiography by Gastrografin showed a cholecystoduodenal fistula. Laparoscopic-assisted simple enterolithotomy was performed. The omentum was severely adherent to the gall bladder and fistula, though biliary surgery was not performed. Without second look operation, for cholecystoduodenal fistula closed spontaneously.

  7. Cystic Echinococcosis: A Case of Extrahepatic Intra-Abdominal Involvement

    Science.gov (United States)

    Carvalho, André; Fernandes, Teresa; Gonçalves, José

    2017-01-01

    Hydatid disease, or echinococcal disease, is a parasitic infestation caused by the larval stage of the Echinococcus tapeworm and it primarily affects the liver and lung but involvement of other organs is also possible secondary to peritoneal seeding or hematogeneous dissemination. We describe a rare case of extensive abdominal disease, with lesions affecting the liver, peritoneum, and lesser omentum, requiring aggressive surgical intervention. Complementary diagnostic exams were crucial to reach the diagnosis and evaluate the extension of the disease. PMID:28194292

  8. TRANSPLANTATION OF CRYOPRESERVED FETAL LIVER CELLS SEEDED INTO MACROPOROUS ALGINATE-GELATIN SCAFFOLDS IN RATS WITH LIVER FAILURE

    Directory of Open Access Journals (Sweden)

    D. V. Grizay

    2015-01-01

    Full Text Available Aim. To study the therapeutic potential of cryopreserved fetal liver cells seeded into macroporous alginategelatin scaffolds after implantation to omentum of rats with hepatic failure.Materials and methods.Hepatic failure was simulated by administration of 2-acetyl aminofl uorene followed partial hepatectomy. Macroporous alginate-gelatin scaffolds, seeded with allogenic cryopreserved fetal liver cells (FLCs were implanted into rat omentum. To prevent from colonization of host cells scaffolds were coated with alginate gel shell. Serum transaminase activity, levels of albumin and bilirubin as markers of hepatic function were determined during 4 weeks after failure model formation and scaffold implantation. Morphology of liver and scaffolds after implantation were examined histologically. Results. Macroporous alginate-gelatin scaffolds after implantation to healthy rats were colonized by host cells. Additional formation of alginate gel shell around scaffolds prevented the colonization. Implantation of macroporous scaffolds seeded with cryopreserved rat FLCs and additionally coated with alginate gel shell into omentum of rats with hepatic failure resulted in signifi cant improvement of hepatospecifi c parameters of the blood serum and positive changes of liver morphology. The presence of cells with their extracellular matrix within the scaffolds was confi rmed after 4 weeks post implantation.Conclusion. The data above indicate that macroporous alginate-gelatin scaffolds coated with alginate gel shell are promising cell carriers for the development of bioengineered liver equivalents.

  9. Embryonic Stem Cells-loaded Gelatin Microcryogels Slow Progression of Chronic Kidney Disease

    Institute of Scientific and Technical Information of China (English)

    Xiao-Dong Geng; Wei Zheng; Cong-Mei Wu; Shu-Qiang Wang; Quan Hong; Guang-Yan Cai; Xiang-Mei Chen

    2016-01-01

    Background: Chronic kidney disease (CKD) has become a public health problem.New interventions to slow or prevent disease progression are urgently needed.In this setting, cell therapies associated with regenerative effects are attracting increasing interest.We evaluated the effect of embryonic stem cells (ESCs) on the progression of CKD.Methods: Adult male Sprague-Dawley rats were subjected to 5/6 nephrectomy.We used pedicled greater omentum flaps packing ESC-loaded gelatin microcryogets (GMs) on the 5/6 nephrectomized kidney.The viability of ESCs within the GMs was detected using in vio two-photon fluorescence confocal imaging.Rats were sacrificed after 12 weeks.Renal injury was evaluated using serum creatinine, urea nitrogen, 24 h protein, renal pathology, and tubular injury score results.Structural damage was evaluated by periodic acid-Schiff and Masson trichrome staining.Results: In vitro, ESCs could be automatically loaded into the GMs.Uniform cell distribution, good cell attachment, and viability were achieved from day 1 to 7 in vitro.After 12 weeks, in the pedicled greater omentum flaps packing ESC-loaded GMs on 5/6 nephrectomized rats group, the plasma urea nitrogen levels were 26% lower than in the right nephrectomy group, glomerulosclerosis index was 62% lower and tubular injury index was 40% lower than in the 5/6 nephrectomized rats group without GMs.Conclusions: In a rat model of established CKD, we demonstrated that the pedicled greater omentum flaps packing ESC-loaded GMs on the 5/6 nephrectomized kidney have a long-lasting therapeutic rescue function, as shown by the decreased progression of CKD and reduced glomerular injury.

  10. Seizure attack and Morgagni diaphragmatic hernia: incidental diagnosis or direct correlation?

    Science.gov (United States)

    Zisa, Monica; Pulvirenti, Elia; Toro, Adriana; Mannino, Maurizio; Reale, Giulio; Di Carlo, Isidoro

    2011-03-01

    Asymptomatic Morgagni hernia can be discovered in adults as an incidental finding or because of acute gastrointestinal symptoms. We report a case of a 76-year-old man with an incidental diagnosis of seizure attack. Obesity and the increased abdominal pressure caused by abdominal muscles contraction during seizure could have contributed to the clinical presentation. The omentum, small bowel, and transverse colon were found in the right side of the chest using an open transabdominal approach. The hernia sac was excised and the diaphragmatic defect closed by direct suturing. The postoperative period was uneventful and the shortness of breath attributed to obesity disappeared.

  11. Asymptomatic congenital intrapericardial diaphragmatic hernia and epigastric hernia in the adult.

    Science.gov (United States)

    La Greca, Gaetano; Sofia, Maria; Randazzo, Valentina; Barbagallo, Francesco; Lombardo, Rosario; Soma, Pierfranco; Russello, Domenico

    2007-08-01

    The congenital intrapericardial hernia is a rare kind of diaphragmatic hernia. It is due to an embryologic defect of the central tendon of the diaphragm, often accompanied by other congenital malformations. This work presents a unique case report in the literature of the congenital association between intrapericardial diaphragmatic hernia and epigastric hernia in an adult woman. In spite of herniation of the colon and omentum the patient was completely asymptomatic, requesting surgery for an epigastric hernia for aesthetic reasons. The defect of the diaphragm was sutured and the abdominal wall was repaired with a prosthetic mesh.

  12. Intraabdominal desmoplastic small cell tumor: radiological aspects - a case report; Tumor de pequenas celulas desmoplasico intra-abdominal - relato de um caso

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Leonardo Velloso; Siciliano, Antonio Alexandre O.; D' Annunciacao, Gisele Esteves; Nunes, Vania Cristina S.R. [Hospital Universitario Clementino Fraga Filho, Rio de Janeiro, RJ (Brazil). Dept. de Radiologia; Marchiori, Edson [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Radiologia

    1999-06-01

    The authors describe a case of a 21-year-old white female admitted with abdominal pain and distension, as well as bowel movement alteration. A hard, lobulated and painful abdominal mass was found at physical exam and signs of ascitis were also presented. Abdominal and pelvic ultrasound and computed tomography demonstrated and heterogeneous mass, adhering to the anterior abdominal wall, extending from the umbilicus to the pelvis and displacing the urinary bladder inferiorly and bowel loops posteriorly. Cul-the-sac implants were also noted. The major omentum was diffusely infiltrated by nodules as laparotomy. A desmoplastic small cell tumor was found after histopathological analysis of the surgical specimen. (author)

  13. Intrahepatic ovulation

    Directory of Open Access Journals (Sweden)

    Artur L. Wozniak, HBSc

    2014-01-01

    Full Text Available Ectopic ovaries are a rare finding in the literature, with fewer than 50 published cases to date. This phenomenon has been found in the omentum, bladder, mesentery, and uterus; attached to the colon; inside the left labia majora; and in the kidney. Various etiologies have been proposed, including postsurgical or postinflammatory transplantation, malignant origins, and abnormal embryologic development. We report the ultrasonographic, computed tomographic (CT, and magnetic resonance (MR imaging of, what is to the best of our knowledge, the first case of an intrahepatic ectopic ovary.

  14. Ovarian endometrioid adenocarcinoma in a young woman with hemorrhagic shock due to tumor disintegration: A case report

    OpenAIRE

    Hiroyuki Takahashi; Sabine Kajita; Yuki Tazo; Haruko Iwase; Toshihide Matsumoto; Miki Hashimura; Makoto Saegusa

    2016-01-01

    Acute abdomen secondary to ovarian carcinoma is rare, especially in a young woman. A 28-year-old obese woman underwent bilateral salpingo-oophorectomy and omentectomy as emergency surgery. The specimen from the right ovarian adenocarcinoma was fragmented because the tumor had disintegrated. The largest fragment measured 14 × 8 × 2.5 cm. The left ovary had a solid adenocarcinomatous tumor measuring 6 × 5 × 3 cm. In addition, there were disseminated lesions in the greater omentum, peritoneum, p...

  15. Management of Patients with Hernia or Incisional Hernia Undergoing Surgery for Morbid Obesity

    Directory of Open Access Journals (Sweden)

    Ramon Vilallonga

    2011-01-01

    Full Text Available Morbidly obese patients (MOPs are predisposed to developing abdominal wall hernias with the potential complication of small bowel obstruction and other morbidity. We report our experience in treating morbidly obese patients. Hernia prophylaxis has been attempted as a means of decreasing the incisional hernia risk associated with weight loss surgery. The controversy regarding the optimal time and method of repair of abdominal wall hernias in patients undergoing open or laparoscopic gastric bypass is discussed with emphasis placed on either a simultaneous repair or splits of the omentum, and of leaving a plug in the hernia defect, to allow time to perform a delayed repair.

  16. Penetrating abdominal injuries in children in Nigeria.

    Science.gov (United States)

    Ameh, E A; Nmadu, P T

    1999-09-01

    This is a report of a retrospective study of 24 children managed for penetrating abdominal injury over 10 years, and it represents 34% of all abdominal injuries in children in that period. Falls onto sharp objects within and around the home were responsible for ten of the injuries, seven were injured by animal horns and four were sporting injuries. Violence and road traffic accidents were uncommon. Most patients (67%) had evisceration of omentum or intestine, and one of these was found at laparotomy to have a jejuno-jejunal intussusception. Seven children had injury to hollow viscera. There were three deaths, one each from overwhelming sepsis, tetanus and haemorrhage.

  17. The taruca (Hippocamelus antisensis) and the red brocket deer (Mazama americana) as intermediate hosts of Taenia hydatigena in Peru, morphological and molecular evidence.

    Science.gov (United States)

    Gomez-Puerta, Luis A; Pacheco, Joel; Gonzales-Viera, Omar; Lopez-Urbina, Maria T; Gonzalez, Armando E

    2015-09-15

    In the present report metacestodes were collected from the mesentery of a taruca (Hippocamelus antisensis) and from the omentum of a red brocket deer (Mazama americana) in Peru. Various metacestodes parameters, including rostellar hook characteristics, were measured. Molecular analysis was performed to amplify the mitochondrial cytochrome c oxidase subunit 1 gene from metacestode isolates. Metacestodes were identified as T. hydatigena by morphology and molecular methods. This constitutes the first molecular detection of T. hydatigena metacestodes in the taruca and the red brocket deer and demonstrates that these animal species are natural intermediate hosts for this parasite.

  18. A rare case of benign multicystic peritoneal mesothelioma: a clinical dilemma.

    Science.gov (United States)

    Gupta, Ashish; Rao, Harish K; Pande, Raghav; Gupta, Soumya

    2013-06-01

    A middle aged housewife presented with an anterior abdominal wall mass which was slowly growing over a period of 1 years over the midline scar of previous caesarean section with cystic degeneration in a part of the tumor. Fine needle aspiration cytology revealed a papillary serous cystadenoma. At exploratory laparotomy tumor was seen arising from the ventral surface of the parietal peritoneum with normal viscera, omentum and ovaries. The pathologist reported the tumor as Benign Multicystic Peritoneal Mesothelioma. It is a rare but clinically favourable neoplasm with wide excision as the definitive treatment. Of the 130 cases reported in the literature, it has the least incidence in the Indian Subcontinent.

  19. Case report: an unusual case of gallbladder cancer in an automotive worker.

    Science.gov (United States)

    Brandt-Rauf, P W; Branwood, A W

    1980-01-01

    Mucinous adenocarcinoma of the gallbladder was found at autopsy in a 65-year-old male. The tumor was composed predominantly of signet ring cells, an uncommon histologic form. In addition, there was an atypical pattern of metastasis, with cancer involving not only the walls of the cystic duct, large and small bowels, peritoneum, abdominal nodes, and omentum, but also the kidneys, ureters, lungs, and heart. Although the patient lacked the common predisposing factors for gallbladder cancer, he did work in an industry with a significant relative risk for the development of this cancer.

  20. Behandlungsergebnisse der primären und sekundären retroperitonealen Fibrose

    Directory of Open Access Journals (Sweden)

    Heidenreich A

    1999-01-01

    Full Text Available Der retroperitonealen Fibrose (RPF zugrunde liegt eine entzündliche Bindegewebsproliferation ungeklärter Ätiologie mit Bevorzugung des Retroperitoneums. Die Beteiligung des ableitenden Harntraktes manifestiert sich durch uni- oder bilaterale Ureterobstruktion bis hin zur Anurie und Urämie. Aufgrund der ungeklärten Ätiologie wird das therapeutische Vorgehen - konservativ versus operativ - kontrovers diskutiert. Im folgenden berichten wir über unsere Ergebnisse in der Behandlung der RPF. Von 1986 bis 1997 wurde bei 39 Patienten die Diagnose einer RPF gestellt, 21mal lag eine primäre, 18mal eine sekundäre RRF vor. 21 Patienten wiesen eine uni-, 16 Patienten eine bilaterale und 2 Patienten keine Harnstauung auf. Bei 19/21 Patienten erfolgte die primäre Entlastung der Niere mit anschließender Cortison- und/oder Azathioprintherapie über 6 Monate; eine Besserung sahen wir in allen Fällen, eine komplette Remission in 2 Fällen. Bei 19 Patienten war eine operative Intervention notwendig: 17mal Ureterolyse mit Intraperitonealisierung (n = 10 bzw. Omentum maius Ummantelung (n = 7. Bei 1 Patienten war die bilaterale Boari-Plastik, bei 1 Patienten ein bilaterales Ileum-Ureterinterponat notwendig. Bei 16/18 Patienten mit sekundärer RPF erfolgte die primäre Entlastung der Niere gefolgt von Ureterolyse und Omentum maius Ummantelung (n = 11, Harnleiter-Ileuminterponat (n = 3, Nephrektomie (n = 1 und endoluminale Ballondilatation (n = 3. Das Follow-up variiert zwischen 6 und 120 Monaten: 3 Patienten mit primärer RPF und 1 Patient mit sekundärer RPF entwickelten ein Rezidiv. Aufgrund der Therapieergebnisse unserer Serie halten wir die kombinierte operative/immunsupprimierende Behandlung bei der primären RPF für erfolgversprechend; dabei geben wir der präoperativen Cortisontherapie mit nachfolgender Ureterolyse und Omentum maius Ummantelung den Vorzug. Bei sekundärer RPF bietet sich die primäre operative Versorgung mittels Ureterolyse und

  1. An omental teratoma in a young girl

    Directory of Open Access Journals (Sweden)

    Bhushan N. Wani

    2011-12-01

    Full Text Available Teratoma is the most commonly encountered germ cell tumour among the most common ovarian tumours; however, teratomas of the omentum and mesentery are extremely rare. They are usually asymptomatic or can produce compressive symptoms. The imaging features are suggestive. The present report describes such a case of primary omental teratoma encountered in a young patient, which was managed by surgical resection. The histopathological examination confirmed the diagnosis of mature cystic teratoma. Germ cell tumors are congenital tumors containing derivatives of all the three germinal layers, frequently seen in gonads. But their occurrence in extragonadal sites, such as omental teratoma, is relatively rare.

  2. HEREDITARY ANGIOEDEMA IN CHILDREN — A RARE CLINICAL CASE IN THE PRACTICE OF THE ABDOMINAL SURGEON

    Directory of Open Access Journals (Sweden)

    Ye. Yu. Dyakonova

    2014-01-01

    Full Text Available Hereditary angioedema is a rare and dangerous hereditary disease, the differential diagnostics of which is very difficult up to date. Children with this disorder come with acute abdominal pain that may be caused by diseases of the digestive and urinary system, various gynecological diseases, and infectious processes in the body. The main task of the children's surgeon is to exclude acute surgical pathology and perform differential diagnostics with diseases such as acute appendicitis, Meckel diverticulum, intestinal obstruction, omentum infarction and the other as soon as possible. The article presents the clinical observation of a 14-year-old female patient with angioedema.

  3. Surgical Trap of a Routine Procedure. Scrotal Hernia with Concomitant Sliding of the Urinary Bladder – Case Report

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    Cybułka Bartosz

    2015-11-01

    Full Text Available The content of the hernial sac may comprise peritoneal cavity elements, such as small and large bowel loops, visceral adipose tissue, the greater omentum, appendix (amyand hernia, and Meckel's diverticulum. The sliding of part of the urinary bladder wall to the inguinal canal is rare, being observed in 1%-4% (0.5%-3% of inguinal hernia cases. Complete migration of the urinary bladder to the scrotum is considered a rare anomaly. As of today, 100 such cases have been described.

  4. Surgical management of moyamoya disease: a review.

    Science.gov (United States)

    Baaj, Ali A; Agazzi, Siviero; Sayed, Zafar A; Toledo, Maria; Spetzler, Robert F; van Loveren, Harry

    2009-04-01

    Moyamoya disease (MMD) is a progressive, occlusive disease of the distal internal carotid arteries associated with secondary stenosis of the circle of Willis. Symptoms include ischemic infarcts in children and hemorrhages in adults. Bypass of the stenotic vessel(s) is the primary surgical treatment modality for MMD. Superficial temporal artery-to-middle cerebral artery bypass is the most common direct bypass method. Indirect techniques rely on the approximation of vascularized tissue to the cerebral cortex to promote neoangiogenesis. This tissue may be in the form of muscle, pericranium, dura, or even omentum. This review highlights the surgical options available for the treatment of MMD.

  5. Post-pancreatitis Fat Necrosis Mimicking Carcinomatosis.

    Science.gov (United States)

    Smith, Joshua P; Arnoletti, J Pablo; Varadarajulu, Shyam; Morgan, Desiree E

    2008-01-01

    Acute pancreatitis can result in retroperitoneal fat necrosis, typically occurring in the peripancreatic region, with extension into the transverse mesocolon, omentum and mesenteric root. When evaluated with contrast enhanced computed tomography (CECT), acute peripancreatic post necrotic collections typically become lower in attenuation over time, and often appear as homogeneous fluid collections. Saponification as a complication of fat necrosis in patients with acute pancreatitis is a well recognized clinical entity. While retroperitonal fat necrosis is commonly seen on CECT, saponification is not a prominent imaging feature. We present a case of acute pancreatitis complicated by extensive saponification of fat throughout the retroperitoneum and peritoneal lining, mimicking carcinomatosis.

  6. Multiple Isolated Enteric Duplication Cysts in an Infant - A Diagnostic Dilemma.

    Science.gov (United States)

    Udiya, Alok Kumar; Shetty, Gurucharan S; Chauhan, Udit; Singhal, Shweta; Prabhu, Shailesh M

    2016-01-01

    Completely isolated enteric duplication cysts are a rare variety of enteric duplication cysts having an independent blood supply with no communication with any part of the adjacent bowel segment. We report a case showing two completely isolated enteric duplication cysts originating in the greater omentum and transverse mesocolon in an infant. Multiple isolated enteric duplication cysts involving non-contiguous bowel segments have not been previously reported in the literature. In addition the transverse mesocolon duplication cyst was infected showing septations and loss of double wall sign resulting in difficulty in imaging diagnosis. Both the cysts were excised and confirmed on histopathology.

  7. Iatrogenic gastric fistula due to inappropriate placement of intercostal drainage tube in a case of traumatic diaphragmatic hernia.

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    Rege S

    2001-04-01

    Full Text Available A 26-year-old, 30 weeks primigravida presented with a gastric fistula through a left intercostal drain, which was inserted for drainage of suspected haemopneumothorax following minor trauma. It was confirmed to be a diaphragmatic hernia, with stomach and omentum as its contents. On exploratory laparotomy, disconnection of the tube and fistulous tract, with reduction of herniated contents and primary suturing of stomach was carried out. Diaphragmatic reconstruction with polypropylene mesh was also carried out. Post-operative recovery was uneventful with full lung expansion by 3rd postoperative day. Patient was asymptomatic at follow-up 6 months.

  8. Hérnia de Morgagni simulando lipoma torácico Morgagni hernia simulating a thoracic lipomatous tumor

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    Elias Amorim

    2004-12-01

    Full Text Available The Morgagni hernia is the rarest kind of diaphragmatic hernia , occurring in 3% of all cases. It consists of the protrusion of the abdominal content into the thoracic cavity including omentum and transverse colon, among others. It is more common in the right side and appears more frequently after 40 years of age or after a raise in the intra-abdominal pressure. Patients with Morgagni hernia are usually asymptomatic. In the X-ray it appears like an opaque image in the cardiophrenic angle.Surgical correction is the treatment of choice for this conditions. We present one case of Morgagni hernia successfully treated.

  9. PRIMARY TRANSITIONAL CELL CARCINOMA OF THE OVARY: A CASE REPORT

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    Anju

    2016-05-01

    Full Text Available A 38-year-old female presented with a history of progressively enlarging abdominal mass. Abdominal computed tomography showed a pelvic mass involving both the ovaries and omentum. CA-125 was normal. Staging surgery was performed and the histopathological diagnosis of Transitional Cell Carcinoma was made and later confirmed by immuno-histochemistry. Transitional cell carcinoma of the ovary is a rare subtype of epithelial ovarian cancer. Surgical resection is the primary therapeutic approach, and patient’s outcomes after chemotherapy are better than for other types of ovarian cancers.

  10. Free deep inferior epigastric perforator flap used for management of post-pneumonectomy space empyema.

    Science.gov (United States)

    Manley, Kate; Gelvez, Sandra; Meldon, Charlotte J; Levai, Irisz; Malata, Charles M; Coonar, Aman S

    2013-04-01

    Various solutions exist for management of post-pneumonectomy space empyema. We describe the use of a free deep inferior epigastric perforator (DIEP) flap to fill the space and close a pleural window. Previously, flaps involving abdominal muscle or omentum have been used for this purpose. Abdominal surgery to harvest such flaps can impair ventilatory mechanics. The DIEP flap--harvested from the abdomen, and composed primarily of skin and muscle avoids this problem, thus is a desirable technique in patients with impaired lung function. We believe this is the first report of the DIEP flap to close a postpneumonectomy empyema space.

  11. Use of a Yankauer suction tip combined with the Colpo-Pneumo Occluder balloon to suction the surgical field at the vaginal cuff during robotic hysterectomy.

    Science.gov (United States)

    Stitely, Michael L; Hashmi, Mahreen; Jain, Preiya; Hochberg, Charles

    2011-01-01

    A 39-year-old patient with complex endometrial hyperplasia without atypia underwent robotic total laparoscopic hysterectomy with bilateral salpingo-oophorectomy. The procedure was technically challenging because of the patient's obesity (body mass index 50 kg/m(2)). Concomitant suction of pooled blood and retraction of bowel and omentum were necessary to close the vaginal cuff. An endoscopic retractor was used through the assistant's port, and a Yankauer suction tip was placed through an inflated Colpo-Pneumo Occluder balloon in the vagina to provide directed suction to the vagina cuff. This technique enabled efficient closure of the vaginal cuff.

  12. [Abdominal actinomycosis with IUD].

    Science.gov (United States)

    Kamprath, S; Merker, A; Kühne-Heid, R; Schneider, A

    1997-01-01

    We report a case of abdominal actinomycosis in a 54 year old woman using an intrauterine device for a period of 8 years. The most important finding was a tuboovarialabscess at the left pelvic side with involvement of the serosa of the jejunum, ileum, sigma, and omentum majus. Intraoperative exploration showed a solid retroperitoneal infiltration between the pelvic side wall and sigma. Another infiltration was found on the left side of the abdominal wall. The diagnosis was confirmed by histopathological examination and the patient was treated by a combination of Aminopenicillin and Metronidazol. After a period of three months we observed a complete regression of the clinical and the MRI findings.

  13. Cellular and molecular processes in ovarian cancer metastasis. A Review in the Theme: Cell and Molecular Processes in Cancer Metastasis.

    Science.gov (United States)

    Yeung, Tsz-Lun; Leung, Cecilia S; Yip, Kay-Pong; Au Yeung, Chi Lam; Wong, Stephen T C; Mok, Samuel C

    2015-10-01

    Ovarian cancer is the most lethal gynecological malignancy. It is usually diagnosed at a late stage, with a 5-yr survival rate of rethinking of the mode of ovarian cancer metastasis and the importance of the "seed-and-soil" hypothesis for ovarian cancer metastasis. In this review we discuss the possible mechanisms by which ovarian cancer cells metastasize from the primary tumor to the omentum, the cross-talk signaling events between ovarian cancer cells and various stromal cells that play crucial roles in ovarian cancer metastasis, and the possible clinical implications of these findings in the management of this deadly, highly metastatic disease.

  14. Spontaneous Bladder Rupture Masquerading as Pseudo-diverticulum

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    M. Raghavendran

    2017-05-01

    Full Text Available Spontaneous bladder rupture is rare. Presentation is non-specific and in absence of history of trauma, radiation, inflammatory conditions and other leading causes, there is considerable diagnostic delay. Absence of clear cut diagnostic signs leads to increased morbidity and mortality. In many patients, omentum seals perforation, giving diverticular appearance in Cystogram. The objective of this case report is to highlight important specific diagnostic points in history and radiology which will help in clear, early diagnosis and treatment causing immense benefit to the patient. We would also like to highlight a specific radiological point to distinguish true from pseudo-diverticulum.

  15. Repair of open compound lower extremity wounds%下肢开放复杂伤口与创面的修复

    Institute of Scientific and Technical Information of China (English)

    朱敬民; 陈传功; 种亚林; 郝天智; 鲁刚; 周智; 随志甫; 刘静杰; 屠晓军; 罗金超; 范宝玉

    2008-01-01

    Objective To explore the repair of the open compound wounds in lower extremities caused by multiple factors. Methotis Transplantation of cutaneous.musculo-cutaneous or greater omentum flaps were applied to 155 patients of open compound lower extremity wounds. Results The wound healing rate following first operation was 50% and that following two operations was 14.8%.While the wounds were healed in 7.7% of patients after three operations. Conclusion Transplantations of cutaneous,musculo-cutaneous or greater omentum flaps ale effective to repair and reconstruct the open compound lower extremity wounds.%目的 探讨多种原因造成的下肢开放复杂伤口与创面的修复.方法 应用皮瓣、肌皮瓣、大网膜移植等方法,对155例下肢复杂伤口与创面进行修复.结果 一次手术愈合率为50%;两次手术愈合率为14.8%;三次手术愈合率为7.7%.结论 皮瓣、肌皮瓣以及大网膜移植,可以有效修复多种原因造成的下肢复杂伤口与创面.

  16. Intestinal obstruction caused by a strangulated Morgagni hernia in an adult patient.

    Science.gov (United States)

    Barut, Ibrahim; Tarhan, Omer Ridvan; Cerci, Celal; Akdeniz, Yusuf; Bulbul, Mahmut

    2005-08-01

    A Morgagni hernia is a congenital herniation of abdominal contents into the thoracic cavity through a retrosternal diaphragmatic defect. The reported incidence of congenital diaphragmatic hernias is estimated to be 1 in between 2000 to 5000 births. Morgagni hernias comprise 2% of diaphragmatic hernias. Most Morgagni hernias are found and repaired in children, but 5% are found in adults. They are usually asymptomatic and often found incidentally on chest radiography. Symptoms of these hernias are attributable to the herniated viscera. Morgagni hernias containing bowel may require repair on presentation because of the risk of incarceration. We present a case of an incarcerated and strangulated Morgagni hernia in a 71-year-old woman admitted to our clinic for abdominal pain and symptoms of intestinal obstruction. The diagnosis was made preoperatively by chest radiography, sonography, and computed tomography. Emergent laparotomy was performed, with the herniated transverse colon and omentum reduced into the abdomen. The diaphragmatic defect was repaired, followed by resection of the strangulated omentum. In conclusion, a Morgagni hernia may cause intestinal obstruction. Routine radiographic studies are usually sufficient to arrive at the diagnosis, but a CT scan and sonography may be necessary. Laparotomy is appropriate for the management of symptomatic adult patients with Morgagni hernias, particularly those with findings of intestinal strangulation, with laparoscopic treatment an alternative approach in selected cases.

  17. Bilateral Morgagni Hernia: Primary Repair without a Mesh

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    Vassilios Papanikolaou

    2008-07-01

    Full Text Available We present a case of bilateral Morgagni hernia in a 68-year-old male with an intermittent history of progressive onset of breath shortness and occasional cardiac arrhythmias. Diagnosis was made by clinical examination and the findings in a plain chest radiograph and was confirmed by computed tomography scan. The patient was operated electively and subjected to a transabdominal approach. A bilateral subcostal incision revealed a large right side anterior diaphragmatic defect with a hernia containing the ascending colon, the majority of the transverse colon and a huge amount of omentum. Also a second smaller defect was found on the left side with no hernia inside. After large bowel and omentum had been taken down to the peritoneal cavity, both defects were primarily closed using interrupted nylon sutures without the use of a mesh. The patient recovered very well, had an uneventful postoperative course and was released on the 5th postoperative day. 15-month follow-up failed to reveal any signs of recurrence.

  18. Malignant peritoneal mesothelioma presenting with persistent high fever

    Institute of Scientific and Technical Information of China (English)

    Li-ying CHEN; Ling-xiu HUANG; Jin WANG; Yi QIAN; Li-zheng FANG

    2011-01-01

    Malignant peritoneal mesothelioma (MPM) is a rare tumor that develops in the peritoneum. In this paper,we describe an extremely rare case of MPM metastasizing to the appendix in a 48-year-old female who initially presented with a persistent high fever. The woman reported a slight lower abdominal discomfort which had been relieved by urination for four months. She had lost 5 kg of weight. There was no nausea, vomiting, diarrhea, abdominal pain, or abdominal distension. Many broad spectrum antibiotics were given without relief of fever. Computed tomography (CT) scans revealed a thickened omentum majus and diffused multiple omental nodules. An omentectomy, appendectomy, and adnexectomy were carried out. A gross pathologic specimen of omentum tissue revealed a firm gray-white mass. Microscopic and immunohistochemical examinations confirmed the diagnosis of appendiceal and bilateral adnexal metastases of an MPM. These results suggest that MPM should be considered in the differential diagnosis of unexplained persistent high fever. Awareness of such atypical presentations of mesothelioma may help to make a correct diagnosis.

  19. Complete Dissection of a Hepatic Segment after Blunt Abdominal Injury Successfully Treated by Anatomical Hepatic Lobectomy: Report of a Case

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    Takayuki Tanaka

    2011-04-01

    Full Text Available A 21-year-old male patient was transferred to the emergency room of our hospital after suffering seat belt abdominal injury in a traffic accident. Abdominal computed tomography revealed a massive hematoma in the abdominal cavity associated with deep hepatic lacerations in the right lobe. The presence of a solid tissue possibly containing pneumobilia was observed above the greater omentum. These findings were consistent with a tentative diagnosis of hepatic laceration due to blunt trauma; therefore, this prompted us to perform emergency laparotomy. The operative findings revealed a massive hematoma and pulsatile bleeding from the lacerated liver and a retroperitoneal hepatoma, which was most likely due to subcapsular injury of the right kidney. In accordance with the preoperative imaging studies, a pale liver fragment on the greater omentum was observed, which was morphologically consistent with the defect in the posterior segment of the liver. Since the damaged area of the liver broadly followed the course of the middle hepatic vein, we carefully inspected and isolated the inflow vessels and eventually performed a right hepatic lobectomy. The patient’s postoperative course was uneventful, and he was doing well at 10 months after surgery.

  20. Stem Cell Emergence and Hemopoietic Activity Are Incompatible in Mouse Intraembryonic Sites

    Science.gov (United States)

    Godin, Isabelle; Garcia-Porrero, Juan Antonio; Dieterlen-Lièvre, Françoise; Cumano, Ana

    1999-01-01

    In the mouse embryo, the generation of candidate progenitors for long-lasting hemopoiesis has been reported in the paraaortic splanchnopleura (P-Sp)/aorta-gonad-mesonephros (AGM) region. Here, we address the following question: can the P-Sp/AGM environment support hemopoietic differentiation as well as generate stem cells, and, conversely, are other sites where hemopoietic differentiation occurs capable of generating stem cells? Although P-Sp/AGM generates de novo hemopoietic stem cells between 9.5 and 12.5 days post coitus (dpc), we show here that it does not support hemopoietic differentiation. Among mesoderm-derived sites, spleen and omentum were shown to be colonized by exogenous cells in the same fashion as the fetal liver. Cells colonizing the spleen were multipotent and pursued their evolution to committed progenitors in this organ. In contrast, the omentum, which was colonized by lymphoid-committed progenitors that did not expand, cannot be considered as a hemopoietic organ. From these data, stem cell generation appears incompatible with hemopoietic activity. At the peak of hemopoietic progenitor production in the P-Sp/AGM, between 10.5 and 11.5 dpc, multipotent cells were found at the exceptional frequency of 1 out of 12 total cells and 1 out of 4 AA4.1+ cells. Thus, progenitors within this region constitute a pool of undifferentiated hemopoietic cells readily accessible for characterization. PMID:10429669

  1. Omental implantation of BOECs in hemophilia dogs results in circulating FVIII antigen and a complex immune response.

    Science.gov (United States)

    Ozelo, Margareth C; Vidal, Barbara; Brown, Christine; Notley, Colleen; Hegadorn, Carol; Webster, Sandra; Harpell, Lori; Ahlin, James; Winterborn, Andrew; Handforth, Janine; Arruda, Valder R; Hough, Christine; Lillicrap, David

    2014-06-26

    Ex vivo gene therapy strategies avoid systemic delivery of viruses thereby mitigating the risk of vector-associated immunogenicity. Previously, we delivered autologous factor VIII (FVIII)-expressing blood outgrowth endothelial cells (BOECs) to hemophilia A mice and showed that these cells remained sequestered within the implanted matrix and provided therapeutic levels of FVIII. Prior to translating this strategy into the canine (c) model of hemophilia A, we increased cFVIII transgene expression by at least 100-fold with the use of the elongation factor 1 alpha (EF1α) promoter and a strong endothelial enhancer element. BOECs isolated from hemophilia A dogs transduced with this lentiviral vector express levels of cFVIII ranging between 1.0 and 1.5 U/mL per 10(6) cells over 24 hours. Autologous BOECs have been implanted into the omentum of 2 normal and 3 hemophilia A dogs. These implanted cells formed new vessels in the omentum. All 3 hemophilia A dogs treated with FVIII-expressing autologous BOECs developed anti-FVIII immunoglobulin G2 antibodies, but in only 2 of the dogs were these antibodies inhibitory. FVIII antigen levels >40% in the absence of FVIII coagulant function were detected in the circulation for up to a year after a single gene therapy treatment, indicating prolonged cellular viability and synthesis of FVIII. © 2014 by The American Society of Hematology.

  2. Gao is the Protective Layer of Organs in Huangdi Neijing%《内经》的“膏”是指以脂肪为主要结构成分的一类实体

    Institute of Scientific and Technical Information of China (English)

    周波; 欧武

    2012-01-01

    By exploring the anatomy of Gao Source and Huang Source in Huangdi Neijing, Gao refers to fat as the main component of a class of entities, including at least the Apical of the fat and Omentum. Gao in disease entering Gaohuang is the Apical of the fat; Gao in Gao Source is the omentum. Ventral midline of the lower edge of the right lohe and the stomach along the greater curvature of the bottom, it is the anatomical location for Gao Source , and Jiuwei point is along the central line in this.%通过探讨《内经》“肓之原”和“膏之原”的解剖结构,认为《内经》的“膏”是指以脂肪为主要成分的一类实体,其中至少包括了心尖部脂肪和大网膜.“病入膏肓”和“膏之原”中,二者中“膏”的解剖实体,分别指的是心尖部脂肪和大网膜;“膏之原”的解剖位置是腹正中线的肝右叶下缘和胃大弯的沿线之下;“鸠尾穴”位于这条沿线的中央.

  3. Immunohistochemical and Biochemical Characterization of Mucin in Pseudomyxoma Peritonei: A Case Study

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    Anwar S. Mall

    2011-01-01

    Full Text Available We previously reported the presence of MUC2, MUC5AC and, for the first time, MUC5B in a 58-year-old male with pseudomyxoma peritonei (PMP. This is a report on the biochemical and immunohistochemical characterization of mucin in a 50-year-old female with the same rare illness. A right oophorectomy and appendicectomy and a resection of the involved omentum were performed. Approximately a litre of crude material in the sol and gel phases was obtained from the patient during laparotomy. This was briefly homogenized in 6 M guanidinium hydrochloride and proteolytic inhibitors and purified by density gradient centrifugation in caesium chloride. At laparotomy it was noted that the patient had appendiceal and ovarian masses as well as extensive mucinous deposits in the omentum and peritoneum. A mucinous adenocarcinoma of the appendix and ovary was confirmed on histology. The cells expressed both sulphated and non-sulphated acidic mucins. The presence of MUC2, MUC5AC, MUC5B and α-1-acid glycoprotein was shown by Western blotting and MUC4 by immunohistochemical staining. MUC1 and MUC6 were not detectable in the tissue. The study confirms that MUC2, MUC5AC and MUC5B are produced in the mucus of patients with PMP. The expression of MUC4 in this disease has not been previously reported.

  4. Effects of NGF and TrkA on GAP-43+ nerve regeneration in rat autotransplanted splenic tissue

    Institute of Scientific and Technical Information of China (English)

    JIANG Deng-jin; GUO Guang-jin; WANG Lin; ZHANG Kun; ZHANG Tian-fei; ZUO Yan-fang

    2005-01-01

    Objective:To study the time-course of the regeneration of GAP-43+ nerve, and the effects of NGF and TrkA on this process. Methods: Adult Wistar rats underwent splenectomy and splenic autotransplantation, or sham-operation. On day 7, 14, 30, 60, 90, 120, and 180 after surgery, the density of GAP-43+ nerve fibers in spleen tissues were measured with the immunohistochemistry followed by computer image analysis. The expressions of GAP-43, NGF and TrkA were determined with in situ hybrdization, and their mRNA levels were detected with RT-PCR and image analysis qualification. Results: (1)The GAP-43+ nerve fibers began their regeneration on 30 d after operation and extended from greater omentum into splenic autotransplants. Density of the nerve fibers gradually became greater and almost normal 180 d after operation. (2) In splenic autografts, the mRNA expression of GAP-43, NGF and TrkA appeared on day 30 after the operation, gradually reached the peak on day 90. Conclusion: The renascent GAP-43+ nerve fibers may come from the greater omentum packaging the splenic autografts and NGF and TrkA can promote the nerval regeneration in the autotransplant spleen tissues.

  5. A case report of incisional hernia through a 5 mm lateral port site following laparoscopic cholecystectomy

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    Audrius Dulskas

    2011-01-01

    Full Text Available Introduction: Less than 10 mm port-site herniation is a rare complication after laparoscopic surgery. We report a case of complicated herniation through the 5-mm lateral trocar port site. Case Report: A 63-year old obese female was admitted due to intestinal obstruction. She has undergone the laparoscopic cholecystectomy 1 year ago. On examination, abdomen was bloated and roughly 10 cm size mass was palpable on the right subcostal area. Plane radiogram of the abdomen showed signs of intestinal obstruction. Since conservative treatment was ineffective, the patient was operated on. The laparotomy revealed a protrusion of a part of right large intestine and greater omentum into the subcutaneous space through the abdominal wall defect below right subcostal margin. There was a dilatation of intestines proximally incarcerated colon. It was released and a part of omentum was resected. The peritoneum and fascia-muscular defect was closed by interrupted vicryl sutures. Conclusion: Acute herniation through a 5 mm size most lateral trocar port site is a rare complication of laparoscopic surgery requiring prompt differential diagnosis.

  6. Toxicity and oxidative stress of canine mesenchymal stromal cells from adipose tissue in different culture passages

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    Arícia Gomes Sprada

    2015-12-01

    Full Text Available Abstract: Stem cells in regenerative therapy have received attention from researchers in recent decades. The culture of these cells allows studies about their behavior and metabolism. Thus, cell culture is the basis for cell therapy and tissue engineering researches. A major concern regarding the use of cultivated stem cell in human or veterinary clinical routine is the risk of carcinogenesis. Cellular activities require a balanced redox state. However, when there is an imbalance in this state, oxidative stress occurs. Oxidative stress contributes to cytotoxicity, which may result in cell death or genomic alterations, favoring the development of cancer cells. The aim of this study was to determine whether there are differences in the behavior of cultured mesenchymal stem cells from canine adipose tissue according to its site of collection (omentum and subcutaneous evaluating the rate of proliferation, viability, level of oxidative stress and cytotoxicity over six passages. For this experiment, two samples of adipose tissue from subcutaneous and omentum where taken from a female dog corpse, 13 years old, Pitbull. The results showed greater levels of oxidative stress in the first and last passages of both groups, favoring cytotoxicity and cell death.

  7. Giant Omental Fibromatosis Presenting as Pelvic Mass

    Science.gov (United States)

    Singh, Pradyumn; Jain, Neelesh; Jain, Jaswant; Kumar, Vijay

    2015-01-01

    Omental fibromatosis (abdominal desmoids) is a rare benign but locally aggressive neoplasm characterized by mass like or infiltrative growth of fibrous tissue. It usually arises from the abdominal wall or the extremities, however rarely it may also arise in the omentum, ileocolic mesentery, transverse or sigmoid mesocolon and ligamentum teres. Here, we present an 18-year-old male, who presented with lower abdominal pain and palpable lump in hypogastric region. Computed tomography of the abdomen showed large heterogeneous mass in lower abdomen, possibly arising from mesentery with regional adenopathy. Patient underwent exploratory laparotomy with a preoperative diagnosis of mesenteric tumour possibly gastrointestinal stromal tumour (GIST). Histopathological examination revealed the lesion as omental fibromatosis. To the best of our knowledge, very few cases of omental fibromatosis are noted in literature. Here, we describe a rare case of giant omental fibromatosis which resembled mesenteric GIST clinically but finally diagnosed as fibromatosis by histomorphology and immunohistochemistry (IHC). The present article describes fibromatosis of greater omentum and the difficulty in preoperative diagnosis, as it is frequently misdiagnosed as GIST. PMID:25859511

  8. Repair of diaphragmatic hernia following spinal surgery by laparoscopic mesh application: a case report and review of the literature.

    Science.gov (United States)

    Bini, Roberto; Fontana, Diego; Longo, Alessandro; Manconi, Paolo; Leli, Renzo

    2014-01-01

    We describe the laparoscopic management of diaphragmatic hernia (DH) caused by vertebral pedicle screw displacement. A 58-year-old woman underwent surgery for scoliosis and underwent posterior pedicle screw fixation. In the first postoperative (PO)day, she developed mild dyspnea. An anteroposterior chest radiograph revealed bilateral pleural effusion, which was more pronounced on the left side. A thoracoabdominal computed tomography (CT) scan, performed in the second PO day, revealed a solid mass in the pleural cavity that was associated with screw displacement, which had also entered into the peritoneal cavity without apparent other lesion of hollow and solid viscous. In the third PO day, after the screw was removed, explorative laparoscopy was carried out. We observed herniation of the omentum through a small diaphragmatic tear. Once the absence of visceral injury was confirmed, we reduced the omentum into the abdomen. Then, we repaired the hernia by applying a dual layer polypropylene mesh over the defect with a 3-cm overlap. The remainder of the postoperative period was uneventful. Iatrogenic DH due to a pedicle screw displacement has never been described before. In cases of pleural effusion following spinal surgery, rapid assessment and treatment are crucial. We conclude that a laparoscopic approach to iatrogenic DH could be feasible and effective in a hemodynamically stable patient with negative CT findings because it enables the completion of the diagnostic cascade and the repair of the tear, providing excellent visualization of the abdominal viscera and diaphragmatic tears.

  9. Effect of fetal spinal cord graft with different methods on axonal pathology after spinal cord contusion

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To investigate the effect of fetal spinal cord (FSC) graft with different methods on axonal pathology and neurological function recovery after spinal cord injury (SCI).   Methods: Forty Wistar rats were divided into 4 groups. In Group A, the spinal cord was injured and hemisected. In Group B, fetal spinal cord (FSC) was transferred into the injured site. In Group C, after having done as Group B, the upper and lower spinal nerve roots were anastomosed. And in Group D, after having done as Group B, the pedicled omentum was transferred into the hemisection cavity. At 6 weeks after operation, light and electronic microscopes were used to examine the axonal pathology. The neurological function was assessed with inclined plane tests in the open field. The number of axons was quantitated by a computer image analysis system.   Results: A greater loss of axons was observed in Group A than that of other groups at 6 weeks. The sequence of the reduced rate of the axons was as following, Group A>Group B>Group C>Group D (P<0.05). The remaining axons were paralleled with the significant improvement in neurological function recovery of the rats.   Conclusions: It indicates that FSC and pedicled omentum grafts after SCI can protect the axons and promote the neurological function recovery of the rats.

  10. Effect of sunitinib on metastatic gastrointestinal stromal tumor in patients with neurofibromatosis type 1: A case report

    Institute of Scientific and Technical Information of China (English)

    M Emin Kalender; Alper Sevinc; Ediz Tutar; Akif Sirikci; Celalettin Camci

    2007-01-01

    Gastrointestinal stromal tumor (GIST) represents the most common mesenchymal malignancy of the gastrointestinal (GI) tract. In neurofibromatosis (NF),the increased incidence of tumor needs to be considered even in non-symptomatic individuals. Patients with neurofibromatosis NF type 1 have an increased risk of developing GI tumors including rare types such as GIST.We report a case of GIST in a 53-year-old male patient with neurofibromatosis. The patient was diagnosed with NF four years ago and his medical history revealed that he was hospitalized 5 times with a provisional diagnosis of massive lower gastrointestinal bleeding. GIST was diagnosed at explorative laparotomy and the tumor was 21 cm × 13 cm × 7 cm in size. Immunohistochemical examination showed that vimentin, actin and CD117 were positive. Computerized tomography showed peritoneal implants three months later. Imatinib mesylate (600 mg/d) was initiated. However, control computerized tomography revealed liver and omental metastasis. The dosage was elevated to 800 mg/d. Despite high dosage,the progression of the metastatic lesions continued in the liver and omentum. The patient started oral sunitinib malate (Sutent)(R) Pfizer Inc, New York, NY, USA) 50 mg per day for 4 consecutive weeks, followed by 2 wk off per treatment cycle. The metastatic lesions in the liver and omentum were decreased in size after four courses,suggesting that sunitinib is also an effective treatment modality for metastatic GIST in NF patients.

  11. Colopexy as a treatment option for the management of acute transverse colon volvulus: a case report

    Directory of Open Access Journals (Sweden)

    Sage Mark J

    2012-06-01

    Full Text Available Abstract Introduction Transverse colon volvulus is an uncommon acute surgical presentation associated with a higher rate of mortality than volvulae at other locations along the colon. Surgical resection or correction is the only treatment, and various methods have been described in case report literature to relieve the volvulus and prevent recurrence. Case presentation We present the case of a 25-year-old Caucasian woman who was admitted with a three-day history of abdominal pain, absolute constipation and abdominal distension. Subsequent radiographic and computed tomography imaging revealed right-sided colonic dilatation suggestive of a volvulus. An emergency laparotomy was performed during which the dilated proximal bowel was decompressed and colopexy executed by using the greater omentum to fix the transverse colon at the hepatic and splenic flexures. Conclusions Volvulus of the transverse colon is rare but must form part of the clinician's differential diagnosis when encountering a patient with suspected bowel obstruction, especially in younger patients with no previous surgical history. Laparotomy is the treatment of choice and the technique of using the greater omentum as a fixing point for redundant bowel to the lateral abdominal wall is an option that may be considered especially when the bowel appears viable.

  12. Morgagni hernia: A rare case report and review of literature

    Directory of Open Access Journals (Sweden)

    Manoj Kumar Pattnaik

    2016-01-01

    Full Text Available Morgagni hernias (MHs are rare and constitute about 2% of all diaphragmatic hernias. Although uncommon, it has potential for considerable morbidity if the diagnosis is missed. An elderly woman with known history of chronic asthma and constipation presented to us with vague right-sided chest pain. General physical examination was unremarkable and coincidentally diagnosed to have diabetes mellitus. Chest roentgenogram posteroanterior view revealed a right paracardiac opacity and right lateral view showed the opacity in the peridiaphragmatic area of anterior mediastinum. Computed tomographic scan of the chest and abdomen revealed a right-sided MH containing omental fat. Standard right posterolateral thoracotomy was done, and there was a rent at the medial end of the xiphoid process with hernia sac containing the omentum, which was compressing adjacent lungs and heart. The sac was opened; redundant omentum was resected, and rent closed with intercostal muscle with prolene. MH being rare must be addressed with appropriate investigation to prevent unnecessary morbidity and mortality.

  13. Doppler findings in chronic ectopic pregnancy: case report.

    Science.gov (United States)

    Abramov, Y; Nadjari, M; Shushan, A; Prus, D; Anteby, S O

    1997-05-01

    Chronic ectopic pregnancy is an uncommon form of tubal pregnancy manifested as a pelvic mass with minimal symptoms and a low or absent titer of human chorionic gonadotropin. For this reason, most of the reported cases have been diagnosed only after explorative laparotomy. The value of Doppler ultrasonography for preoperative diagnosis of this entity has not yet been established. We report on a 36-year-old patient who was admitted for intermittent right lower quadrant abdominal pain of 3 months' duration, and a right adnexal mass found on pelvic examination. On Doppler ultrasonography, a right complex adnexal mass was demonstrated, characterized by extensive external vascularization, aberrant vessels and arteriovenous shunting, but with no internal blood flow. Explorative laparotomy revealed a right tubal mass adherent to the omentum, and covered by numerous enlarged and tortuous blood vessels originating in the omentum. Pathological examination of the mass revealed a chronic ectopic pregnancy. The possible contribution of Doppler-specific characteristics for the diagnosis of chronic ectopic pregnancy is described and discussed.

  14. IL-12 Expressing oncolytic herpes simplex virus promotes anti-tumor activity and immunologic control of metastatic ovarian cancer in mice.

    Science.gov (United States)

    Thomas, Eric D; Meza-Perez, Selene; Bevis, Kerri S; Randall, Troy D; Gillespie, G Yancey; Langford, Catherine; Alvarez, Ronald D

    2016-10-27

    Despite advances in surgical aggressiveness and conventional chemotherapy, ovarian cancer remains the most lethal cause of gynecologic cancer mortality; consequently there is a need for new therapeutic agents and innovative treatment paradigms for the treatment of ovarian cancer. Several studies have demonstrated that ovarian cancer is an immunogenic disease and immunotherapy represents a promising and novel approach that has not been completely evaluated in ovarian cancer. Our objective was to evaluate the anti-tumor activity of an oncolytic herpes simplex virus "armed" with murine interleukin-12 and its ability to elicit tumor-specific immune responses. We evaluated the ability of interleukin-12-expressing and control oncolytic herpes simplex virus to kill murine and human ovarian cancer cell lines in vitro. We also administered interleukin-12-expressing oncolytic herpes simplex virus to the peritoneal cavity of mice that had developed spontaneous, metastatic ovarian cancer and determined overall survival and tumor burden at 95 days. We used flow cytometry to quantify the tumor antigen-specific CD8(+) T cell response in the omentum and peritoneal cavity. All ovarian cancer cell lines demonstrated susceptibility to oncolytic herpes simplex virus in vitro. Compared to controls, mice treated with interleukin-12-expressing oncolytic herpes simplex virus demonstrated a more robust tumor antigen-specific CD8(+) T-cell immune response in the omentum (471.6 cells vs 33.1 cells; p = 0.02) and peritoneal cavity (962.3 cells vs 179.5 cells; p = 0.05). Compared to controls, mice treated with interleukin-12-expressing oncolytic herpes simplex virus were more likely to control ovarian cancer metastases (81.2 % vs 18.2 %; p = 0.008) and had a significantly longer overall survival (p = 0.02). Finally, five of 6 mice treated with interleukin-12-expressing oHSV had no evidence of metastatic tumor when euthanized at 6 months, compared to two of 4 mice treated

  15. PVA/SiO2/HMDS 薄膜的制备及性能研究%Studying on the Preparation and Properties of PVA/SiO2/HMDS Film

    Institute of Scientific and Technical Information of China (English)

    章富; 耿蒙蒙; 沈伟良; 鲍晓冰; 刘浏; 王翠平; 谢安建; 沈玉华

    2013-01-01

    Here, the poly -vinyl -alcohol(PVA) nanofibers omentum are prepared on the surface of the glass substrate via electrospinning, then terabutyl orthosilicate is used as a precursor to induce silica particles to the omentum , and lastly bis(trime-thylsilyl)amine is coated on PVA /SiO2 omentum for reducing the surface energy.The prepared PVA /SiO2 /HMDS film on glass substrate is characterized by SEM images, water contact angle (WCA) and so on.The results show that the surface of the treated glass possesses higher roughness, WCA of the thin film reaches 135.7°, indicating the prepared film has good hydrophobic per-formance.Also the film presents excellent transparency and wear -stability, which may be widely applied in high -grade outdoor wall body, windscreen and spectacle lens, etc.%  采用静电纺丝技术在玻璃基片表面构筑聚乙烯醇( PVA)纳米纤维网膜,以正硅酸丁酯( TEOS)为硅源,通过气相沉积法向 PVA 纳米纤维网膜间隙中引入 SiO2纳米粒子。然后以六甲基二硅氮烷( HMDS)为修饰剂,对玻璃基片表面 PVA /SiO2膜进行疏水改性,从而降低其表面能。利用扫描电镜(SEM),静态水接触角(WCA)等测试手段对在玻璃表面制备的 PVA /SiO2/HMDS 薄膜进行了表征。结果显示,处理过的玻璃基片具有较高的粗糙度,表面水接触角( WCA)达135.7°,表明其具有很好的疏水性能。而且制备的薄膜疏水性能稳定,耐磨性能好,能够保持较好的透明性。因此在高档室外墙体、汽车挡风玻璃、眼镜片等领域具有潜在的应用前景。

  16. Bilaterally Incarcerated Morgagni Hernia

    Directory of Open Access Journals (Sweden)

    Zuhal Demirhan Yananli

    2013-06-01

    Full Text Available Morgagni hernia is a rare congenital diaphragmatic hernia. It is seen rarely bilaterally. Patients are usually asymptomatic. Therefore, diagnosis may be delayed until adulthood. Significant morbidity can occur in case complications arise and diagnosis is delayed. The patient, a 74 year-old female, presented in this article, was admitted to the emergency department with abdominal pain, vomiting, and shortness of breath. The plain abdominal radiograph of the patient revealed bowel obstruction and suspicious appearence in favor of the diaphragmatic hernia on both sides of the sternum. Computed tomography revealed bilaterally incarcerated Morgagni hernia with strangulated omentum in the right side of the sternum and a part of colon in the left side of sternum. Incarcerated organs were withdrawn to peritoneal cavity and defects of hernia were sutured primarily on laparatomy. Because bilateral incarcerated Morgagni hernia can be seen rarely, this case was reported.

  17. [A case of left-sided Morgagni hernia complicating incarcerated small bowel hernia].

    Science.gov (United States)

    Kim, Se Won; Jung, Sang Hun; Kang, Su Hwan

    2008-01-01

    Morgagni hernia is an uncommon presentation representing about 3% in incidence and usually located in the right-sided anterior diaphragm. We experienced a case of Morgagni hernia in a seventy four-year-old male who was admitted complaining of intermittent abdominal pain. The diagnosis was made initially by chest and abdominal radiography, and an incarcerated Morgagni hernia was finally diagnosed with abdominal CT scans. Emergent laparotomy was performed. Morgagni foramen was located on the left-sided anterior diaphragm and Morgagni hernia which contained greater omentum and strangulated small intestine was gently reducted. Morgagni foramen measuring 4 x 5 cm was repaired with a Gortex mesh. We reported the experience of left-sided Morgagni hernia complicating incarcerated small bowel hernia in an old male patient.

  18. Incarcerated Morgagni hernia in an octogenarian with incidental right-sided colonic malignancy.

    Science.gov (United States)

    Gaco, Suad; Krdzalic, Goran; Krdzalic, Alisa

    2013-01-01

    We present an incarcerated Morgagni hernia in an octogenarian with incidental right-sided colonic malignancy who was admitted to clinic due to abdominal pain and symptoms of intestinal obstruction. An 85-old male patient had a history of constipation, abdominal distension, pain, vomiting, nausea and radiographic features of bowel obstruction and mediastinal mass in right lower chest. Under suspicion of acute intestinal obstruction due to transverse colon herniation in thorax through Morgagni foramen, emergent laparotomy was performed. Morgagni foramen was located on the right-sided anterior diaphragm and Morgagni hernia which contained of incarcerated transverse colon, greater omentum and 70 cm small bowel after releasing the adhesions was gently reduced. In the same time right-sided colon malignancy was found. Morgagni foramen measuring 7 cm in diameter was sutured first and decompressive bypass ileocolic anastomosis was created. The role of emergent surgery, even in advanced age, is emphasized.

  19. Surgical treatment of a Morgagni hernia causing intermittent gastric outlet obstruction.

    Science.gov (United States)

    Griffiths, Ewen A; Ellis, Andrew; Mohamed, Ahmed; Tam, Eddie; Ball, Chris S

    2010-11-05

    A Morgagni hernia is a rare diaphragmatic hernia which develops through a congenital defect in the retrosternal area, usually on the right hand side. Because of its congenital aetiology, Morgagni hernias are rarely considered in the differential diagnosis of gastric outlet obstruction symptoms in adults. We present a patient with an incarcerated Morgagni hernia who presented with gastric outlet obstruction. A 77-year-old woman presented with symptoms and signs of gastric outlet obstruction, dehydration and acute renal impairment. She was treated by fluid resuscitation and nasogastric tube insertion. Radiological imaging showed a Morgagni hernia containing stomach, omentum and colon. This was treated surgically via an abdominal approach and the defect was closed with mesh. The patient recovered well from this procedure and was discharged. We discuss the anatomy, clinical presentation and surgical treatment of this rare diaphragmatic hernia to raise awareness among surgeons and surgical trainees.

  20. Gastric perforation due to foreign body ingestion mimicking acute cholecystitis.

    Science.gov (United States)

    Henneman, Daniel; Bosman, Willem-Maarten; Ritchie, Ewan D; van den Bremer, Jephta

    2015-03-04

    An 82-year-old man presented with signs and symptoms that were suggestive of acute cholecystitis. He underwent a laparoscopic cholecystectomy. During the intervention, a wooden foreign body was removed from the infiltrated omentum, probably after it had perforated the gastric antrum. The gastric perforation had led to a secondary infection of the gallbladder. The presumed gastric perforation was treated conservatively, and the patient recovered well and was discharged after 7 days. Secondary inflamed gallbladders are rare; the current case is, to the best of our knowledge, the first case reporting a secondary infection of the gallbladder due to a gastric perforation. Clinicians should be aware of possible ingestion of foreign bodies in elderly patients wearing dental prosthetic devices.

  1. Splenosis simulating an intrahepatic mass

    Institute of Scientific and Technical Information of China (English)

    晁明; 徐宏伟

    2004-01-01

    Splenosis is the autotransplantation of splenic tissue that usually follows traumatic rupture of the spleen. Splenic implants may be seeded within or beyond the peritoneal cavity.1 The most frequent locations of splenosis in the descending order are the serosal surface of the small intestine, the greater omentum, parietal peritoneum, surface of the large intestine, mesentery, undersurface of the diaphragm and the thorax.1,2 However, intrahepatic splenosis is very rare. We recently encountered a patient in whom results of ultrasonography (US) and computed tomography (CT) revealed an intrahepatic mass that consisted of ectopic splenic tissue. To our knowledge, this is the fifth report of ectopic splenic tissue in the liver in the English-language literature. We present the imaging findings of the splenic implants in the liver and discuss the diagnosis and its practical significance.

  2. Torsion of a parasitic myoma that developed after abdominal myomectomy.

    Science.gov (United States)

    Cho, In Ae; Baek, Jong Chul; Park, Ji Kwon; Song, Dae Hyun; Kim, Wan Ju; Lee, Yoon Kyoung; Park, Ji Eun; Shin, Jeong Kyu; Choi, Won Jun; Lee, Soon Ae; Lee, Jong Hak; Paik, Won Young

    2016-01-01

    Iatrogenic parasitic myomas are rare. The condition is defined by the presence of multiple smooth-muscle tumorous nodules in the peritoneal cavity. This may be attributable to seeding of myoma particles during uterine surgery. The clinical course is usually indolent. The disease is often asymptomatic and is usually discovered only incidentally. A 38-year-old woman who had undergone abdominal myomectomy 7 months prior presented with acute abdominal pain and a huge pelvic mass. We performed exploratory laparotomy. A parasitic mass 17 cm in diameter with a twisted omental pedicle was identified. En bloc excision of the mass and omentum was performed, followed by total abdominal hysterectomy. Histopathological examination of multiple sections revealed features compatible with an infarcted leiomyoma. Thus, we present a very rare case of an iatrogenic, rapidly growing parasitic myoma complicated by omental torsion (which caused the acute abdominal pain). We also offer a literature review.

  3. A 33-year-old Haitian immigrant with 7 months of abdominal pain and progressive distension.

    Science.gov (United States)

    Farhadian, Shelli; Shenoi, Sheela V; Villanueva, Merceditas S

    2014-07-09

    We report a case of a 33-year-old previously healthy Haitian immigrant with a 7-month history of abdominal pain, fever and ascites. He had a history of positive tuberculin skin test but never underwent treatment for latent tuberculosis (TB) infection. Initial examination showed abdominal distension. Abdominal CT scan showed mild ascites, abnormal soft tissue in the greater omentum and small bowel mesentery, retroperitoneal adenopathy, peritoneal thickening and dilated loops of small bowel. Paracentesis and thoracentesis were initially non-diagnostic. HIV testing was negative. The differential diagnosis included lymphoma and TB peritonitis. The omental mass was biopsied under ultrasound guidance, and histopathology revealed non-necrotising granulomas. Sputum cultures and omental biopsy cultures subsequently grew Mycobacterium tuberculosis, and a diagnosis was made of pulmonary TB with TB peritonitis. The patient responded well to the initiation of anti-TB treatment.

  4. Epidural Brain Metastases in a Patient with Early Onset Pancreatic Cancer: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Aibek E. Mirrakhimov

    2012-01-01

    Full Text Available We present a case of early onset pancreatic cancer related extra-axial brain metastases. A 46-year-old Caucasian non-Jewish nonobese male with a history of PC diagnosed 3 months ago with metastases to the liver, omentum, malignant ascites, and a history of a pulmonary embolism was admitted to the hospital because of a new onset headache, nausea, and vomiting which started 2 days prior to the encounter. Brain MRI was ordered, which showed acute bihemispheric subdural hematomas and left hemispheric extra-axial heterogeneously enhancing lesions consisting with metastatic disease. The patient was started on ondansentron, metoclopramide, and dexamethasone. The cranial irradiation was started, and the patient’s headache and nausea significantly improved. There are only 9 published reports of extra-axial brain metastases related to the pancreatic cancer, whereas our paper is the first such case reported on a patient with epidural metastases and early onset pancreatic cancer.

  5. US and CT findings in the diagnosis of tuberculous peritonitis

    Energy Technology Data Exchange (ETDEWEB)

    Demirkazik, F.B. [Dept. of Radiology, School of Medicine, Hacettepe Univ., Ankara (Turkey); Akhan, O. [Dept. of Radiology, School of Medicine, Hacettepe Univ., Ankara (Turkey); Oezmen, M.N. [Dept. of Radiology, School of Medicine, Hacettepe Univ., Ankara (Turkey); Akata, D. [Dept. of Radiology, School of Medicine, Hacettepe Univ., Ankara (Turkey)

    1996-07-01

    Purpose: To evaluate the ultrasonographic and CT findings of tuberculous peritonitis. Material and Methods: Ultrasonographic and CT findings of 11 patients with the ascitic type of tuberculous peritonitis were reviewed. Results: All patients had ascites, and ultrasonography (US) demonstrated fine complete and incomplete mobile septations in 10 patients. In 5 of them, the ascites had a lattice-like appearance. Diffuse regular peritoneal thickening was detected in all patients by CT and in 10 patients by US. CT demonstrated infiltration of the greater omentum in 9 patients, whereas US showed omental thickening in only 5 patients. Conclusion: Peritoneal and omental thickening detected by CT and ascites with fine, mobile septations shown by US strongly suggest the ascitic type of tuberculous peritonitis. The 2 imaging modalities should be used together for accurate diagnosis of tuberculous peritonitis. (orig.).

  6. Tissue engineering of the small intestine by acellular collagen sponge scaffold grafting.

    Science.gov (United States)

    Hori, Y; Nakamura, T; Matsumoto, K; Kurokawa, Y; Satomi, S; Shimizu, Y

    2001-01-01

    Tissue engineering of the small intestine will prove a great benefit to patients suffering from short bowel disease. However cell seeding in tissue engineering, such as fetal cell use, is accompanied by problems of ethical issues, rejection, and short supply. To overcome these problems, we carried out an experimental study on tissue engineering of the small intestine by acellular collagen sponge scaffold grafting. We resected the 5 cm long jejunum from beagle dogs and reconstructed it by acellular collagen sponge grafting with a silicon tube stent. The graft was covered with the omentum. At 1 month after operation, the silicon stent was removed endoscopically. Animals were sacrificed 1 and 4 months after operation, and were examined microscopically. Neo-intestinal regeneration was observed and the intestinal mucosa covered the luminal side of the regenerated intestine across the anastomosis. Thus, the small intestine was regenerated by tissue engineering technology using an acellular collagen sponge scaffold.

  7. Laparoscopic paracostal herniorrhaphy in a dog: case report

    Directory of Open Access Journals (Sweden)

    A.B. Trindade

    2013-12-01

    Full Text Available Traumatic paracostal hernia is classified as an abdominal hernia that protrudes from the abdomen to a non physiologic space over the ribs. Treatment requires surgical reconstruction of the disrupted musculature in the thoracoabdominal region. Laparoscopic paracostal herniorrhaphy was performed in an eight-month-old male Teckel, presented after a car accident injury. A three-portal laparoscopic access was used for definitive diagnosis and hernia correction. After traction of the herniated omentum, a thoracoabdominal communication caused a left side pneumothorax, which was successfully drained with a chest tube placement. The herniorrhaphy was accomplished with intracorporeal sutures by a combination of Ford interlocking and cross mattress patterns. The postoperative period was uneventful. The laparoscopic paracostal herniorrhaphy was satisfactory, allowing both diagnosis and correction of the paracostal defect, showing to be a feasible alternative to the open surgery.

  8. Partial resection and omentalization: a new technique for management of prostatic retention cysts in dogs.

    Science.gov (United States)

    Bray, J P; White, R A; Williams, J M

    1997-01-01

    The purpose of this study was to determine the results of a new technique for management of prostatic retention cysts in dogs. A retrospective clinical study. Eighteen client-owned dogs. Dogs with prostatic retention cysts were treated by celiotomy and drainage of the cysts. The majority of the cyst wall was resected and residual cyst cavities were packed with omentum. All dogs were castrated. Long-term resolution of clinical signs was achieved in all dogs, with follow-up periods ranging from 6 to 42 months. Five dogs developed urinary incontinence postoperatively. This persisted in two dogs, but was well controlled with phenylpropanolamine. In the remaining dogs, the incontinence was transient and resolved within 2 months of surgery. Partial cyst resection combined with omentalization and castration was a simple and effective means of managing prostatic retention cysts. The incidence of serious complications, including postoperative urinary incontinence, was low.

  9. Transplantation of an eight-organ multivisceral graft in a patient with frozen abdomen after complicated Crohn's disease

    Institute of Scientific and Technical Information of China (English)

    Andreas Pascher; Jochen Klupp; Sven Kohler; Jan M Langrehr; Peter Neuhaus

    2006-01-01

    To report an extended multivisceral transplantation (MVTx) including right kidney and ascending colon in a patient with complicated Crohn's disease (CD).A 36-year old female suffering from short bowel syndrome and frozen abdomen due to fistulizing CD after multiple abdominal operations underwent MVTx of eight organs including stomach, pancreatoduodenal complex, liver, intestine, ascending colon, right kidney,right adrenal gland, and greater omentum in November 2003. Immunosuppression consisted of alemtuzumab,tacrolimus and steroids. The patient was off parenteral nutrition by postoperative wk 3. She experienced one episode of pneumonia. The patient recovered completely and discharged 2.5 mo and was doing well 30 mo after MVTx. This is one of the very rare cases in which a complete mulitivisceral graft of eight abdominal organs was transplanted orthotopically.

  10. An Unusual Case of Ascending Pancreatitis with Mediastinal Involvement: A Case Report with CT and MRI Findings

    Directory of Open Access Journals (Sweden)

    Ernesto Di Cesare

    2014-01-01

    Full Text Available Fluid collections are common findings of pancreatitis and spread, more often, along preferential drainage pathways in the abdomen. In some rare cases, fluid collections may spread towards extra-abdominal sites like the mediastinum leading to the formation of mediastinal collections. We present the case of a 52-years-old man with pain in the right upper quadrant of the abdomen and mid-epigastrium lasting for some hours. Laboratory tests suggested a diagnosis of pancreatitis. CT and subsequent MRI revealed changes consistent with acute exacerbation on chronic pancreatitis spreading to the mediastinum and to the greater omentum. The patient received medical treatment and reported gradual improvement in his laboratory results and CT findings.

  11. A ventral incisional hernia with herniation of the left hepatic lobe and review of the literature.

    Science.gov (United States)

    Neelamraju Lakshmi, Harish; Saini, Devendra; Om, Prabha; Bagree, Rajendra

    2015-01-28

    Ventral incisional hernias with hepatic herniation are extremely rare. Only six cases have been reported so far in the literature. We report a case of a ventral incisional hernia with hepatic herniation along with a review of the literature. A 70-year-old female patient with a history of coronary artery bypass graft surgery 6 months earlier, was admitted to our hospital with symptoms of epigastric swelling and discomfort for 3 months. On examination, she had a mild tender 5 cm×5 cm epigastric lump and was diagnosed as ventral incisional hernia. Contrast-enhanced CT of the abdomen revealed a ventral hernia with herniation of omentum and left hepatic lobe. The patient underwent onlay mesh repair and is asymptomatic at 1-month follow-up. There is a need for evaluation of risk factors for this type of ventral incisional hernia and to recognise it as a special entity.

  12. Solitary axillary lymph node metastasis without breast involvement from ovarian Cancer: Case report and brief literature review

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Ji In; Kim, Soo Jin; Park, Sung Hee; Kim, Hee Sung [Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul (Korea, Republic of)

    2014-11-15

    Axillary lymph node metastasis without breast involvement from ovarian cancer is rare. We report a case of a 68-year-old woman proven as ovarian serous papillary carcinoma and metastatic papillary carcinoma of the omentum on surgical diagnostic laparoscopy. In addition, a hypermetabolic lymph node was detected in left axilla and was considered a reactive benign lesion. Mammography and ultrasonography showed no focal lesion in both breasts, but ultrasonography-guided core needle biopsy for the lymph node revealed metastatic serous papillary carcinoma from ovarian origin. Even with a low incidence of axillary lymph node metastasis without breast involvement from ovarian cancer and only marginally elevated standardized uptake value in positron emission tomography, the possibility of metastasis at axillary lymph node in patients with known primary ovarian cancer must be considered.

  13. The effect of polyethylene glycol adhesion barrier (Spray Gel) on preventing peritoneal adhesions.

    Science.gov (United States)

    Dasiran, F; Eryilmaz, R; Isik, A; Okan, I; Somay, A; Sahin, M

    2015-01-01

    The prominent cells in the late phase of wound healing during proliferation and matrix deposition are fibroblasts. Foreign materials in the operation site like prosthesis prolong the inflammation and induce fibroblast proliferation (8). 3 different prostheses used in this study induced chronic inflammation and fibrosis and provided an effective repair. Dense and thick adhesions due to fibrosis also induced strong adhesions to omentum and small intestine if only polypropylene mesh used for hernia repair. However, there was no difference between SprayGel treated polypropylene mesh and Sepramesh when compared for fibrosis. It also prevents the intraabdominal adhesion formation. It is nontoxic, sticky adherent, non- immigrant and easy to use both in open and laparoscopic surgeries. This experimental study revealed that polyethyleneglycol applied polypropylene mesh accomplishes hernia repair with significantly less adhesion formation than polypropylene mesh alone while securing a remarkable economy than adhesion barrier coated dual meshes (Tab. 6, Fig. 7, Ref. 23). Text in PDF www.elis.sk.

  14. A case of idiopathic omental hemorrhage

    Directory of Open Access Journals (Sweden)

    Toshimitsu Hosotani

    2016-05-01

    Full Text Available With the exception of trauma, intraperitoneal hemorrhage in young women is caused by the high frequency of ectopic pregnancy and ovarian bleeding. Here, we describe a case of idiopathic omental hemorrhage, which is a rare cause of intraperitoneal hemorrhage. Intraperitoneal hemorrhage was suspected in a 38-year-old Japanese woman based on contrast-enhanced computed tomography. Her last menstrual period was 23 days prior, and ovarian bleeding was considered based on bloody ascites revealed by culdocentesis. She underwent emergency surgery for hypovolemic shock. Although both ovaries were of normal size and no abnormal findings were observed, we performed a partial omentectomy because multiple clots were attached only to the greater omentum. Postoperatively, no rebleeding occurred, and she was discharged 11 days after the surgery. Because she did not have a clear history of trauma and underlying disease, idiopathic omental hemorrhage was diagnosed.

  15. CYTOLOGICAL DIAGNOSIS OF GELATINOUS ASCITES

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    Samith

    2013-04-01

    Full Text Available ABSTRACT: Pseudomyxoma peritonei (PMP is a condition characte rized by the accumulation of mucinous material in the peritoneal cavity (gela tinous ascites. Pseudomyxoma peritonei is an uncommon condition in which mucinous ascites causes progressive abdominal distension and gastrointestina l dysfunction. We present a case of 44 year old female who presented with gradually progres sive abdominal distension since 6 months. An ascitic tap was performed and the fluid wa s sent for cytological study. Cytology showed pools of acellular mucin. On laparotomy there was mucinous material in the abdomen that was evacuated. Appendix and omentum were found t o be thickened, hence appendicectomy was done and omental biopsy taken. Histopathological diagnosis of well differentiated mucinous adenocarcinoma of appendix with rupture and mucinous ascitis was made.

  16. Spontaneous disappearance of a normal adnexa associated with a contralateral polycystic-appearing ovary.

    Science.gov (United States)

    Olufowobi, O; Sorinola, O; Afnan, M; Papaioannou, S; McHugo, J M; Sharif, K

    2002-11-01

    Absence of the adnexa may be congenital or acquired. However, the etiology is often uncertain. A 27-year-old woman presented with a 3-year history of subfertility. Her irregular menstruation was associated with acne vulgaris, alopecia, and elevated body mass index. Transvaginal ultrasonography of the pelvis showed a normal uterus, a normal right ovary, but a polycystic-appearing left ovary. A hysterosalpingogram demonstrated a normal uterine cavity, prompt filling and spilling of contrast material from the left fallopian tube, but no filling on the right. Subsequent laparoscopy showed an unexpected absence of right adnexa and presence of a solitary rounded free-floating mass enshrouded in the omentum. She did not have a history of abdominal pain or surgery. The evidence suggests that the patient might have had an asymptomatic infarction of the right adnexa.

  17. [Ultrasound semiotics in recurrent ovarian cancer after optimal cytoreductive surgery].

    Science.gov (United States)

    Baklanova, N S; Kolomiets, L A; Frolova, I G; Viatkina, N V; Krasil'nikov, S É

    2014-01-01

    Features of ultrasound picture of morphologically verified recurrence of ovarian cancer in 21 patients are presented, who received combined treatment including cytoreductive surgery in the form of hysterectomy with oophorectomy, resection of the greater omentum and 6 courses of chemotherapy CAP for ovarian cancer stage III (FIGO). In all patients cytoreductive surgery was optimal--without residual tumor. Recurrence of the disease was detected in 12-48 months in 80.9% of the cases. Three variants of recurrence was revealed by ultrasonography: isolated peritoneal dissemination, in 14.2% of the cases, which was mainly detected during the first 12 months; single entities in the projection of the small pelvis (61.9%) and mixed form (local lesions of small pelvis and peritoneal dissemination) in 23.8% of the cases.

  18. Isolated omental duplication cyst with respiratory epithelium & pancreatic glands: Case report & review of literature

    Directory of Open Access Journals (Sweden)

    Phuoc T. Nguyen

    2016-08-01

    Full Text Available Duplication cysts are uncommon congenital anomalies. They are usually in communication with or are attached to an adjacent segment of bowel. Rarely are they completely isolated from the gastrointestinal tract. To date, there have been 29 reported cases of non-communicating or isolated duplication cysts. Few contain respiratory epithelium and pancreatic glands. Patients may present with pain, an acute abdomen, bleeding or malignant degeneration. Differential diagnoses for an isolated cystic mass should include duplication cyst in the pediatric population. Recognition and awareness of these anomalies and their various presentations can aid in management. The unusual case of an isolated duplication cyst containing respiratory and pancreatic tissue, found within omentum, is presented with a review of the literature.

  19. ACCESSORY SPLEEN

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    Radhika

    2016-05-01

    Full Text Available Accessory spleen is a small nodule of splenic tissue found apart from main body of spleen. Other name for accessory spleen is supernumerary spleen, splenule or splenunculus. It is usually congenital failure of fusion of splenunculus found close to hilum of spleen, greater omentum, tail of pancreas. Accessory spleen is found approximately in 10% population. MATERIALS AND METHODS The present study 100 cadaveric spleens obtained from routine dissection, specimens present in Department of Anatomy, Andhra Medical College, Vishakhapatnam in 3 years span, out of which 25 are foetal spleens, 75 are adult spleens. RESULTS We got 4 accessory spleens in adult and 1 in foetal spleen. CONCLUSION The knowledge of accessory spleen is medically significant. That they may result in interpretation errors in diagnostic imaging and symptoms may be continued after splenectomy.

  20. Peritonitis Aguda por Diverticulo Apendicular Perforado / Acute perforated diverticulum appendiceal peritonitis

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    Martinez Villalba N

    2015-11-01

    Full Text Available Appendix diverticular disease is a casual finding after appendectomies or pathological studies of surgical samples. Most patients are male adults between the fourth and fifth decade of life. 16 years old male consults for a 48 hours stitch pain in right iliac fossa of moderate intensity radiating to lower abdomen with nausea and fever, without vomiting or diarrhea. Presents lower abdominal pain with muscle guarding and pain on physical examination. Bowel sounds negative. Laboratory routine study shows leukocytosis with neutrophilia. A perforated diverticulum of about 15cm diameter is found during surgery in the middle third of the cecum appendix with 200cc purulent fluid in and multiple adhesions to transverse colon, omentum and small intestine. A conventional appendectomy is performed. Acute appendix diverticulitis is a rare entity and its finding is by casualty. It is important to consider it a differential diagnosis especially in the intraoperative treatment which in most cases does not differ from conventional appendectomy.

  1. Function of the replanted spleen in dogs

    Energy Technology Data Exchange (ETDEWEB)

    Velcek, F.T.; Kugaczewski, J.T.; Jongco, B.; Shaftan, G.W.; Rao, P.S.; Schiffman, G.; Kottmeier, P.K.

    1982-06-01

    The function of replanted splenic fragments was studied by comparing three groups of five dogs each, one group with intact spleens; one, post-splenectomy; and one with splenic replantation. Fifteen fragments were implanted into the omentum. Howell-Jolly bodies appeared after splenectomy but cleared in the replanted group after several months. /sup 125/I-tagged attenuated pneumococcal clearance studies showed a significant difference between control and replanted group compared with the splenectomized group. The increase of pneumococcal antibody titers after vaccination differed significantly between the splenectomized and the replanted group. All replanted fragments were viable and showed growth over a 2-year period. These studies demonstrate that omental replantation of the canine spleen leads to the maintenance of certain functional splenic parameters comparable to the normal spleen which are significantly different from the splenectomized animal.

  2. Benign multicystic mesothelioma with concurrent colonic adenocarcinoma: a report of two cases.

    Science.gov (United States)

    Husain, Anwar; Ozdemirli, Metin

    2012-10-01

    Benign multicystic mesothelioma (BMM) is a rare tumoral lesion of the peritoneum often discovered incidentally upon surgery, laparoscopy, or radiographical imaging in females of childbearing age. The etiology and question as to whether these lesions occur via a neoplastic or reactive process still remain unknown. In this report, we present two cases of BMM detected in females with concurrent colonic adenocarcinoma arising in the ileocecal region. The tumors were present in the serosa surrounding the colonic adenocarcinoma in one case, and in the omentum in the other case, which grossly mimicked peritoneal seeding of carcinoma. An immunohistochemical analysis revealed that the cells lining the cystic spaces in both lesions were positive for keratin and calretinin, confirming their mesothelial origin. To the best of our knowledge, these cases represent the first documented examples of multicystic mesothelioma concurrent with colonic adenocarcinoma.

  3. Appendiceal mucinous cystadenoma associated with pseudomyxoma peritonei and multicystic peritoneal mesothelioma: report of a case.

    Science.gov (United States)

    Kusuyama, T; Fujita, M

    1995-01-01

    An extremely rare case of mucinous cystadenoma developing to pseudomyxoma peritonei together with multicystic peritoneal mesothelioma is herein reported. The patient was 25-year-old Japanese woman who underwent an appendectomy under the diagnosis of acute appendicitis because of right lower abdominal pain. The patient histopathologically demonstrated appendiceal mucocele with pseudomyxoma peritonei. She underwent a laparotomy in our unit following detailed examinations. Several cystic tumors measuring from 3 to 5 cm in diameter were found in the omentum, and thus omentectomy, partial cecectomy and left oophorectomy were all performed to resect the tumors. Immunostaining and electron microscopy showed the appendiceal lesion to be mucinous cystadenoma, while the peritoneal lesion was multicystic mesothelioma. To our knowledge, this is the first report in the world literature of this rare combination of diseases.

  4. Cystic mesothelioma of the peritoneum.

    Science.gov (United States)

    Datta, R V; Paty, P B

    1997-10-01

    A 48-year-old man presented with a 3-month history of weight loss and progressive right lower quadrant abdominal pain. His medical history was notable for appendectomy at age 17. Ultrasonography and computed tomography of the abdomen revealed a 12 cm multicystic mass in the right paracolic space. At laparotomy a large serous cyst was found arising from the lateral wall of the cecum, and four additional small cysts were found on the small bowel mesentery, greater omentum, liver capsule, and right hemi-diaphragm. Complete removal of the tumor was accomplished by right colectomy with extraperitoneal dissection of the large cyst and simple excision of the four smaller cysts. Final pathology with immunohistochemical staining confirmed cystic mesothelioma of the peritoneum. In this report we discuss the diagnostic workup and treatment of this rare disease.

  5. Multicystic, peritoneal mesothelioma: a report with electron microscopy of a case mimicking intra-abdominal cystic hygroma (lymphangioma).

    Science.gov (United States)

    Mennemeyer, R; Smith, M

    1979-08-01

    A 27-year-old Caucasian female complained of persistent, poorly localized abdominal pain of several months' duration, found to be due to a multicystic diffuse lesion involving omentum, peritoneum and pelvic viscera. Three resections were required within a ten-month period for symptomatic control. The tumor showed many of the clinical, operative, gross and light microscopic features of intra-abdominal lymphagioma. Tissues removed at the third operation, however, were examined by electron microscopy, and found to consist of a myriad of small cysts and channels lined by mesothelial cells. In view of these findings, the lesion was regarded as a cystic peritoneal mesothelioma. Similarities between lymphangioma and peritoneal mesothelioma are discussed. It is suggested that electron microscopic examination of lining cells of cystic lesions which are considered grossly consistent with lymphagiomas may yield additional similar cases.

  6. A RARE CASE OF BOWEL PERFORATION SECONDARY TO VENTRICULO PERITONEAL SHUNT

    Directory of Open Access Journals (Sweden)

    Aditya Pratap

    2014-10-01

    Full Text Available Bowel perforation is an unusual complication of ventriculo peritoneal shunt. We are presenting a case of 15 month old male child with the shunt tubing protruding through the anus associated with bowel perforation. This complication occurred after the 13 months of insertion of ventriculo peritoneal shunt for congenital hydrocephalus. There were no signs of meningitis but mild signs of peritonitis were present. At laparotomy the tube was seen to enter the sigmoid colon and was encapsulated by the greater omentum. The tube was cut and the distal end removed via the anus. Proximal part of shunt also removed because there was contralateral shunt present. Perforation was repaired. We are here in presenting a rare complication of VP shunt.

  7. Extensive gastric varices demonstrated by technetium-99m red blood cell scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Shih, W.J.; Domstad, P.A.; Loh, F.G.; Pulmano, C.

    1987-04-01

    An alcohol abuse patient complicated by chronic pancreatitis had splenic vein thrombosis leading to gastric varices and underwent abdominal Tc-99m red blood cell scintigraphy. First pass study, sequential images up to 1 hour, and a 2.5 hour image showed abnormal radioactivity in the left side of the abdomen and midabdomen. In 24 hour images, the high level of activity in the left side persisted; in addition, there was accumulation of radioactivity in the cecum, ascending, transverse colon, the splenic flexure, and descending colon. A splenectomy was performed and during the surgical procedure, a large dilated vein in the greater omentum was noted. It is reemphasized that delayed imaging up to 24 hours is important when the results of earlier images are equivocal or negative.

  8. Torsión de un apéndice epiploico. Reporte de 2 casos: características ecográficas y tomográficas

    Directory of Open Access Journals (Sweden)

    Daniel Sayago-Castro

    2002-03-01

    Full Text Available El infarto de una apéndice epiploica produce un proceso inflamatorio que se localiza en la región del colon afectada así como a la porción correspondiente del omento mayor. La apendagitis epiploica tiene hallazgos sonográficos y de TAC característicos los cuales contribuyen al diagnostico rápido y por lo tanto ayudan con el manejo del paciente. Se presentan aquí dos casos.Acute infarction of an appendix epiploica results in an inflammatory process localizad to the affected portion of the colon and the adjacent greater omentum. The primary epiploic apendagitis has fairly characteristic US and CT features that contribute to a rapid diagnosis and help in the hand ling of the patient. We present here two cases recently seen by the author that illustrate this condition.

  9. Mummified papyraceous fetuses in the abdominal cavity of an elderly female dog with pyometra

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    F.A. Voorwald

    2012-04-01

    Full Text Available This paper reports on a rare case of fetal papyraceous mummification after asymptomatic uterine rupture in an elderly female dog with pyometra. The patient had a history of mating six months before the examination but no apparent signs of gestation or parturition. Exploratory laparotomy was used to identify a rupture of the left uterine horn and the presence of cystic endometrial hyperplasia and pyometra. Two mummified papyraceous fetuses were observed in the abdominal cavity and had adhered to the spleen, pancreas, intestine and omentum. Ovariehysterectomy and corrective surgery were performed. The patient had remained healthy after uterine rupture until a new estrous cycle and the development of pyometra. Bitches that are 10 years old or more are predisposed to implantation failure, pregnancy or parturition problems and they should not be breed to avoid complications.

  10. Peritoneal adhesion index (PAI: proposal of a score for the “ignored iceberg” of medicine and surgery

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    Coccolini Federico

    2013-01-01

    Full Text Available Abstract Peritoneal adhesions describe a condition in which pathological bonds form between the omentum, the small and large bowels, the abdominal wall, and other intra-abdominal organs. Different classification systems have been proposed, but they do not resolve the underlying problem of ambiguity in the quantification and definition of adhesions. We therefore propose a standardized classification system of adhesions to universalize their definition based on the macroscopic appearance of adhesions and their diffusion to different regions of the abdomen. By scoring with these criteria, the peritoneal adhesion index (PAI can range from 0 to 30, unambiguously specifying precise adhesion scenarios. The standardized classification and quantification of adhesions would enable different studies to more meaningfully integrate their results, thereby facilitating a more comprehensive approach to the treatment and management of this pathology.

  11. Parietal wall endometriosis: a rare case report

    Directory of Open Access Journals (Sweden)

    Mahija Sahu

    2015-04-01

    Full Text Available A 28 year old P2L1 with one previous cesarean presented with cyclical pain in periumblical area just below umbilicus for 1 year with USG finding suggestive of parietal wall endometriosis planned for surgery on her 2nd day of menstruation. She underwent diagnostic laparoscopy with complete excision of endometrioma. Diagnostic laparoscopy showed no evidence of endometrioma in the pelvic cavity except for omental adhesion at parietal wall endometrioma site, adhesiolysis of omentum, mesh repair of rectus sheath defect done. She is followed up for last 3 cycles post-operative and has no cyclical pain further. [Int J Reprod Contracept Obstet Gynecol 2015; 4(2.000: 524-526

  12. Perspectives of treatment of anemias with cells of fetal liver, immobilized in macroporous alginate-gelatin carriers

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    Gritsay D.V.

    2014-06-01

    Full Text Available Aim of the work was to study possibility of erythropoiesis stimulation by transplantation of fetal liver cells, seeded into macro¬porous carriers to the rats with post-hemorrhargic anemia, induced by 70% hepatectomy. Fetal liver cells (FLC were isolated from fetuses of rats with 15 days’ gestation and were cryopreserved. Decryopreserved FLC were seeded into macroporous spongy alginate-gelatin scaffolds, which were covered by alginate capsule and implanted into omentum of rats with modeled liver insufficiency. It was shown that fetal liver cells, immobilized in macroporous scaffolds after implantation have positive effect on red blood count and hemoglobin content, indicating that this approach is promising for the development of new methods of anemia treatment.

  13. Giant hepatic hydatid cyst: A case report

    Institute of Scientific and Technical Information of China (English)

    Ali Ezer; Tank Zafer Nursal; Turgut Noyan; G(o)khan Moray

    2007-01-01

    Large type 1 cysts are prone to perforation. Furthermore, insufficient drainage with subsequent abscess is a frequent problem of large cysts. We report here a case of a 19-year old man who was admitted to the hospital with pain in the right upper quadrant and epigastric region. An asymmetrical right upper quadrant enlargement was detected on physical examination. Ultrasonography and computerized tomography revealed a type 1 giant hydatid cyst in the right hepatic lobe, measuring 16 cm in diameter. During operation, partial cystectomy and drainage were done. The large dead space was obliterated by the 'sandwich' method. Omentum and gelatin sponges were used to fill the cavity. The postoperative period was uneventful and the patient was discharged on the 5th postoperative day.

  14. CT findings of hepatic abscess arising from perforated acute cholecystitis

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Sang Hee; Lee, Kyoung Soo; Lee, Jin Seoung; Lee, Moon Gyu; Chung, Young Hwa; Lee, Young Sang; Lee, Sung Gyu; Auh, Yong Ho [Ulsan Univ. College of Medicine, Seoul (Korea, Republic of)

    1996-01-01

    The purpose of this study was to report the CT findings of four patients with hepatic abscess secondary to perforated acute cholecystitis. We retrospectively reviewed the CT findings of four patients with surgically proven hepatic abscess secondary to perforated acute cholecystitis. CT findings were analysed with respect to the observation of the gallbladder, pericholecystic space, hepatic lesions, and peritoneal cavity. All patients underwent cholecystectomy, with drainage of the hepatic abscess. CT findings of hepatic abscess secondary to perforated acute cholecystitis were hypodense mass formation in the pericholecystic space(n=3), irreguarity and wall defect of Gallbladder(n=4), thickened Gallbladder wall(n=4), stone with debris(n=4), and local or diffuse infiltration of the pericholecystic area(n=3), omentum, and mesentery. CT was helpful in diagnosing the hepatic abscess secondary to perforated acute cholecystitis.

  15. [Enteral nutrition through long-term jejunostomy].

    Science.gov (United States)

    Fernández, T; Neira, P; Enríquez, C

    2008-01-01

    We present the case of a female patient suffering a peritonitis episode after subtotal gastrectomy due to gastric neoplasm in relation to lesser curvature necrosis extending to the anterior esophageal wall. This an uncommon andsevere complication that made mandatory further aggressive surgery: transection of the abdominal esophagus, transection of the gastric stump, and cervical esophagostomy with creation of a jejunostomy with a needle catheter for feeding. This digestive tube access technique is generally used during major abdominal post-surgery until oral intake is reestablished. Our patient has been 187 days with this therapy since reconstruction of the GI tract was ruled out due to tumoral infiltration of the colon and tumor recurrence at the gastrohepatic omentum. To date, there has been no complication from permanence and/or long-term use of this technique.

  16. Hernia sacs: is histological examination necessary?

    Science.gov (United States)

    Wang, Tao; Vajpeyi, Rajkumar

    2013-12-01

    The hernia sac is a common surgical pathology specimen which can occasionally yield unexpected diagnoses. The College of American Pathologists recommends microscopic examination of abdominal hernias, but leaves submission of inguinal hernias for histology to the discretion of the pathologist. To validate this approach at a tertiary care centre, we retrospectively reviewed 1426 hernia sacs derived from inguinal, femoral and abdominal wall hernias. The majority of pathologies noted were known to the clinician, including herniated bowel, lipomas and omentum. A malignancy was noted in three of 800 inguinal hernias and seven of 576 abdominal wall hernias; five of these lesions were not seen on gross examination. Other interesting findings in hernia sacs included appendices, endometriosis, a perivascular epithelioid cell tumour, and pseudomyxoma peritoneii. All hernia sacs should be examined grossly as most pathologies are grossly visible. The decision to submit inguinal hernias for histology may be left to the discretion of the pathologist, but abdominal and femoral hernias should be submitted for histology.

  17. Non-Hodgkin lymphoma: computed tomographic demonstration of unusual extranodal involvement

    Energy Technology Data Exchange (ETDEWEB)

    Glazer, H.S.; Lee, J.K.T.; Balfe, D.M.; Mauro, M.A.; Griffith, R.; Sagel, S.S.

    1983-10-01

    With the advent of computed tomography, lymphomatous involvement of sites other than lymph nodes is being seen with increasing frequency. Review of computed tomographic scans in 400 patients with newly diagnosed or recurrent non-Hodgkin lymphoma revealed 37 patients to have involvement of 56 unusual sites below the diaphragm: psoas/iliacus muscle (16 patients), kidney (13 patients), pancreas (5 patients), adrenal (4 patients), skin/subcutaneous tissue (4 patients), abdominal wall musculature (4 patients), peritoneum (4 patients), omentum (3 patients), and female reproductive tract (3 patients). These were mostly seen in patients with lymphomas of diffuse architecture, especially diffuse histiocytic lymphoma. Concomitant retroperitoneal and/or mesenteric adenopathy was very common; extraodal involvement was rarely the only site of initial or recurrent lymphoma.

  18. Non-Hodgkin lymphoma: computed tomographic demonstration of unusual extranodal involvement.

    Science.gov (United States)

    Glazer, H S; Lee, J K; Balfe, D M; Mauro, M A; Griffith, R; Sagel, S S

    1983-10-01

    With the advent of computed tomography, lymphomatous involvement of sites other than lymph nodes is being seen with increasing frequency. Review of computed tomographic scans in 400 patients with newly diagnosed or recurrent non-Hodgkin lymphoma revealed 37 patients to have involvement of 56 unusual sites below the diaphragm: psoas/iliacus muscle (16 patients), kidney (13 patients), pancreas (5 patients), adrenal (4 patients), skin/subcutaneous tissue (4 patients), abdominal wall musculature (4 patients), peritoneum (4 patients), omentum (3 patients), and female reproductive tract (3 patients). These were mostly seen in patients with lymphomas of diffuse architecture, especially diffuse histiocytic lymphoma. Concomitant retroperitoneal and/or mesenteric adenopathy was very common; extranodal involvement was rarely the only site of initial or recurrent lymphoma.

  19. An estimation of diazinon in omental tissue.

    Science.gov (United States)

    Kirkbride, K P

    1987-01-01

    A fatality in which diazinon was the suspected toxic agent was investigated. Samples of omental tissue, blood, and liver tissue were examined by gas chromatography and thin layer chromatography. Diazinon was found in the omentum (at a level of 5.1 mg/kg) and blood (in a trace amount), but no diazinon was found in the liver tissue. Methods are given for the extraction of diazinon from omental fat, the purification of these extracts by sweep co-distillation and fat precipitation, and for an estimation of the amount of diazinon present. It is not possible to determine whether the low level found arose from chronic occupational exposure, accidental dermal contact, or ingestion of a lethal dose.

  20. Bochdaleck's hernia complicating pregnancy: Case report

    Institute of Scientific and Technical Information of China (English)

    Nikolaos Barbetakis; Andreas Efstathiou; Michalis Vassiliadis; Theocharis Xenikakis; Ioannis Fessatidis

    2006-01-01

    Diaphragmatic hernia complicating pregnancy is rare and results in a high mortality rate, particularly if early surgical intervention is not undertaken. We report a case in which a woman presenting at 23 wk's gestation was admitted with symptoms of respiratory failure and bowel obstruction due to incarceration of viscera through a left posterolateral defect of the diaphragm (Bochdalek's hernia). Surgery (left thoracoabdominal incision)demonstrated compression atelectasis, mediastinal shift, strangulation and gangrene of the herniated viscera which led to segmental resection of the involved portion of large intestine with re-establishment of bowel continuity by end to end anastomosis. The greater omentum was partly necrotic necessitating resection.The diaphragmatic defect was closed with interrupted sutures. Postoperative period was uncomplicated.Pregnancy was allowed to continue until 39 wk's gestation at which time elective cesarean delivery was performed. It is concluded that symptomatic maternal diaphragmatic hernia during pregnancy is a surgical emergency and requires a high index of suspicion.

  1. Renal Cell Carcinoma Metastasis from Biopsy Associated Hematoma Disruption during Robotic Partial Nephrectomy

    Directory of Open Access Journals (Sweden)

    Christopher Caputo

    2014-01-01

    Full Text Available We describe a case in which a patient with a past medical history of ovarian cancer received a diagnostic renal biopsy for an incidentally discovered renal mass. During left robotic partial nephrectomy (RPN, a perinephric hematoma was encountered. The hematoma was not present on preoperative imaging and was likely a result of the renal biopsy. The renal cell carcinoma (RCC and the associated hematoma were widely excised with negative surgical margins. On follow-up imaging at five months postoperatively, a recurrent renal mass at the surgical resection bed and several new nodules in the omentum were detected. During completion left robotic total nephrectomy and omental excision, intraoperative frozen sections confirmed metastatic RCC. We believe that a hematoma seeded with RCC formed as a result of the renal biopsy, and subsequent disruption of the hematoma during RPN caused contamination of RCC into the surrounding structures.

  2. Feline infectious peritonitis (FIP in our section material

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    Aleksić-Kovačević Sanja

    2004-01-01

    Full Text Available Feline infectious peritonitis (FIP has been diagnozed in our section material in 23 cats, 19 Persian and 4 domestic, of both sexes, aged between 5 months and 8 years. The majority of the infected population were animals under 20 months of age. The macroscopic finding in most cats was of granulomatous character, and large quantities of goldenyellow gelatinous exudate were observed in the stomach cavity of 7 animals, corresponding to the exudative form of FIP. Granulomas were in most cases located in the abdomen wall, liver, spleen, omentum and serous membrane of intestines, and the histological structure was characterized by fibrinoid-necrotic centers with numerous lymphocytes, monocytes, angioblasts and fibroblasts. Immunohistochemically, feline corona virus (FCV antigens were exprimed in the cytoplasm of macrophages, more rarely in plasma cells in granulomas, and sometimes in necrotized areas.

  3. Omental Torsion after Laparoscopic Roux-en-Y Gastric Bypass Mimicking Appendicitis: A Case Report and Review of the Literature

    Science.gov (United States)

    Basilicata, Giacinto; Nocito, Antonio

    2016-01-01

    Introduction. Laparoscopic Roux-en-Y gastric bypass (LRYGBP) is a common procedure in obesity surgery. The aim of an antecolic approach is to reduce the rate of internal herniation. Our aim is to make bariatric surgeons aware of another possible complication of antecolic LRYGBP. Methods and Results. We present a case report of omental torsion 24 months after antecolic LRYGBP presenting as an acute abdomen, suggesting appendicitis. During diagnostic laparoscopy, omental infarction due to torsion was observed. Resection of the avital omentum was performed. Discussion. Omental torsion after antecolic LRYGBP is a rare complication. When appearing in the early postoperative phase, it may mimic an anastomotic leakage. It may also occur as late complication, presenting with acute abdomen as an appendicitis. PMID:27019758

  4. Data Report. Volume II. Velocity and Temperature Profile Data for Accelerating, Transitional Boundary Layers.

    Science.gov (United States)

    1981-01-01

    CELTA ’ INTEGPAL = -.46312 -. 43524 CLAUSEPS ’G’ INTEGRAL : 5.b0813 3.11775 DISPLACEMENT THICKNESS - CONST6NT DENSITY : .029C9 .C2426 0OMENTUM...FE (FEX) = 4C~n :NCLT VALLr CF ELCCITY CELTA = 1C- jLtJLT vALLE CF TEP j r’,TLK r E LT A:=2 C tLCLLATEC, (ELT A= E’ E~i L ;E’ I f.P U 7 16 CiL C...5 FLYNCLr, KLvEL~ R E X) Z 7Z457Q.6C 1t\\PLI VALL’ CF E L(CCITy C E L T t 1’L I AL LE CF TE f T LRF-’ VL T P C!LCLLA1En CELTA = [JSL4C-.1’FK1 THIC$ ES

  5. Contaminants in Otter, Mink and Marten in British Colombia

    Directory of Open Access Journals (Sweden)

    Harding L.

    1999-10-01

    Full Text Available As a continuation of studies of mustelids on the Columbia and Fraser River systems in north-western North America, chlorinated hydrocarbon and trace metal contamination of mink, marten and river otter were assessed in relation to physiological and reproductive measures of condition. Mink, marten and river otter were collected during the winters 1994/95 and 1995/96 from commercial trappers. Necropsies included evaluation of the following biological parameters: sex, body mass and length, age, thymus, heart, liver, lung, spleen, pancreas, kidney, gonad, omentum, adrenal gland and baculum (in males masses, baculum length, and stomach contents. Livers were analysed, individually or in pools, for residues of organochlorine (OC pesticides, polychlorinated biphenyls (PCBs, dibenzo-p-dioxins (PCDDs and dibenzofurans (PCDFs. Contamination levels were relatively low compared to those documented in other North American populations, although they ranged higher than those detected during an earlier survey (1990-92 of these regional populations. Nutritional condition varied slightly amongst collection regions, but showed no relationships with contaminant burdens. Specifically, mink from the upper Fraser River appeared to have less fat stores (evaluated by stomach contents and omentum mass, but also showed some of the lowest OC contamination levels observed. Similarly, a few individuals with enlarged livers and kidneys had unremarkable contamination profiles. Although a few individuals with gross abnormalities of reproductive systems did not show high levels of contamination, there was a significant negative correlation between Aroclor 1260 concentrations and baculum length in juvenile mink. The influence of baculum length on reproductive success is unknown, but given similar associations found in juvenile otter from Oregon, the incidence of smaller baculum size and its influence on reproduction needs to be further characterized in a larger subset of these

  6. [Covering of a thoraco-lumbar defect by omentoplasty].

    Science.gov (United States)

    Le Fourn, B; Loirat, Y; Sartre, J Y; Lejeune, F; Pannier, M

    1997-02-01

    With a case of thoraco-lumbar defect, the authors discuss about different procedures to cover it. In this place, the better procedure is certainly the latissimus dorsi flap, in all combinations. The indication for omentoplasty at this spinal site should not be performed by first intention but by exclusion of other procedures, as in the case considered by the authors. It was a 37-year-old man, paraplegic from the age of 16, with a deep chronic spinal wound, secondary to sepsis of a posterior segmental fixations. A staphylococcus aureus infection which developed as a surgical complication was initially treated with antibiotics and surgical cleaning procedures without removing instrumentation. However, the infection remained active and the material was finally removed. Spinal immobilisation was strengthened by external fixation. The area was cleared of all suspect material, including bone graft, leaving a wide back-wound open to the spine. Spontaneous healing was first attempted, but the size and the chronicity of the wound led us to use pedicled greater omentum to close the defect. The omentum was pedicled on the right gastroepiploic vessels and transferred to the back wound through the posterior abdominal wall muscles, next to the right kidney. This procedure allows rapid healing. In association with suitable antibiotics, it has prevented any recurrent infection after 18 months of follow-up. It was no feasible to cover the wound with a latissimus dorsi flap, considering the importance of this muscle in the movements of a paraplegic and considering the initial impossibility of removing the external fixation.

  7. Bilateral primary fallopian tube papillary serous carcinoma in postmenopausal woman: Report of two cases

    Directory of Open Access Journals (Sweden)

    Dipanwita Nag

    2016-01-01

    Full Text Available Primary carcinoma of the fallopian tube is rare and accounts for about 0.14-1.8% of all gynecological malignancies. Correct diagnosis is rarely made preoperatively as clinically tubal carcinoma closely resembles ovarian carcinoma. Here, we report two cases of bilateral primary fallopian tube carcinomas. Case 1: A 54-year-old female presented with postmenopausal bleeding, abdominal pain, and pervaginal watery discharge for 10 days. Ultrasonography (USG of pelvis showed endometrial thickening and multiple tiny echogenic foci in omentum suggestive of omental cake. With a provisional diagnosis of endometrial carcinoma, total abdominal hysterectomy with bilateral salpingo-oophorectomy and omentectomy was done. On gross examination, small and rudimentary right ovary was adherent to the fimbrial end of the tube. Left-sided tubo-ovarian mass was present, cut section of which showed yellowish solid area in tubal wall and encroaching on ovarian surface. On histological examination, sections from the fimbrial end of both fallopian tubes showed features of papillary serous adenocarcinoma. Case 2: 70-year-old lady, 15 years postmenopausal presented with gradual onset pain and swelling of abdomen, urinary incontinence since 4 days. USG showed bulky uterus, 5 cm × 2 cm fibroid, bilateral tubes, and ovaries were not visualized. Serum cancer antigen-125 was raised (159.7 U/ml. Total hysterectomy and bilateral salpingo-oophorectomy with infracolic omentectomy was done. On gross examination, ovaries were firmly attached to tubes and no apparent solid area was noted. On microscopy, papillary serous adenocarcinoma arising from tubal wall was seen infiltrating focally into ovarian stroma; tubal epithelium showed dysplastic change. Sections from omentum showed numerous psammoma bodies.

  8. A malignant omental extra-gastrointestinal stromal tumor on a young man: a case report and review of the literature

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    Almaroof Babatunde

    2008-05-01

    Full Text Available Abstract Background Gastrointestinal stromal tumors (GIST are uncommon intra-abdominal tumors. These tumors tend to present with higher frequency in the stomach and small bowel. In fewer than 5% of cases, they originate primarily from the mesentery, omentum, or peritoneum. Furthermore, these extra-gastrointestinal tumors (EGIST tend to be more common in patients greater than 50 years of age. Rarely do EGIST tumors present in those younger than 40 years of age. Case presentation We report a case of a large EGIST in a 27-year-old male. An abdominal pelvic computerized tomography imaging demonstrated an intra-abdominal mass of 22 cm, without invasion of adjacent viscera or liver lesions. This mass was resected en bloc with its fused omentum and an adherent portion of sigmoid colon. Pathology results demonstrated a malignant gastrointestinal stromal tumor with positive CD117 (c-kit staining, and negative margins of resection, and no continuity of tumor with the sigmoid colon. Due to the malignant and aggressive nature of this patient's tumor, he was started on STI-571 as adjuvant chemotherapy. Conclusion Stromal tumors of an extra-gastrointestinal origin are rare. Of the reported omental and mesenteric EGISTs in four published series, a total of 99 tumors were studied. Of the 99 patients in these series only 8 were under 40 years of age, none were younger than 30 years old; and only 5 were younger than 35 years old. Our patient's age is at the lower end of the age spectrum for the reported EGISTs. Young patients who present with an extra-gastrointestinal stromal tumor (EGIST, who have complete resection with negative margins, have a good prognosis. There is little data to support the role of STI-571 in adjuvant or neoadjuvant therapy after curative resection. Given the lack of data, the use of STI-571 must be individualized.

  9. Significant association of TREM-1 with HMGB1, TLRs and RAGE in the pathogenesis of insulin resistance in obese diabetic populations.

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    Subramanian, Saravanan; Pallati, Pradeep K; Sharma, Poonam; Agrawal, Devendra K; Nandipati, Kalyana C

    2017-01-01

    Activated cell surface and intracellular receptors lead to insulin resistance in obesity. Among these receptors, triggering receptors expressed on myeloid cells (TREM)-1, toll like receptors (TLRs), and receptors for advanced glycation end products (RAGE) play a significant role in the induction of inflammatory response in innate immunity. TREM-1 potentially amplifies TLRs and RAGE synergistically with DNA-binding high-mobility group box 1 (HMGB-1). The objective of the study was to analyze the association between TREM-1/DAP12 and HMGB-1, RAGE and TLRs in obesity-induced insulin resistance. We examined the mRNA expression by RT-PCR and protein expression by Western blotting and immunofluorescence for TREM-1, TREM-2, DAP-12, HMGB-1, RAGE, TLR-4 and TLR-2 in omentum, subcutaneous and liver biopsy tissues of obese diabetic (n=22) and non-diabetic subjects (n=24) and compared with the non-obese non-diabetic controls (n=5). There was a significantly increased expression of TREM-1, DAP-12, HMGB-1, RAGE, TLR-4 and TLR-2 and decreased expression of TREM-2 in the omentum, subcutaneous and liver biopsy of obese diabetic subjects compared to obese non-diabetics and the non-obese population. Overall, obese diabetic subjects had high expression of TREM-1 in association with HMGB1 (100% vs 58.3%, P=0.003), RAGE (77.3% vs 41.7%, P=0.045), TLR4 (100% vs 58.3%, P=0.003), and TLR2 (100% vs 50%, P=0.003) in liver biopsy samples in comparison to obese non-diabetic subjects. Obese diabetics have significantly increased TREM-1, HMGB1, RAGE, and TLRs compared to obese non-diabetics. Our findings suggest a potential pathophysiological role of TREM-1 in conjunction with HMGB1 and inflammatory cell receptors (RAGE, TLR-4 and TLR-2) in obesity-induced insulin resistance.

  10. Functional relevance of the switch of VEGF receptors/co-receptors during peritoneal dialysis-induced mesothelial to mesenchymal transition.

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    María Luisa Pérez-Lozano

    Full Text Available Vascular endothelial growth factor (VEGF is up-regulated during mesothelial to mesenchymal transition (MMT and has been associated with peritoneal membrane dysfunction in peritoneal dialysis (PD patients. It has been shown that normal and malignant mesothelial cells (MCs express VEGF receptors (VEGFRs and co-receptors and that VEGF is an autocrine growth factor for mesothelioma. Hence, we evaluated the expression patterns and the functional relevance of the VEGF/VEGFRs/co-receptors axis during the mesenchymal conversion of MCs induced by peritoneal dialysis. Omentum-derived MCs treated with TGF-β1 plus IL-1β (in vitro MMT and PD effluent-derived MCs with non-epithelioid phenotype (ex vivo MMT showed down-regulated expression of the two main receptors Flt-1/VEGFR-1 and KDR/VEGFR-2, whereas the co-receptor neuropilin-1 (Nrp-1 was up-regulated. The expression of the Nrp-1 ligand semaphorin-3A (Sema-3A, a functional VEGF competitor, was repressed throughout the MMT process. These expression pattern changes were accompanied by a reduction of the proliferation capacity and by a parallel induction of the invasive capacity of MCs that had undergone an in vitro or ex vivo MMT. Treatment with neutralizing anti-VEGF or anti-Nrp-1 antibodies showed that these molecules played a relevant role in cellular proliferation only in naïve omentum-derived MCs. Conversely, treatment with these blocking antibodies, as well as with recombinant Sema-3A, indicated that the switched VEGF/VEGFRs/co-receptors axis drove the enhanced invasion capacity of MCs undergoing MMT. In conclusion, the expression patterns of VEGFRs and co-receptors change in MCs during MMT, which in turn would determine their behaviour in terms of proliferation and invasion in response to VEGF.

  11. Clinical application of local anesthesia in the operation of inguinal incarcerated hernia for elderly( A report of 9 cases)%局部麻醉在老年性腹股沟绞窄疝手术中的临床应用(附9例报告)

    Institute of Scientific and Technical Information of China (English)

    罗国德; 曹永宽; 张林; 张国虎; 王培红; 龚加庆; 王永华

    2012-01-01

    目的:探讨局部麻醉行小肠部分切除吻合和(或)大网膜部分切除治疗老年性腹股沟绞窄疝的可行性和安全性.方法:回顾性分析成都军区总医院全军普外中心2007 -06 -2011 -06对9例老年患者采用局部麻醉行腹股沟绞窄疝手术的临床资料,其中单纯行小肠部分切除吻合6例,大网膜部分切除2例,同时行小肠部分切除吻合和大网膜部分切除1例.结果:手术全部成功,手术时间85-128 min,平均98 min,术后住院时间7-11d,平均8.1d,1例术后出现切口感染,经换药治愈,其余病例无任何并发症发生.结论:局部麻醉行小肠部分切除吻合和(或)大网膜部分切除治疗腹股沟绞窄疝是安全可行的,特别适用于伴有慢性阻塞性肺疾病(COPD)的老年患者.%Objective: To explore the feasibility and security of local anesthesia in the operation of partial small bowel resection and anastomosis or ( and) greater omentum resection for old patients with inguinal incarcerated hemia. Methods; The clinical data of 9 old patients who underwent local anesthesia in the operation of inguinal incarcerated hemia from June 2007 to June 2011 in our hospital were analyzed retrospectively. Six cases underwent partial small bowel resection and anastomosis, 2 cases underwent greater omentum resection, 1 case underwent both of small bowel resection and anastomosis and greater amentum resection simultaniously. Results; All of operations were successful. Operating time was 85 -128 min averaging 98 min. Time of postoperative hospitalization was 7 -11 days averaging 8. Ldays. Infection occurred at the incision site after operation in one case but was cured after dressing. No any of complications occurred in other cases. Conclusion: It is feasible and safe of local anesthesia in the operation of partial small bowel resection and anastomosis or( and) greater omentum resection for patients with inguinal incarcerated hernia, especially for those old patients with

  12. Clinicopathological, immunohistochemical, and ultrastructural study of 13 cases of melanotic schwannoma

    Institute of Scientific and Technical Information of China (English)

    ZHANG Hong-ying; ZHANG Yuan-heng; YANG Guang-hua; CHEN Hui-jiao; WEI Bing; KE Qi; GUO Hua; YE Lü; BU Hong; YANG Ke

    2005-01-01

    Background Melanotic schwannoma is a rare variant of schwannoma composed of melanin-producing cells with ultrastructural features of schwann cells. The description of the course of the tumors differs somewhat, but it is generally considered as a benign lesion. We investigated the clinicopathologic features, immunophenotypes, and ultrastructural features of 13 patients with nonpsammomatous melanotic schwannoma (NPMS).Methods Tumor specimens of each patient were sectioned and stained with hematoxylin-eosin, Fontana-Masson, Prussian blue, and periodic acid-Schiff (PAS). Immunohistochemical markers such as S-100, Leu-7, HMB-45, Melan-A, CK, EMA, vimentin, GFAP, laminin, collagen Ⅳ and MIB-1 were detected with the Envision immunohistochemical staining method. Four of the cases were observed by electron microscopy.Results Of the 13 patients, 8 were male and 5 female, aged from 11 to 92 years (mean, 38.6 years). The tumor sites included the spinal nerve root (5 patients), cranial nerve (1), greater omentum (1), subcutaneous tissue (3), mesentery (1), bone (1) and mediastinum (1). Eleven patients were followed up for over 2 years, with a mean of 5.9 years. One patient (9.1%) with a primary tumor in the greater omentum developed another primary tumor of the same type in the subcutaneous tissue of the abdominal wall after the first operation. Local recurrence of the tumor was seen in 2 patients (18.2%). One patient (9.1%) showed the local recurrence and metastasis. Seven patients (63.6%) showed no evidence of the recurrence or metastasis. Grossly, all tumors were well-circumscribed and the gross findings were suggestive of melanin-containing tumors. The tumor was composed of spindled and epithelioid cells with abundant intracytoplasmic melanin pigments. Nuclei were round and contained delicate, evenly distributed chromatins as well as small, distinct nucleoli. In some areas, the nucleoli were large and prominent. Rare mitoses were seen in most lesions except the larger

  13. 腹股沟难复性疝临床分析35例%Analysis of irreducible inguinal hernia:a study on 35 cases

    Institute of Scientific and Technical Information of China (English)

    徐建敏; 王珂; 王京立

    2014-01-01

    目的:探讨腹股沟难复性疝的手术时机选择。方法回顾性分析2008年10月至2013年12月,无锡市第三人民医院收治难复性腹股沟疝患者35例的临床资料,分析疝环大小、疝囊内容物与手术时机的关系。结果35例患者中,10例行急诊手术,其中股疝8例,腹股沟疝2例,术中发现疝囊内容物为大网膜,疝环直径均<1.0 cm。25例行择期手术,术中证实疝囊内容物均为大网膜,大网膜与疝囊有粘连,疝环直径1.5~3.0 cm。术后均无切口感染、肠梗阻等并发症,随访3个月至3年,均无复发。结论腹股沟难复性疝疝囊内容物大网膜多见,病情严重程度与疝环大小密切相关,疝环大小在手术时机上起决定性作用。%Objective To investigate operation timing of irreducible inguinal hernia.Methods From October 2008 to December 201 3,thirty-five cases of irreducible inguinal hernia in the Third People′s Hospital of Wuxi were reviewed retrospectively to analyze the relationship between hernia ring size,hernia content and operation timing.Results Among the 35 cases,1 0 cases underwent emergency operations, include 8 cases of femoral hernia and 2 cases of inguinal hernia.It was confirmed by operation that the hernia contents were the greater omentum and the hernia rings were <1 .0 cm.The other 25 cases had elective operation.In operations,it was found that the hernia contents were the greater omentum,which had adhesion to sac,and the hernia rings were 1 .5 to 3.0 cm.There were no wound infections,bowel obstructions,postoperative complications.After a follow-up of 3 months to 3 years,no recurrence was observed.Conclusions The greater omentum is the most common hernia content in irreducible inguinal hernia.The severity of disease seems to be associated with the size of hernia ring,which,therefore,play a decisive rolein choice of operationtiming.

  14. Transplantation of microencapsulated umbilical-cord-bloodderived hepatic-like cells for treatment of hepatic failure

    Institute of Scientific and Technical Information of China (English)

    Fang-Ting Zhang; Hui-Juan Wan; Ming-Hua Li; Jing Ye; Mei-Jun Yin; Chun-Qiao Huang; Jie Yu

    2011-01-01

    AIM:To investigate intraperitoneal transplantation of microencapsulated hepatic-like cells from human umbilical cord blood for treatment of hepatic failure in rats.METHODS:CD34+ cells in umbilical cord blood cells were isolated by magnetic cell sorting.In the in vitro experiment,sorted CD34+ cells were amplified and induced into hepatic-like cells by culturing with a combination of fibroblast growth factor 4 and hepatocyte growth factor.Cultures without growth factor addition served as controls.mRNA and protein levels for hepatic- like cells were analyzed by reverse transcriptionpolymerase chain reaction,immunohistochemistry and immunofluorescence.In the in vivo experiment,the hepatic-like cells were encapsulated and transplanted into the abdominal cavity of acute hepatic failure (AHF) rats at 48 h after D-galactosamine induction of acute hepatic failure.Transplantation with PBS and unencapsulated hepatic-like cells served as controls.The mortality rate,hepatic pathological changes and serum biochemical indexes were determined.The morphology and structure of microcapsules in the greater omentum were observed.RESULTS:Human albumin,alpha-fetoprotein and GATA-4 mRNA and albumin protein positive cells were found among cultured cells after 16 d.Albumin level in culture medium was significantly increased after culturing with growth factors in comparison with culturing without growth factor addition (P < 0.01).Compared with the unencapsulated group,the mortality rate of the encapsulated hepatic-like cell-transplanted group was significantly lower (P < 0.05).Serum biochemical parameters,alanine aminotransferase,aspartate aminotransferase and total bilirubin in the encapsulated group were significantly improvement compared with the PBS control group (P < 0.01).Pathological staining further supported these findings.At 1-2 wk post-transplantation,free microcapsules with a round clear structure and a smooth surface were observed in peritoneal lavage fluid,surviving cells

  15. Increased levels of dioxin-like substances in adipose tissue in patients with deep infiltrating endometriosis.

    Science.gov (United States)

    Martínez-Zamora, M A; Mattioli, L; Parera, J; Abad, E; Coloma, J L; van Babel, B; Galceran, M T; Balasch, J; Carmona, F

    2015-05-01

    Are the levels of biologically active and the most toxic dioxin-like substances in adipose tissue of patients with deep infiltrating endometriosis (DIE) higher than in a control group without endometriosis? DIE patients have higher levels of dioxins and polychlorinated biphenyls (PCBs) in adipose tissue compared with controls without endometriosis. Some studies have investigated the levels of dioxin-like substances, in serum samples, in patients with endometriosis, with inconsistent results. Case-control study including two groups of patients. The study group (DIE group) consisted of 30 patients undergoing laparoscopic surgery because of DIE. In all patients, an extensive preoperative work-up was performed including clinical exploration, magnetic resonance imaging (MRI) and transvaginal sonography. All patients with DIE underwent a confirmatory histological study for DIE after surgery. The non-endometriosis control group (control group), included the next consecutive patient undergoing laparoscopic surgery in our center due to adnexal benign gynecological disease (ovarian or tubal procedures other than endometriosis) after each DIE patient, and who did not present any type of endometriosis. During the surgical procedure 1-2 g of adipose tissue from the omentum were obtained. Dioxin-like substances were analyzed in adipose tissue in DIE patients and controls without endometriosis. The total toxic equivalence and concentrations of both dioxins and PCBs were significantly higher in patients with DIE in comparison with the control group (P dioxins (2,3,7,8-tetrachlorodibenzo-p-dioxin [2,3,7,8-TCDD] and 1,2,3,7,8-pentachlorodibenzo-p-dioxin [1,2,3,7,8-PeCDD]) (P dioxins and PCBs widely vary in different countries. Furthermore, the strict eligibility criteria used may preclude generalization of the results to other populations and the surgery-based sampling frame may induce a selection bias. Finally, adipose tissue was obtained only from the omentum, and not from other

  16. Retroperitoneoscopic pyelolithotomy: A minimally invasive alternative for the management of large renal pelvic stone

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    Saurabh Sudhir Chipde

    2014-01-01

    Full Text Available Introduction: Large stones in renal pelvis can be treated with percutaneous nephrolithotomy (PCNL or pyelolithotomy (either by open or laparoscopic techniques. PCNL is difficult in undilated system. For pyelolithotomy, laparoscopy is more preferable over the open surgery. Surgeons are more familiar with the tansperitoneoscopic anatomy than retroperitoneoscopic one, but retroperitoneoscopic approach can be attempted if we anticipate the problems in the transperitoneal route. Case: A fifty years old gentleman presented to us with the complaint of dull aching right flank pain. On ultrasonographic examination, he was found to have a large stone in renal pelvis with minimal hydronephrosis and thickened omentum on right side. Xray KUB showed a large radio-opaque shadow in renal area. We did the CECT-Urogram of the patient to know the detailed anatomy, which showed a stone of 5.3 x 3.7 cm in right extra-rena pelvis without hydronephrosis and a large focal area of marked fat stranding in omentum on the right side in mid and lower abdomen with swirling of fat stranding on the superior aspect suggestive of omental infarction and torsion. Due to undilated caliceal system, we preferred laparoscopic surgery over the PCNL in this patient. As whole of the omental tissue was stuck on right side we decided to proceed with transperitoneoscopic route instead of retroperitoneoscopic one. The DJ stent was inserted preoperatively.The surgery was performed in the flank position with three ports, one 10mm port just antero-inferior to tip of 12th rib for camera and two 5mm working ports, one at anterior axillary line and other at renal angle. We created the retroperitoneal space with the customized balloon, made with the glove-fingure. Results: The operative time was 1 hour 40 minutes, and there were no intra or post-operative complications. The stone was removed in toto. Patient was orally allowed on first postoperative day and foleys was removed on second day. patient

  17. Mechanisms of the formation of the peritoneal dissemination in gastric cancer.

    Science.gov (United States)

    Yonemura, Y; Endo, Y; Yamaguchi, T; Fujimura, T; Obata, T; Kawamura, T; Nojima, N; Miyazaki, I; Sasaki, T

    1996-04-01

    To clarify the mechanisms of the formation of peritoneal dissemination, a new animal model by the i.p. inoculation of highly metastatic gastric cancer cell line MKN-45-P was developed. Peritoneal dissemination with bloody ascites was found in 100% of nude mice, injected 1x10(7) MKN-45-P cells in suspension into the peritoneal cavity. By a highly sensitive method for specific detection of metastasized human tumor cells in nude mice using polymerase chain reaction, a human beta-globin-related sequence in the DNA from various parts of the peritoneum was specifically amplified and detected by gel electrophoresis and by a specific oligonucleotide probe. Greater omentum showed a strong signal of the amplified fragments of human beta-globin gene from the 1st day and the signals gradually increased. The signals in the gonadal fat, mesentery and ovarium could be weakly detected on the Ist day, transiently decreased on the 3rd day, and then increased from the 7th day. In the diaphragm, and abdominal wall, signals could be detected from the 7th day. In contrast, small intestine and colon did not show any human beta-globin signals. In greater omentum and gonadal fat, cancer cells were selectively detected in the milky spots stained by activated carbon on the 3rd day. In the diaphragm, cancer cells adhered to the small pores termed stomata, and invaded into the subdiaphragmatic lymphatic lacunae connected with stomata. From the 3rd day, mesothelial cells of the abdominal cavity became round and separated, resulting in the exposure of the underlying connective tissue. MKN-45-P cells were found to adhere to the naked areas of the submesothelial connective tissue. From these results, we conclude that the major metastatic route of the peritoneum may be firstly through milky spots, secondly through the diaphragmatic stomata, and thirdly by the adhesion to the naked connective tissue exposed after shrinkage of the mesothelial cells. The third process may be related to the interaction

  18. Retalho de omento maior para indução de vascularização e consolidação óssea em cão Use of omental flap to induce vascularization and bone healing in a dog

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    Cássio Ricardo Auada Ferrigno

    2010-09-01

    Full Text Available Este trabalho relata o caso de uma cadela da raça whippet, de 10 anos, com união retardada de tíbia e fíbula esquerdas, exposta, cotaminada e com grande perda de massa muscular e óssea e de pele causada por instabilidade óssea decorrente de duas intervenções cirúrgicas realizadas anteriormente. Foi realizado retalho de omento maior em camada simples, alcance ao foco de fratura via túnel subcutâneo e recobrimento por enxerto cutâneo em malha. O objetivo do trabalho foi avaliar a capacidade de indução vascular do omento maior para foco de fratura e consequentemente consolidação óssea, tendo como hipótese a acentuada função de angiogênese do omento maior. A tíbia e fíbula esquerdas foram estabilizadas com fixador circular externo. Após 80 dias, houve consolidação óssea da tíbia, volta do apoio do membro e retirada do implante.This research reports the case of a whippet female dog, 10 years old, with delayed union of left tibia and fibula, exposure of the fracture focus with localized infection, and extensive loss of, muscle, bone and skin after instability caused by two surgical interventions accomplished previously. A flap was made of the greater omentum in a single layer. The fracture site was reached through the subcutaneous tunnel and the coating by mesh skin grafts. The objective of this study was to evaluate the ability of the larger omentum to induce angiogenesis to the fracture site and the subsequent bone healing, considering the strong role of angiogenesis. The left tibia and fibula were stabilized with external circular fixator. After 80 days there was bone healing of the tibia around the support member and removal of the implant. Postoperative complications included partial necrosis of the cutaneous (25% flap and shortening of the tibia with consequent laxity ligament of the member.

  19. A High-Throughput Screening Model of the Tumor Microenvironment for Ovarian Cancer Cell Growth.

    Science.gov (United States)

    Lal-Nag, Madhu; McGee, Lauren; Guha, Rajarshi; Lengyel, Ernst; Kenny, Hilary A; Ferrer, Marc

    2017-06-01

    The tumor microenvironment plays an important role in the processes of tumor growth, metastasis, and drug resistance. We have used a multilayered 3D primary cell culture model that reproduces the human ovarian cancer metastatic microenvironment to study the effect of the microenvironment on the pharmacological responses of different classes of drugs on cancer cell proliferation. A collection of oncology drugs was screened to identify compounds that inhibited the proliferation of ovarian cancer cells growing as monolayers or forming spheroids, on plastic and on a 3D microenvironment culture model of the omentum metastatic site, and also cells already in preformed spheroids. Target-based analysis of the pharmacological responses revealed that several classes of targets were more efficacious in cancer cells growing in the absence of the metastatic microenvironment, and other target classes were less efficacious in cancer cells in preformed spheres compared to forming spheroid cultures. These findings show that both the cellular context of the tumor microenvironment and cell adhesion mode have an essential role in cancer cell drug resistance. Therefore, it is important to perform screens for new drugs using model systems that more faithfully recapitulate the tissue composition at the site of tumor growth and metastasis.

  20. A morphometric study of the intestinal mucosa of rats submitted to omentoenteropexy

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    Pedro Muñoz Fernandez

    2011-12-01

    Full Text Available CONTEXT: The omentoenteropexy technique was developed as an alternative method for intestinal neovascularization, due to the angiogenic properties of factors from the omentum. OBJECTIVES: This study investigated changes in intestinal villi heights and crypts depths due to surgical techniques: seromiotomy with and without omentoenteropexy. METHOD: Thirty rats were operated on, after being divided into three groups, namely GI, GII and GIII with 10 rats each. In the GI rats were submitted to omentoenteropexy; rats in GII were submitted only to a seromiotomy, and in the GIII only laparotomy. Sixty days after the first surgery, the animals were sacrificed and a segment of intestine was removed for histology using Masson's trichrome technique and morphometric study of intestinal mucosa. RESULTS: The histological findings showed that seromiotomy with or without omentoenteropexy increased the length of intestinal villi when compared with GIII (only laparotomy (analysis of variance: P = 0.0068; GI 38.88 ± 4.17; GII 39.41± 6.33; GIII 31.85 ± 5.56; GI = GII P>0.05; GII>GIII PGIII P<0.001. CONCLUSION: No differences were demonstrated in relation to crypt depths between the groups (P = 0.60. Ongoing studies are being set forth by our group to add more data on the role of omentopexy as a tool to promote neovascularization and intestinal mucosal growth.

  1. Management of desmoplastic small round cell tumor.

    Science.gov (United States)

    Hayes-Jordan, Andrea; LaQuaglia, Michael P; Modak, Shakeel

    2016-10-01

    Desmoplastic small round cell tumor (DSRCT) is a soft tissue sarcoma of mesenchymal cell origin that typically presents with multiple intra-abdominal tumors and exhibits a multi-phenotypic pattern of immunohistochemical staining. The specific organ or tissue type of origin has yet to be identified. DSRCT rarely arises as a singular tumor in the abdomen; in most cases, there are dozens to hundreds of abdominal peritoneal tumors that are detected on diagnosis. One very large dominant mass is usually present in the omentum, with an additional one or two large conglomerates of tumors in the pelvis and right peritoneum, respectively. Despite an often overwhelmingly large number of abdominal tumors, symptoms of bowel obstruction are rare. Ascites may be present. In late stages, pleural effusions, pleural implants, mediastinal adenopathy, supraclavicular adenopathy, or bone metastasis may be present. With this challenging disease, multidisciplinary therapy, including aggressive surgery, is warranted. This review will address DSRCT biology and treatment options and discuss outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Concurrent Mesh Repair of a Morgagni and Umbilical Hernia during a Laparoscopic Sleeve Gastrectomy in a Morbidly Obese Individual

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    N.R Kosai

    2016-10-01

    Full Text Available Morgagni Hernia is a rare form of diaphragmatic hernia. It is mainly asymptomatic and often identified incidentally during surgery. Tension-free synthetic mesh repair is the preferred treatment modality. However, the use of synthetic mesh concurrently during a clean-contaminated surgery such as sleeve gastrectomy remains controversial due to the remote possibility of mesh infection. A middle-aged female 2 with BMI of 47 Kg/m was admitted electively for laparoscopic sleeve gastrectomy with concurrent umbilical hernia repair. Intra-operatively, a left Morgagni Hernia containing omentum and a segment of transverse colon was noted. She underwent a laparoscopic sleeve gastrectomy and simultaneous laparoscopic tension-free composite mesh repair of both Morgagni and umbilical hernia. Outpatient review three months later revealed excess weight loss of almost 30% with no recurrence of either hernia. In conclusion, the advantages of concurrent hernia repair during bariatric surgery outweigh the risk of mesh infection and should be performed to prevent future risk of visceral herniation and strangulation. Laparoscopic mesh repair of a Morgagni Hernia and umbilical hernia in the setting of an electively planned sleeve gastrectomy is feasible, effective and safe in the hands of a trained laparoscopic surgeon.

  3. Retrospective Evaluation of Patients with Morgagni Hernia

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    Erkan Akar

    2012-07-01

    Full Text Available Aim: Morgagni hernia develops due to the defect in Larrey’s space. Intestine and ometum passes to thorax and lead to respiratory problems. Herein, we present our patients who had pulmonary symptoms and diagnosed as Morgagni hernia with clinical, radiologic and operative methods. Material and Method: Data of four patients who were diagnosed as Morgagni hernia in our clinic between 2005 and 2011 were evaluated retrospectively. Posteroanterior (PA chest graphy and thorax computed tomography were performed to all patients as diagnostic tools and thorax magnetic resonance imaging was performed to one patient additionally. Results: All patients were female with mean age of 57 years (range 42-67. Transthoracic route was used in two patients and transabdominal route was used for two patients for surgical access. When hernia sac was opened, presence of intestinal anses and omentum structures and passing to thorax via diaphragmatic defect from the right of sternum were observed. Ischemia and necrosis were not detected. Hernia sacs were not excised. Defect was closed primarily. Mean duration of hospital stay was found as 12 days (range 6-20 days. Recurrence, morbidity and mortality were not seen during average one year follow up.Discussion: Surgery is the treatment of Morgagni hernia. We consider that evaluating the patients diagnosed in adulthood in detail would be beneficial for correct decision for surgical approach and for prevention of vital complications.

  4. An unusual presentation of a malignant jejunal tumor and a different management strategy.

    Science.gov (United States)

    Samaiya, Atul; Deo, Sv Suryanarayana; Thulkar, Sanjay; Hazarika, Sidhartha; Kumar, Sunil; Parida, Dillip K; Shukla, Nootan K

    2005-01-09

    BACKGROUND: Malignant small bowel tumors are very rare and leiomyosarcoma accounts for less than 15% of the cases. Management of these tumors is challenging in view of nonspecific symptoms, unusual presentation and high incidence of metastasis. In this case report, an unusual presentation of jejunal sarcoma and management of liver metastasis with radiofrequency ablation (RFA) is discussed. CASE PRESENTATION: A 45-year-old male presented with anemia and features of small bowel obstruction. Operative findings revealed a mass lesion in jejunum with intussusception of proximal loop. Resection of bowel mass was performed. Histopathological findings were suggestive of leiomyosarcoma. After 3-years of follow-up, the patient developed recurrence in infracolic omentum and a liver metastasis. The omental mass was resected and liver lesion was managed with radiofrequency ablation. CONCLUSION: Jejunal leiomyosarcoma is a rare variety of malignant small bowel tumor and a clinical presentation with intussusception is unusual. We suggest that an aggressive management approach using a combination of surgery and a newer technique like RFA can be attempted in patients with limited metastatic spread to liver to prolong the long-term survival in a subset of patients.

  5. Experimental study on spinal cord injury treated by embryonic spinal cord transplantation and greater omental transposition

    Institute of Scientific and Technical Information of China (English)

    Hao Dingjun(郝定均); Zheng Yonghong(郑永宏); Yuan Fuyong(袁福镛); He Liming; Wang Rong; Yuan Yong

    2004-01-01

    Objective: To observe the clinical efficacy of the embryonic spinal cellular transplantation and greater omental transposition for treatment of the spinal cord injury in 24 mongrel dogs. Methods: 24 adult mongrel dogs, weighing 10 ~ 13kg,bryonic spinal cellular transplantation and greater omental transposition group (group D). Each group consisted of 6 dogs. SEP(somatosensory evoked potential) and MEP (motor evoked potential) of the spinal cord were examed prior to the spinal cord injury and 2 months after the treatment to observe the changes of the animals' behavior. All dogs were killed 2 months after surgery and the spinal cord sections were obtained from T12 to L1 level for pathological analysis and observation under the electron microscope.Results: There was an obvious difference in the spinal somatosensory evoked potential and the motor evoked potential between the group D and the other three groups (group A, B, and C). Recovery of the behavior was noted. The spinal cells had survived for two months following the transplantation. Conclusion: Transplantation of the embryonic spinal cell and greater omentum for treatment of the spinal cord injury in dogs can gain a better outcome than the other groups in behavior and spinal somatosensory and motor evoked potential, but the further study is still essential to confirm its clinical efficacy.

  6. Natural history of extensive diaphragmatic injury on the right side: experimental study in rats

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    Jorge Henrique Rivaben

    2014-08-01

    Full Text Available OBJECTIVE: To evaluate the natural healing of the rat diaphragm that suffered an extensive right penetrating injury.METHODS: Animals were submitted to an extensive penetrating injury in right diaphragm. The sample consisted of 40 animals. The variables studied were initial weight, weight 21 days after surgery; healing of the diaphragm, non-healing of the diaphragm, and herniated abdominal contents into the chest.RESULTS: Ten animals were used as controls for weight and 30 animals were operated. Two animals died during the experiment, so 28 animals formed the operated group; healing of the diaphragm occurred in 15 animals (54%, 11 other animals showed diaphragmatic hernia (39% and in two we observed only diaphragmatic injury without hernia (7%. Among the herniated organs, the liver was found in 100% of animals, followed by the omentum in 77%, small bowel in 62%, colon in 46%, stomach in 31% and spleen in 15%. The control group and the diaphragmatic healing subgroup showed increased weight since the beginning of the study and the 21 days after surgery (p <0.001. The unhealed group showed no change in weight (p = 0.228.CONCLUSION: there is a predominance of spontaneous healing in the right diaphragm; animals in which there was no healing of the diaphragm did not gain weight, and the liver was the organ present in 100% the diaphragmatic surface in all rats with healed diaphragm or not.

  7. Gross anatomy of the intestine and its mesentery in the nutria (Myocastor coypus).

    Science.gov (United States)

    Pérez, W; Lima, M; Bielli, A

    2008-11-01

    The intestines and mesentery of the nutria (Myocastor coypus) have not been fully described. In the present study 30 adult nutrias were studied using gross dissection. The small intestine was divided into the duodenum, jejunum and ileum as usual. The duodenum started at the pylorus with a cranial portion, which dilated forming a duodenal ampulla. The ileum was located within the concavity of the caecum and attached to the coiled caecum by means of the iliocaecal fold. The ascending colon had two ansae, one proximal and one distal. The proximal ansa was fixed to the caecum by the caecocolic fold. The base of the caecum and a short proximal part of the ascending colon belonging to the proximal ansa were attached to the mesoduodenum descendens. The distal ansa of the ascending colon had a proximal part which was sacculated and a distal part which was smooth. The two parts of the distal ansa of the ascending colon were parallel and joined by a flexure of variable localisation. The smooth part of the distal ansa of the ascending colon was attached to the initial portion of the descending colon by a peritoneal fold. The short transverse colon was directly attached to the mesoduodenum and greater omentum. In conclusion, we have described the anatomy of the intestines of the nutria and its mesentery in detail, and provided a nomenclature list adapted to the Nomina Anatomica Veterinaria.

  8. Intrathoracic Hernia after Total Gastrectomy

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    Yoshihiko Tashiro

    2016-05-01

    Full Text Available Intrathoracic hernias after total gastrectomy are rare. We report the case of a 78-year-old man who underwent total gastrectomy with antecolic Roux-Y reconstruction for residual gastric cancer. He had alcoholic liver cirrhosis and received radical laparoscopic proximal gastrectomy for gastric cancer 3 years ago. Early gastric cancer in the remnant stomach was found by routine upper gastrointestinal endoscopy. We initially performed endoscopic submucosal dissection, but the vertical margin was positive in a pathological result. We performed total gastrectomy with antecolic Roux-Y reconstruction by laparotomy. For adhesion of the esophageal hiatus, the left chest was connected with the abdominal cavity. A pleural defect was not repaired. Two days after the operation, the patient was suspected of having intrathoracic hernia by chest X-rays. Computed tomography showed that the transverse colon and Roux limb were incarcerated in the left thoracic cavity. He was diagnosed with intrathoracic hernia, and emergency reduction and repair were performed. Operative findings showed that the Roux limb and transverse colon were incarcerated in the thoracic cavity. After reduction, the orifice of the hernia was closed by suturing the crus of the diaphragm with the ligament of the jejunum and omentum. After the second operation, he experienced anastomotic leakage and left pyothorax. Anastomotic leakage was improved with conservative therapy and he was discharged 76 days after the second operation.

  9. CT features of peritonitis associated with continuous ambulatory peritoneal dialysis

    Energy Technology Data Exchange (ETDEWEB)

    Yun, Ji Young; Byun, Jae Young; Lee, Sang Hoon; Kwon, Tae Ahn; Kim, Yeon Kil; Kim, Young Ok; Song, Kyung Sup [The Catholic Univ. of Korea College of Medicine, Seoul (Korea, Republic of)

    1999-01-01

    To evaluate the CT findings of peritonitis associated with continuous ambulatory peritoneal dialysis(CAPD). We retrospectively analyzed CT scans of 14 symptomatic patients with peritonitis after CAPD. Diffuse abdominal pain was present in 11, fever in two, and abdominal mass with vomiting in one. The mean duration of CAPD ranged from 10 months to 5 years(mean : 3.9 years). On abdominal CT, we evaluated the presence and location of ascites, bowel wall thickening, cocoon formation, the pattern of enhancement of peritoneal thickening, the presence of calcifications in the peritoneum, and mesenteric and omental change. On enhanced CT, multiloculated ascites was observed in all cases(n=14) ; it was located mainly in the pelvic cavity with small multi-loculated fluid collections in the peritoneal cavity(n=13), including the lesser sac(n=3). In one patient, ascites was located in the space between the greater omentum and anterior peritoneal surface. CT showed ileus in 12 cases, small bowel wall thickening in 11, and cocoon formation in five. Uneven but smooth thickening of the peritoneum, with contrast enhancement, was seen in eight cases, and in five of these, peritoneal thickening was more prominent in the anterior peritoneum. Other findings included reticular opacity in two cases, hematoma of the rectus muscle in one, and umbilical hernia in one. Multiloculated fluid collection, ileus, small bowel wall thickening, uneven but smooth peritoneal thickening, and cocoon formation appear to be CT features of CAPD peritonitis.

  10. Omental and pleural milky spots: different reactivity patterns in mice infected with Schistosoma mansoni reveals coelomic compartmentalisation

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    Mônica S Panasco

    2010-07-01

    Full Text Available In vertebrate animals, pleural and peritoneal cavities are repositories of milky spots (MS, which constitute an organised coelom-associated lymphomyeloid tissue that is intensively activated by Schistosoma mansoni infection. This study compared the reactive patterns of peritoneal MS to pleural MS and concluded from histological analysis that they represent independent responsive compartments. Whole omentum, lungs and the entire mediastinum of 54 S. mansoni-infected mice were studied morphologically. The omental MS of infected animals were highly activated, modulating from myeloid-lymphocytic (60 days of infection to lymphomyeloid (90 days of infection and lymphocytic or lymphoplasmacytic (160 days of infection types. The non-lymphoid component predominated in the acute phase of infection and was expressed by monocytopoietic, eosinopoietic and neutropoietic foci, with isolated megakaryocytes and small foci of late normoblasts and mast cells. Nevertheless, pleural or thoracic MS of infected mice were monotonous, consisting of small and medium lymphocytes with few mast and plasma cells and no myeloid component. Our data indicate that compartmentalisation of the MS response is dependent on the lymphatic vascularisation of each coelomic cavity, limiting the effects or consequences of any stimulating or aggressive agents, as is the case with S. mansoni infection.

  11. Hernia diafragmática traumática multivisceral: A propósito de 1 caso

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    Armando Leal Mursulí

    1999-08-01

    Full Text Available La hernia diafragmática constituye un problema infrecuente para el cirujano de trauma, y se necesita un alto índice de sospecha para su diagnóstico, especialmente en los casos de trauma cerrado. Se presenta un paciente operado por esta afección, luego de sufrir trauma cerrado torácico izquierdo, al que se le halla hernia diafragmática multivisceral, formada por colon transverso, bazo y epiplón mayor. Se hace referencia a los principales medios para llegar al diagnóstico, así como a los principios fundamentales para la reparación de estas lesionesDiaphragmatic hernia is an uncommon problem for the trauma surgeon and it is necessary a high index of suspicion for its diagnosis, specially in those cases of closed trauma. A patient operated on of multivisceral diaphragmatic hernia composed of transverse colon, spleen and greater omentum, after suffering from closed left thoracic trauma is presented. Reference is made to the main aids used to determine the diagnosis and to the fundamental principles considered to repair these lesions

  12. A Geant4 simulation analysis of the low energy muon experimental setup at PSI: optimization of the muon beam spot

    CERN Document Server

    Xiao, Ran; Salman, Zaher; Morenzoni, Elvezio; Ye, Bangjiao

    2016-01-01

    The low-energy muon (LEM) facility at PSI provides slow fully polarized positive muons with tunable energies in the keV range to carry out muon spin rotation and relaxation ($\\mu$SR) experiments with nanometer depth resolution on thin films, heterostructures and near-surface regions. The beam is focussed and transported to the sample by electrostatic lenses. A spin rotator upstream of the sample can be used to rotate the muon spin. An electric field along the muon omentum can also be applied to accelerate/decelerate the muons to different energies (0.5-30 keV). Moreover, external magnetic fields at the sample are necessary for transverse and longitudinal field $\\mu$SR experiments. All these fields affect the beam spot at the sample position, so that presently the LEM beam has a beam spot at the sample position with root-mean-square (RMS) values in $x$ and $y$ of about 6 mm. This practically limits the application of LEM to sample sizes of $\\gtrsim$ 1 cm$^2$. Here, we present beam transport simulation results ...

  13. Biocompatibility versus peritoneal mesothelial cells of polypropylene prostheses for hernia repair, coated with a thin silica/silver layer.

    Science.gov (United States)

    Muzio, Giuliana; Perero, Sergio; Miola, Marta; Oraldi, Manuela; Ferraris, Sara; Vernè, Enrica; Festa, Federico; Canuto, Rosa Angela; Festa, Valentino; Ferraris, Monica

    2017-08-01

    Hernias are generally repaired using synthetic prostheses. Infection may already be present or develop during implantation. Based on the increasing resistance to antibiotics, and the well-known antimicrobial properties of silver (Ag), the possibility of coating hernia prostheses with a nanostructured layer containing Ag was explored. Prostheses (Clear Mesh Composite [CMC]) made up of two polypropylene layers (macroporous light mesh and thin transparent film) were tested with human mesothelial cells from omentum biopsies. Mesotheliocytes modulate abdominal wall healing producing cytokines, growth factors, and adhesion molecules. Evaluating the growth of these cells on CMC or film alone showed that cell numbers on CMC increased over time, and were higher than those on film alone. Vimentin immunostaining confirmed the cells to be mesotheliocytes. Subsequently, the biocompatibility of mesh layer, coated or not with a thin layer of Ag/SiO2 -nanoclusters, was analyzed, showing no difference in absence or presence of Ag/SiO2 . Differently, TGF-β2 production, involved in tissue repair and fibrosis, increased in the presence of Ag/SiO2 . Moreover, Ag/SiO2 -coated mesh showed antibacterial properties. In conclusion, the mesh layer coated with Ag/SiO2 afforded cell growth, and showed antibacterial activity. Coating only the mesh layer did not decrease film transparency, and did not favor the formation of adhesions on the visceral side. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 1586-1593, 2017. © 2016 Wiley Periodicals, Inc.

  14. Right intercostal insertion of a Veress needle for laparoscopy in dogs.

    Science.gov (United States)

    Fiorbianco, Valentina; Skalicky, Monika; Doerner, Judith; Findik, Murat; Dupré, Gilles

    2012-04-01

    To evaluate right intercostal Veress needle (VN) insertion for laparoscopy in dogs. Longitudinal cohort study. Female dogs (n = 56). The VN was inserted in the last palpable right intercostal space, either 1/3 (Group T; 28 dogs) or mid distance (Group H; 28 dogs) from the xiphoid cartilage to the most caudal extent of the costal arch. Problems encountered during VN insertion and injuries were recorded, graded, and compared between groups, and also between the first and last 20 insertions. Pneumoperitoneum was successfully achieved by VN insertion in 49 (88%) dogs after a single (45 dogs) or 2nd attempt (4 dogs). Frequency of complications was as follows: 20 grade 1 (subcutaneous emphysema, omentum, or falciform injuries); 6 grade 2 (liver or spleen injury), and 1 grade 3 complication (pneumothorax occurred). No significant difference was found between the 2 groups or between the first and last 20 dogs. Right intercostal VN insertion facilitates pneumoperitoneum in dogs with few consequential complications. No significant difference was found between entry sites; however, the mid distance insertion site in the last palpable intercostal space with dog positioned in dorsal recumbency is likely to result in less complications. © Copyright 2012 by The American College of Veterinary Surgeons.

  15. Massive right-sided Bochdalek hernia with two unusual findings: a case report

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    Deb Subrato J

    2011-10-01

    Full Text Available Abstract Introduction In this report, the case of an adult patient with a massive right-sided Bochdalek hernia with multiple displaced abdominal organs, including the liver and gallbladder, is described. This patient presented with acute cholecystitis of the malpositioned gallbladder. During surgery, nodular regenerative hyperplasia of the liver was also found. To the best of this author's knowledge, these two entities have never been reported in association with this rare condition. Case presentation A 54-year-old Caucasian man presented with nausea and epigastric pain. He had a known history of right-sided Bochdalek hernia which was being managed expectantly. A computerized tomogram revealed the massive hernia with displaced stomach, liver, intestine and omentum into his right thorax. It was believed that our patient had bowel incarceration and he was therefore taken to surgery, where acute cholecystitis and a macronodular liver was identified. A thoracoabdominal approach was used to remove his gallbladder, reduce the herniated viscera and reconstruct his diaphragm. A liver biopsy identified nodular regenerative hyperplasia of the ectopic liver. There were no postoperative complications and at 12 month follow-up, our patient continues to do well. Conclusion This case report describes two unusual findings associated with a congenital Bochdalek diaphragmatic hernia that have never been reported. In addition, unique caveats to the surgical management of this complex rare condition are discussed.

  16. Microscopic Omental Metastasis in Clinical Stage I Endometrial Cancer: A Meta-analysis.

    Science.gov (United States)

    Joo, Won Duk; Schwartz, Peter E; Rutherford, Thomas J; Seong, Seok Ju; Ku, Junbeom; Park, Hyun; Jung, Sang Geun; Choi, Min Chul; Lee, Chan

    2015-10-01

    A patient with early-stage endometrial cancer may possibly have microscopic metastasis in the omentum, which is associated with a poor prognosis. The purpose of this study was to identify risk factors for microscopic omental metastasis in patients with clinical stage I endometrial cancer to establish the indications for selective omentectomy. We searched the PubMed, EMBASE, and Cochrane Library databases for published studies from inception to August 2014, using terms such as 'endometrial cancer' or 'uterine cancer' for disease, 'omentectomy' or 'omental biopsy' for intervention, and 'metastasis' for outcome. Two reviewers independently identified the studies that matched the selection criteria. We calculated the pooled risk ratios (RRs) with 95 % confidence intervals (CI) of each surgicopathologic finding for microscopic omental metastases in clinical stage I endometrial cancer. We also calculated the prevalence of microscopic omental metastases. Among 1163 patients from ten studies, 22 cases (1.9 %) of microscopic omental metastases were found, which accounted for 26.5 % of all omental metastases. Positive lymph nodes (RR 8.71, 95 % CI 1.38-54.95), adnexal metastases (RR 16.76, 95 % CI 2.60-107.97), and appendiceal implants (RR 161.67, 95 % CI 5.16-5061.03) were highly associated with microscopic omental metastases. Microscopic omental metastases were not negligible in patients with clinical stage I endometrial cancer. Those with a risk factor of microscopic omental metastases were recommended for selective omentectomy.

  17. Delayed traumatic diaphragmatic hernia

    Science.gov (United States)

    Lu, Jing; Wang, Bo; Che, Xiangming; Li, Xuqi; Qiu, Guanglin; He, Shicai; Fan, Lin

    2016-01-01

    Abstract Background: Traumatic diaphragmatic hernias (TDHs) are sometimes difficult to identify at an early stage and can consequently result in diagnostic delays with life-threatening outcomes. It is the aim of this case study to highlight the difficulties encountered with the earlier detection of traumatic diaphragmatic hernias. Methods: Clinical data of patients who received treatment for delayed traumatic diaphragmatic hernias in registers of the First Affiliated Hospital of Xi’an Jiaotong University from 1998 to 2014 were analyzed retrospectively. Results: Six patients were included in this study. Left hemidiaphragm was affected in all of them. Most of the patients had a history of traffic accident and 1 a stab-penetrating injury. The interval from injury to developing symptoms ranged from 2 to 11 years (median 5 years). The hernial contents included the stomach, omentum, small intestine, and colon. Diaphragmatic injury was missed in all of them during the initial managements. All patients received operations once the diagnosis of delayed TDH was confirmed, and no postoperative mortality was detected. Conclusions: Delayed TDHs are not common, but can lead to serious consequences once occurred. Early detection of diaphragmatic injuries is crucial. Surgeons should maintain a high suspicion for injuries of the diaphragm in cases with abdominal or lower chest traumas, especially in the initial surgical explorations. We emphasize the need for radiographical follow-up to detect diaphragmatic injuries at an earlier stage. PMID:27512848

  18. A case of two different tumors in the heart of a dog.

    Science.gov (United States)

    Grieco, Valeria; Locatelli, Chiara; Riccardi, Elena; Brambilla, Paola

    2008-05-01

    A 9-year-old, spayed, female Maremmano shepherd had a bilateral mastectomy for multiple mammary adenocarcinomas 2 years previous and was referred to the Cardiology Service of the School of Veterinary Medicine of Milan after an acute episode of cardiogenic collapse. Because of severe cardiovascular symptoms and poor prognosis, the dog was euthanized. Necropsy examination revealed the presence of multiple firm grayish neoplastic nodules in the myocardium of the left ventricle and scattered in the pulmonary parenchyma. Neoplastic nodules were also detected in the spleen, pancreas, liver, kidneys, and omentum. Histological examination revealed the coexistence of tubular adenocarcinoma and an undifferentiated sarcoma in the myocardium. Immunohistochemical staining of the sarcoma cells was negative for cytokeratin, desmin, and smooth muscle myosin, thus excluding their epithelial or myoepithelial origin, as well as an origin from smooth muscles cells. These findings, together with the coexpression of vimentin and alpha-smooth muscle actin, suggested that the sarcoma was derived from myofibroblasts. To the authors' knowledge, this is the first report describing cardiac sarcoma of presumptive myofibroblastic origin in a dog with simultaneous occurrence of cardiac metastasis of mammary gland adenocarcinoma.

  19. A patient with spontaneous rupture of the esophagus and concomitant gastric cancer whose life was saved: case of report and review of the literature in Japan

    Directory of Open Access Journals (Sweden)

    Matsuhashi Nobuhisa

    2011-12-01

    Full Text Available Abstract A 71-year-old man suddenly developed abdominal pain and vomiting on drinking soda after a meal, and visited a physician. Cervical subcutaneous and mediastinal emphysemas were observed on CT, and the patient was transferred to the emergency medical center of our hospital on the same day. Esophagography was performed at our department. A ruptured region was identified on the left side of the lower thoracic esophagus, and surgery was emergently performed employing sequential left thoracoabdominal incision. The chest wall was adhered due to inflammation, and large amounts of residual food and sloughing were present in the thoracic cavity and mediastinum. Moreover, necrotic changes were noted in the superior through inferior mediastinum. An about 2-cm rupture site was confirmed on the left side of the lower thoracic esophagus and closed by suture and filling with pediculate omentum. The presence of a tumorous lesion located mainly in the body of the stomach and lymph node enlargement were also diagnosed before surgery, for which gastric and intestinal fistulae were inserted to prepare for the second-stage surgery. The patient was admitted to an ICU after surgery. ARDS and MRSA-induced pneumonia and enteritis concomitantly developed but remitted. Curative surgery for gastric cancer was performed at 40 POD. Spontaneous rupture of the esophagus is relatively rare and that complicated by gastric caner is very rare, with only six cases being reported in Japan. Herein, we report the case.

  20. Urinary bladder smooth muscle regeneration utilizing bone marrow derived mesenchymal stem cell seeded elastomeric poly(1,8-octanediol-co-citrate) based thin films.

    Science.gov (United States)

    Sharma, Arun K; Hota, Partha V; Matoka, Derek J; Fuller, Natalie J; Jandali, Danny; Thaker, Hatim; Ameer, Guillermo A; Cheng, Earl Y

    2010-08-01

    Bladder regeneration studies have yielded inconclusive results possibly due to the use of unfavorable cells and primitive scaffold design. We hypothesized that human mesenchymal stem cells seeded onto poly(1,8-octanediol-co-citrate) elastomeric thin films would provide a suitable milieu for partial bladder regeneration. POCfs were created by reacting citric acid with 1,8-octanediol and seeded on opposing faces with human MSCs and urothelial cells; normal bladder smooth muscle cells and UCs, or unseeded POCfs. Partial cystectomized nude rats were augmented with the aforementioned POCfs, enveloped with omentum and sacrificed at 4 and 10 weeks. Isolated bladders were subjected to Trichrome and anti-human gamma-tubulin, calponin, caldesmon, smooth muscle gamma-actin, and elastin stainings. Mechanical testing of POCfs revealed a Young's modulus of 138 kPa with elongation 137% its initial length without permanent deformation demonstrating its high uniaxial elastic potential. Trichrome and immunofluorescent staining of MSC/UC POCf augmented bladders exhibited typical bladder architecture with muscle bundle formation and the expression and retention of bladder smooth muscle contractile proteins of human derivation. Quantitative morphometry of MSC/UC samples revealed muscle/collagen ratios approximately 1.75x greater than SMC/UC controls at 10 weeks. Data demonstrate MSC seeded POCfs support partial regeneration of bladder tissue in vivo. 2010 Elsevier Ltd. All rights reserved.

  1. Urethral Reconstruction Using Mesothelial Cell-Seeded Autogenous Granulation Tissue Tube: An Experimental Study in Male Rabbits

    Science.gov (United States)

    Jiang, Shiwei; Xu, Zhonghua; Zhao, Yuanyuan; Yan, Lei; Zhou, Zunlin

    2017-01-01

    Objective. This study was to evaluate the utility of the compound graft for tubularized urethroplasty by seeding mesothelial cells onto autogenous granulation tissue. Methods. Silastic tubes were implanted subcutaneously in 18 male rabbits, of which nine underwent omentum biopsies simultaneously for in vitro expansion of mesothelial cells. The granulation tissue covering the tubes was harvested 2 weeks after operation. Mesothelial cells were seeded onto and cocultured with the tissue for 7 days. A pendulous urethral segment of 1.5 cm was totally excised. Urethroplasty was performed with mesothelial cell-seeded tissue tubes in an end-to-end fashion in nine rabbits and with unseeded grafts in others as controls. Serial urethrograms were performed at 1, 2, and 6 months postoperatively. Meanwhile, the neourethra was harvested and analyzed grossly and histologically. Results. Urethrograms showed cell-seeded grafts maintained wide at each time point, while strictures formation was found in unseeded grafts. Histologically, layers of urothelium surrounded by increasingly organized smooth muscles were observed in seeded grafts. In contrast, myofibroblasts accumulation and extensive scarring occurred in unseeded grafts. Conclusions. Mesothelial cell-seeded granulation tissue tube can be successfully used for tubularized urethroplasty in male rabbits.

  2. PERFORATED PEPTIC ULCER: A CLINICAL ANALYSIS AND OUTCOME

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    Bijit

    2016-03-01

    Full Text Available BACKGROUND The incidence of perforated peptic ulcer is approximately 7-10 cases per one lakh population per year. Perforation is seen in about 7% of patients hospitalized for peptic ulcer disease. Peptic ulcer perforation, which can be gastric/duodenal perforation can be a serious life-threatening condition if not detected early and treated urgently. Peptic ulcer disease has decreased considerably worldwide with the advent of potent anti-ulcer medicines, but its complication like peptic ulcer perforation has not. Our study is to analyse the clinical, radiological and management related findings in influencing the outcome of patients of peptic ulcer perforation after surgery. MATERIALS AND METHODS A series of 47 patients of peptic ulcer perforation were evaluated. Patients expiring within six hours of admission were not included in this study. RESULTS Age of the patients ranged from 17-80 years. The incidence of perforation was highest in the age group of 41-50 years (31.9%. Out of 47 patients, 41 (87.2% survived. CONCLUSION The incidence of perforation was highest in the age group of 41-50 years. Prognosis becomes poor with age, delayed treatment, shock at admission and concomitant diseases. Direct repair of the perforation with pedicled omentum gave excellent results.

  3. Mesenteric and Omental Primary Cysts: Image Findings; Quistes primarios mesentericos y omentales: hallazgos e imagen

    Energy Technology Data Exchange (ETDEWEB)

    Castillo Caro, S.; Vargas Serrano, B. [Hospital Universitario Virgen del Rocio. Sevilla (Spain); Rodriguez, M. L. [Hospital Morales Meseguer. Murcia (Spain)

    2004-07-01

    To describe the radiological appearance of different histological subtypes of mesenteric and omental cysts: lymph angioma, enteric duplication cysts, enteric and mesothelial, and non-pancreatic pseudocysts. The basis of this study is the clinical, radiological and pathological review os 13 cases from our departmental archives involving cystic lesions of the omentum or mesentery: 3 lympangiomas, one enteric duplication cyst, 7 mesothelial cysts and 2 non-pancreatic pseudocysts. The sex distribution was 9 women and 4 men. Most common clinical findings were pain and abdominal distension. Echography (ultra-sound scanning) was performed in 8 cases, abdominal x-ray in 10 and computerized tomography (CT in 13 cases. In the ultra-sound and CT studies, lymphangiomas appeared as large thin-walled multilocular cystic lesions. Mesonthelial cysts were observed as unilocular thin-walled (calcified in 2 cases) cystic lesions of varying size. Duplication cysts were unilocular, seemingly liquid-filled under ultrasound scan and with a thick calcified wall. the non-pancreatic pseudocysts were of varying size, heterogeneous and thick-walled. Aside from being able to determine whether abdominal masses are cystic in nature, ultrasound scan and CT can determine whether such are mesenteric or omental in origin. They can also determine the cystic nature of an abdominal mass which would be helpful in narrowing down diagnostic possibilities. It is important to remember that some malignant neoplasia can occasionally resemble cystic lesions with imaging techniques. (Author) 7 refs.

  4. Determination of phagocytic functions of macrophages,vascular density and NPY-nerve within autotransplanted splenic tissue in adult rats

    Institute of Scientific and Technical Information of China (English)

    JIANG Deng-jin; GUO Guang-jin; ZHANG Kun; LAN Yang-jun; WANG Lin; ZHANG Tian-fei; ZUO Yan-fang

    2004-01-01

    Abstract Objective: To estimate directly phagocytic functions of the macrophages because of the importance in innate immunity, determine blood vessel density and re-innervation density which are basis of function. Methods: Eighty adult Wistar rats were randomly divided into experimental and control groups. The formers underwent splenotomy and a half splenic slice was transplanted into greater omentum. The latter only moved. After 6 months, examination was made as follows: ① After injection of 0.4% carbon particles by vein, splenic tissues were taken out at different times for estimating phagocytosis by light microscope. ② When splenic tissues had been intubated into left ventricle under total anesthesia, animals were perfused by formalin and India ink mixture suspension. Splenic tissues were taken out for making sections for measurement of area density of blood vessels. ③ Immunohistochemical procedure was used for detecting neuropeptide Y (NPY). Results: Phagocytic functions had no difference between two groups, but the area density of blood vessels and NPY-positive fibers redued ( P < 0.01 ) in experimental group. Conclusion: Autotransplanted splenic tissues show good innate immunity though regeneration of blood vessels and nerves do not reach normal level.

  5. Radiological Diagnosis of Congenital Diaphragmatic Hernia in 17th Century Korean Mummy

    Science.gov (United States)

    Kim, Yi-Suk; Lee, In Sun; Jung, Go-Un; Kim, Myeung Ju; Oh, Chang Seok; Yoo, Dong Su; Lee, Won-Joon; Lee, Eunju; Cha, Soon Chul; Shin, Dong Hoon

    2014-01-01

    Congenital diaphragmatic hernia (CDH) is a birth defect of the diaphragm resulting in pulmonary sequelae that threaten the lives of infants. In computed tomography (CT) images of a 17th century middle-aged male mummy (the Andong mummy), we observed that the abdominal contents had protruded into the right thoracic cavity through the diaphragmatic defect, accompanied by a mediastinal shift to the left. On autopsy, the defect in the right posterolateral aspect of the diaphragm was reconfirmed, as was the herniation of the abdominal organs. The herniated contents included the right lobe of the liver, the pyloric part of the stomach, a part of the greater omentum, and the right colic flexure connecting the superior part of the ascending colon and the right part of the transverse colon. Taking our CT and autopsy results together, this case was diagnosed as the Bochdalek-type CDH. Herein we make the first ever report of a CT-assisted diagnosis of a pre-modern historical case of CDH. Our results show the promising utility of this modality in investigations of mummified human remains archaeologically obtained. PMID:24988465

  6. Complex Rectovaginal Fistula-an Experience at a Tertiary Care Centre.

    Science.gov (United States)

    Lalwani, Shailendra; Varma, Vibha; Kumaran, Vinay; Mehta, Naimish; Nundy, Samiran

    2015-12-01

    Complex rectovaginal fistulae are difficult to manage. With an initial failed attempt, a simple fistula becomes complex and the success rate of a subsequent repair decreases. A review of our prospectively maintained records over a period of 16 years revealed 25 patients with rectovaginal fistulae. A variety of procedures was performed in these patients according to their aetiology, site and if there had been a previous attempt at repair. The mean age of the patients was 45 years. The most common cause was operative trauma in 14 cases. Ten patients had previous attempts at repair which had not been successful. The surgical procedures we performed included re-enforcement flaps, resection with diversion, repair with re-enforcement with omentum and simple diversion. Two patients developed recurrence, and one of them healed after a second repair. No recurrence developed in 10 patients who had failed attempts at repair elsewhere. Our experience has shown that most complex rectovaginal fistulae can be successfully repaired but they might require repeated operations. Faecal diversion is usually necessary, and in recurrent fistulae, we found that rather than a local repair, a muscle flap or omental interposition improves the chances of healing.

  7. Mesothelial cells promote early ovarian cancer metastasis through fibronectin secretion.

    Science.gov (United States)

    Kenny, Hilary A; Chiang, Chun-Yi; White, Erin A; Schryver, Elizabeth M; Habis, Mohammed; Romero, Iris L; Ladanyi, Andras; Penicka, Carla V; George, Joshy; Matlin, Karl; Montag, Anthony; Wroblewski, Kristen; Yamada, S Diane; Mazar, Andrew P; Bowtell, David; Lengyel, Ernst

    2014-10-01

    Ovarian cancer (OvCa) metastasizes to organs in the abdominal cavity, such as the omentum, which are covered by a single layer of mesothelial cells. Mesothelial cells are generally thought to be "bystanders" to the metastatic process and simply displaced by OvCa cells to access the submesothelial extracellular matrix. Here, using organotypic 3D cultures, we found that primary human mesothelial cells secrete fibronectin in the presence of OvCa cells. Moreover, we evaluated the tumor stroma of 108 human omental metastases and determined that fibronectin was consistently overexpressed in these patients. Blocking fibronectin production in primary mesothelial cells in vitro or in murine models, either genetically (fibronectin 1 floxed mouse model) or via siRNA, decreased adhesion, invasion, proliferation, and metastasis of OvCa cells. Using a coculture model, we determined that OvCa cells secrete TGF-β1, which in turn activates a TGF-β receptor/RAC1/SMAD-dependent signaling pathway in the mesothelial cells that promotes a mesenchymal phenotype and transcriptional upregulation of fibronectin. Additionally, blocking α5 or β1 integrin function with antibodies reduced metastasis in an orthotopic preclinical model of OvCa metastasis. These findings indicate that cancer-associated mesothelial cells promote colonization during the initial steps of OvCa metastasis and suggest that mesothelial cells actively contribute to metastasis.

  8. 不同部位脂肪源性干细胞的生物学特性比较☆%Comparison of biological characteristics of adipose-derived stem cells from different parts

    Institute of Scientific and Technical Information of China (English)

    林立新; 黄勇; 王玉婷; 王鹏; 王学明; 姜蕾; 林冠妤

    2013-01-01

      背景:大鼠不同部位来源的脂肪源性干细胞在体外培养时的特性是否存在差异目前尚无定论。目的:比较同一只大鼠不同部位来源的脂肪源性干细胞在体外培养时的生长特性和成脂诱导分化能力的差异。方法:无菌操作下取 F344大鼠腹股沟及腹腔大网膜脂肪组织各5 mL,Ⅰ型胶原酶酶解法分离出脂肪源性干细胞,细胞计数后进行体外培养,观察其形态特征和生长状态,MTT 法测定不同部位细胞的倍增时间。取不同部位来源的第2代脂肪源性干细胞进行成脂诱导,诱导14 d 进行油红 O 染色,观察不同部位来源的脂肪源性干细胞的成脂分化能力。结果与结论:在同一只大鼠内脏大网膜脂肪获得的脂肪源性干细胞数目为(281±10)×107 L-1,明显多于腹股沟皮下脂肪的(85±5)×107 L-1(P <0.01)。从内脏大网膜脂肪与腹股沟皮下脂肪获得的脂肪源性干细胞分别于第5,6天进入指数增长期;第9,10天到达平台期;倍增时间为50 h 和60 h 左右。传代后的细胞生长分化活跃,呈成纤维细胞样,成脂诱导后,大网膜组织来源的脂肪源性干细胞的成脂诱导分化率明显高于腹股沟组织来源的脂肪源性干细胞[(38.90±2.86)%,(35.30±3.29)%,P <0.01]。可见同一只大鼠不同部位脂肪组织分离得到的脂肪源性干细胞数目不同,体外成脂诱导分化能力亦存在差异。%BACKGROUND: Whether the differences exist between adipose-derived stem cells isolated from different parts of rats when cultured in vitro has been poorly understood. OBJECTIVE: To compare the growth characteristics and adipogenic ability of adipose-derived stem cells isolated from different parts of rats. METHODS: Freshly isolated adipose-derived stem cells were obtained from 5 mL inguinal groove and greater omentum adipose tissue of F344 rats using type Ⅰ col agenase digestion method. Then, adipose

  9. Intestinal malignancy masquerading as primary ovarian carcinoma

    Directory of Open Access Journals (Sweden)

    Mona Asnani

    2015-06-01

    Full Text Available About 4-5 % of ovarian tumours are metastatic from other organs, most frequently from the female genital tract, the breast, or the gastrointestinal tract. Ovarian metastases constitute 76% of genital tract metastases from extragenital primary tumours, of which 78% arise in the gastrointestinal tract. Metastatic ovarian tumours, often mistaken as primary ovarian carcinomas. A 37 year old P2+0 presented with c/o - Abdominal distension since last 6 months. It was associated with anorexia, constipation and generalised weakness. Not having any menstrual complaint. P/A: moderate ascitis was there. A mass of 8x10 cm felt through right fornix extending up to right iliac fossa. Mass was firm in consistency with restricted mobility. Uterus felt separately from the mass. Left fornix clear. A right sided ovarian mass of approx. 10x15 cm of variegated consistency identified. Bladder wall was thickened. Small nodules of approximately 1 cm present over dome of bladder under visceral peritoneum. Omentum, ascending colon, transverse colon, descending colon, caecum, greater curvature and lesser curvature were thickened. Liver and spleen were normal. Total abdominal hysterectomy with bilateral Salpingo oophorectomy with partial omentectomy was done. Histopathology Revealed metastatic adenocarcinoma of the genital tract and B/L ovaries. So it was concluded that secondaries from intestinal malignancy can present as primary ovarian malignancy. [Int J Reprod Contracept Obstet Gynecol 2015; 4(3.000: 848-850

  10. A Rare Cause of Acute Abdomen: Perforation of Double Meckel’s Diverticulum

    Directory of Open Access Journals (Sweden)

    İlhan Tas

    2015-01-01

    Full Text Available Meckel’s diverticulum is the most common congenital anomaly of the gastrointestinal tract. In this report, we aimed to represent a case of intestinal perforation, caused by double Meckel’s diverticulum, which is a very rare entity in surgical practice. The patient was a 20-year-old Caucasian man, admitted to hospital with complaints of abdominal pain, nausea, and vomitting during the last 3 days. Physical examination indicated tenderness, rebound, and guarding in the right lower quadrant of abdomen. Abdominal X-ray revealed a few air-liquid levels in the left upper quadrant. In the operation, 2 Meckel’s diverticula were observed, one at the antimesenteric side, at 70 cm distance to the ileocecal valve, approximately in 3 cm size, and the other between the mesenteric and antimesenteric sides, approximately in 5 cm size. The first one had been perforated at the tip and wrapped with omentum. A 30 cm ileal resection, including both diverticula with end-to-end anastomosis, was performed. The diagnosis of symptomatic Meckel’s diverticulum is considerably hard, especially when it is complicated. Diverticulectomy or segmentary resections are therapeutic options. In patients with acute abdomen clinic, Meckel’s diverticulum and its complications should be kept in mind, and the intestines should be observed for an extra diverticulum for caution although it is a very rare condition.

  11. Benign multicystic peritoneal mesothelioma mimicking recurrence of an ovarian borderline tumor: a case report.

    Science.gov (United States)

    Takemoto, Shuji; Kawano, Ryosuke; Honda, Kazumi; Nakazono, Aki; Shimamatsu, Kazuhide

    2012-05-14

    Benign multicystic peritoneal mesothelioma is an extremely rare tumor that occurs mainly in women in their reproductive age. Its preoperative diagnosis and adequate treatment are quite difficult to attain. Our patient was a 23-year-old Japanese woman who had a history of right oophorectomy and left ovarian cystectomy for an ovarian tumor at 20 years of age. The left ovarian tumor had been diagnosed on histology as a mucinous borderline tumor. Two years and nine months after the initial operation, multiple cysts were found in our patient. A laparotomy was performed and her uterus, left ovary, omentum and pelvic lymph nodes were removed due to suspicion of recurrence of the borderline tumor. A histological examination, however, revealed that the cysts were not a recurrence of the borderline tumor but rather benign multicystic peritoneal mesothelioma. There were no residual lesions and our patient was followed up with ultrasonography. She remains free from recurrence nine months after treatment. We report a case of benign multicystic peritoneal mesothelioma mimicking recurrence of an ovarian borderline tumor. Benign multicystic peritoneal mesothelioma should be suspected when a multicystic lesion is present in the pelvis as in the case presented here, especially in patients with previous abdominal surgery.

  12. Mesothelial neoplasms presenting as, and mimicking, ovarian cancer.

    Science.gov (United States)

    Mani, Haresh; Merino, Maria J

    2010-11-01

    Mesotheliomas of the abdominal cavity are rare tumors that primarily involve the peritoneum, mesentery, and omentum. The involvement of the viscera is usually secondary to bulky and extensive serosal disease. We describe 7 cases of mesothelioma in which the initial manifestation was that of an ovarian mass. All patients underwent surgery with a primary diagnosis of ovarian cancer. Clinical histories, gross features, and histology slides were reviewed. Immunostains were performed on all cases and electron microscopy was performed in 2 cases. The patients ranged in age from 22 to 52 years and the lesions ranged in size from 3.8 to 9 cm. Of the 7 cases, 4 were predominantly cystic and 3 were solid. Histologically, all cystic tumors were multicystic mesothelioma, whereas the 3 solid tumors were diffuse malignant mesotheliomas. One patient had a borderline mucinous tumor with the mesothelioma occurring as a mural nodule, an association not described earlier. The oldest patient in this series had a diffuse malignant mesothelioma of the peritoneum with predominant ovarian surface involvement. Mesothelial neoplasms can present as ovarian masses in young women. Awareness of this presentation is important to establish appropriate management.

  13. What's new in intraperitoneal test on Kevlar (asbestos substitute)?

    Science.gov (United States)

    Brinkmann, O A; Müller, K M

    1989-09-01

    The intraperitoneal test is a suitable experimental method for studying the different patterns of morphological reaction to foreign body substances of various kinds and concentrations as well as their transport within and elimination from the organism, Kevlar fibres are synthetic aromatic polyamid (aramid) fibres which, investigated by means of the intraperitoneal test in Wistar rats, show distinct pathogenetic reaction patterns: 1. In the early stage after application, the formation of multinucleated giant cells with phagocytosis of the amber-coloured Kevlar fibres, and an inflammatory reaction are foremost features. 2. The typical feature of the second stage is the development of granulomas with central necrosis indicating the cytotoxic nature of Kevlar fibres. 3. The third stage is dominated by the mesenchymal activation with capsular structures of collagenous fibres. Besides granulomatous foci, a slight submesothelial fibrosis is observed. 4. Fragments of Kevlar fibres are drained through lymphatic pathways and stored in lymph nodes where they lead to inflammatory reactions. 5. The reactive granulomatous changes in the greater omentum of rats are accompanied by proliferative mesothelial changes which, in one cases, even led to the development of a multilocular mesothelioma.

  14. LH/hCG-Receptor Expression May Have a Negative Prognostic Value in Low-Risk Endometrial Cancer.

    Science.gov (United States)

    Noci, Ivo; Sorbi, Flavia; Mannini, Luca; Projetto, Elisabetta; Pillozzi, Serena; Ghizzoni, Viola; Lottini, Tiziano; Moncini, Daniela; Baroni, Gianna; Mungai, Francesco; Arcangeli, Annarosa; Fambrini, Massimiliano

    2016-01-01

    A 51 year-old woman was diagnosed with endometrial cancer (EC) and underwent surgical staging. Pathological evaluation showed a 2 cm × 1 cm G2 endometrioid EC with a 30% myometrial deep invasion (FIGO Stage 1A). The patient was classified as low risk of recurrence, and no adjuvant treatment was offered. Six months after surgery, the patient developed an early vescico-vaginal recurrence, and chemotherapy treatment was started. Few months later, a subsequent involvement of vaginal wall, ileum, and omentum was detected, and the patient underwent second surgery. LH/hCG-receptor (LH/hCG-R) expression has been previously reported to be associated with an invasive phenotype in EC cells. Moreover, in a preclinical mouse model of EC behaves as a prometastatic molecular device. We analyzed the expression level of LH/hCG-R in cancer specimens collected during surgeries. Molecular and immunohistochemical analyses showed a strong expression of both mRNA and protein for LH/hCG-R in all specimens. LH/hCG-R expression may be assessed together with other clinicopathological parameters in order to better predict the risk of recurrence in low-risk EC patients. Further clinical trials are warranted in order to validate LH/hCG-R as biomarker in EC.

  15. Natural history of extensive diaphragmatic injury on the right side: experimental study in rats.

    Science.gov (United States)

    Rivaben, Jorge Henrique; Saad, Roberto; Dorgan Neto, Vicente; Botter, Marcio; Gonçalves, Roberto

    2014-01-01

    To evaluate the natural healing of the rat diaphragm that suffered an extensive right penetrating injury. Animals were submitted to an extensive penetrating injury in right diaphragm. The sample consisted of 40 animals. The variables studied were initial weight, weight 21 days after surgery; healing of the diaphragm, non-healing of the diaphragm, and herniated abdominal contents into the chest. Ten animals were used as controls for weight and 30 animals were operated. Two animals died during the experiment, so 28 animals formed the operated group; healing of the diaphragm occurred in 15 animals (54%), 11 other animals showed diaphragmatic hernia (39%) and in two we observed only diaphragmatic injury without hernia (7%). Among the herniated organs, the liver was found in 100% of animals, followed by the omentum in 77%, small bowel in 62%, colon in 46%, stomach in 31% and spleen in 15%. The control group and the diaphragmatic healing subgroup showed increased weight since the beginning of the study and the 21 days after surgery (p right diaphragm; animals in which there was no healing of the diaphragm did not gain weight, and the liver was the organ present in 100% the diaphragmatic surface in all rats with healed diaphragm or not.

  16. Momentum Driving: which physical processes dominate AGN feedback?

    CERN Document Server

    Ostriker, Jeremiah P; Ciotti, Luca; Novak, Gregory S; Proga, Daniel

    2010-01-01

    The deposition of mechanical feedback from a supermassive black hole (SMBH) in an active galactic nucleus (AGN) into the surrounding galaxy occurs via broad-line winds which must carry mass and radial momentum as well as energy. The effect can be summarized by the dimensionless parameter $\\eta=dot{M_outflow}/dot{M_accretion}= (2 \\epsilon_w c^2)/v_w^2$ where ($\\epslion_w \\equiv dot{E}_w/(dot{M_accretion} c^2)$) is the efficiency by which accreted matter is turned into wind energy in the disc surrounding the central SMBH. The outflowing mass and omentum are proportional to $\\eta$, and many prior treatments have essentially assumed that $\\eta=0$. We perform one- and two-dimensional simulations and find that the growth of the central SMBH is very sensitive to the inclusion of the mass and momentum driving but is insensitive to the assumed mechanical efficiency. For example in representative calculations, the omission of momentum and mass feedback leads to an hundred fold increase in the mass of the SMBH to over $...

  17. Polypropylene-based composite mesh versus standard polypropylene mesh in the reconstruction of complicated large abdominal wall hernias: a prospective randomized study.

    Science.gov (United States)

    Kassem, M I; El-Haddad, H M

    2016-10-01

    To compare polypropylene mesh positioned onlay supported by omentum and/or peritoneum versus inlay implantation of polypropylene-based composite mesh in patients with complicated wide-defect ventral hernias. This was a prospective randomized study carried out on 60 patients presenting with complicated large ventral hernia in the period from January 2012 to January 2016 in the department of Gastrointestinal Surgery unit and Surgical Emergency of the Main Alexandria University Hospital, Egypt. Large hernia had an abdominal wall defect that could not be closed. Patients were divided into two groups of 30 patients according to the type of mesh used to deal with the large abdominal wall defect. The study included 38 women (63.3 %) and 22 men (37.7 %); their mean age was 46.5 years (range, 25-70). Complicated incisional hernia was the commonest presentation (56.7 %).The operative and mesh fixation times were longer in the polypropylene group. Seven wound infections and two recurrences were encountered in the propylene group. Mean follow-up was 28.7 months (2-48 months). Composite mesh provided, in one session, satisfactory results in patients with complicated large ventral hernia. The procedure is safe and effective in lowering operative time with a trend of low wound complication and recurrence rates.

  18. Guidance of Signaling Activations by Cadherins and Integrins in Epithelial Ovarian Cancer Cells

    Directory of Open Access Journals (Sweden)

    Francesca Roggiani

    2016-08-01

    Full Text Available Epithelial ovarian cancer (EOC is the deadliest tumor among gynecological cancer in the industrialized countries. The EOC incidence and mortality have remained unchanged over the last 30 years, despite the progress in diagnosis and treatment. In order to develop novel and more effective therapeutic approaches, the molecular mechanisms involved in EOC progression have been thoroughly investigated in the last few decades. At the late stage, peritoneal metastases originate from the attachment of small clusters of cancer cells that shed from the primary site and carried by the ascites adhere to the abdominal peritoneum or omentum. This behavior suggests that cell–cell or cell–matrix adhesion mechanisms regulate EOC growth and dissemination. Complex downstream signalings, which might be influenced by functional cross-talk between adhesion molecules and co-expressed and activated signaling proteins, can affect the proliferation/survival and the migration/invasion of EOC cells. This review aimed to define the impact of the mechanisms of cell–cell, through cadherins, and cell–extracellular matrix adhesion, through integrins, on the signaling cascades induced by membrane receptors and cytoplasmic proteins known to have a role in the proliferation, migration and invasion of EOC cells. Finally, some novel approaches using peptidomimetic ligands to cadherin and integrins are summarized.

  19. Culture Models to Define Key Mediators of Cancer Matrix Remodeling

    Directory of Open Access Journals (Sweden)

    Emily Suzanne Fuller

    2014-03-01

    Full Text Available High grade serous epithelial ovarian cancer (HG-SOC is one of the most devastating gynecological cancers affecting women worldwide, with a poor survival rate despite clinical treatment advances. HG-SOC commonly metastasizes within the peritoneal cavity, primarily to the mesothelial cells of the omentum which regulate an extracellular matrix (ECM rich in collagens type I, III and IV along with laminin, vitronectin and fibronectin. Cancer cells depend on their ability to penetrate and invade secondary tissue sites to spread, however a detailed understanding of the molecular mechanisms underlying these processes remain largely unknown. Given the high metastatic potential of HG-SOC and the associated poor clinical outcome, it is extremely important to identify the pathways and the components of which that are responsible for the progression of this disease. In-vitro methods of recapitulating human disease processes are the critical first step in such investigations. In this context, establishment of an in-vitro ‘tumor-like’ microenvironment, such as 3D culture, to study early disease and metastasis of human HG-SOC is an important and highly insightful method. In recent years many such methods have been established to investigate the adhesion and invasion of human ovarian cancer cell lines. The aim of this review is to summarize recent developments in ovarian cancer culture systems and their use to investigate clinically relevant findings concerning the key players in driving human HG-SOC.

  20. Heterotopic transplantation of glycerin-preserved trachea: effect of respiratory epithelium desquamation on acute rejection

    Directory of Open Access Journals (Sweden)

    Saueressig M.G.

    2005-01-01

    Full Text Available An effective preservation method and decreased rejection are essential for tracheal transplantation in the reconstruction of large airway defects. Our objective in the present study was to evaluate the antigenic properties of glycerin-preserved tracheal segments. Sixty-one tracheal segments (2.4 to 3.1 cm were divided into three groups: autograft (N = 21, fresh allograft (N = 18 and glycerin-preserved allograft (N = 22. Two segments from different groups were implanted into the greater omentum of dogs (N = 31. After 28 days, the segments were harvested and analyzed for mononuclear infiltration score and for the presence of respiratory epithelium. The fresh allograft group presented the highest score for mononuclear infiltration (1.78 ± 0.43, P <= 0.001 when compared to the autograft and glycerin-preserved allograft groups. In contrast to the regenerated epithelium observed in autograft segments, all fresh allografts and glycerin-preserved allografts had desquamation of the respiratory mucosa. The low antigenicity observed in glycerin segments was probably the result of denudation of the respiratory epithelium and perhaps due to the decrease of major histocompatibility complex class II antigens.

  1. CT of acute left-sided colonic diverticulitis and differential diagnoses

    Energy Technology Data Exchange (ETDEWEB)

    Ferstl, F.J.; Obert, R.; Cordes, M. [St. Theresien-Krankenhaus, Nuernberg (Germany). Radiologisch-Nuklearmedizinisches Zentrum

    2005-07-01

    This review shows the diagnostic potential of computed tomography (CT) in the diagnosis and differential diagnosis of acute left-sided colonic diverticulitis. Using a single detector spiral CT, standard examination of the entire abdomen is performed after oral and rectal administration of diluted iodinated contrast medium with collimation of 8 mm, pitch of 1.5, and reconstruction increment of 8 mm before and after intravenous contrast injection. Intravenous administration of spasmolytic agents, various patient positions, and the thin-section technique with 3-5 mm slices are beneficial in difficult cases. The differential diagnosis of acute left-sided colonic diverticulitis includes tumorous, inflammatory, and ischemic diseases of the colon as well as infarctions of epiploic appendages and the omentum majus. The knowledge of the various CT criteria of acute colonic diverticulitis and their differential diagnoses helps to establish a correct diagnosis in a wide majority of cases. At present, CT is the diagnostic procedure of choice for assessing acute diverticulitis. Distinct knowledge of the CT features helps to differentiate the various entities accurately.

  2. Complement activated granulocytes can cause autologous tissue destruction in man

    Directory of Open Access Journals (Sweden)

    E. Löhde

    1992-01-01

    Full Text Available Activation of polymorphonuclear granulocytes (PMNs by C5a is thought to be important in the pathogenesis of multiple organ failure during sepsis and after trauma. In our experiment exposure of human PMNs to autologous zymosan activated plasma (ZAP leads to a rapid increase in chemiluminescence. Heating the ZAP at 56°C for 30 min did not alter the changes, while untreated plasma induced only baseline activity. The respiratory burst could be completely abolished by decomplementation and preincubation with rabbit antihuman C5a antibodies. Observation of human omentum using electron microscopy showed intravascular aggregation of PMNs, with capillary thrombosis and diapedesis of the cells through endothelial junctions 90 s after exposure to ZAP. PMNs caused disruption of connections between the mesothelial cells. After 4 min the mesothelium was completely destroyed, and connective tissue and fat cells exposed. Native plasma and minimum essential medium did not induce any morphological changes. These data support the concept that C5a activated PMNs can cause endothelial and mesothelial damage in man. Even though a causal relationship between anaphylatoxins and organ failure cannot be proved by these experiments C5a seems to be an important mediator in the pathogenesis of changes induced by severe sepsis and trauma in man.

  3. An effect of wrapping peripheral nerve anastomosis with pedicled muscle flap on nerve regeneration in experiment

    Directory of Open Access Journals (Sweden)

    Naumenko L.Yu.

    2010-01-01

    Full Text Available Despite intrinsic capacity of peripheral nerves to regenerate, functional outcomes of peripheral nerves injury remain poor. Nerve ischemia, intra-/perineurial fibrosis and neuroma formation contribute a lot to that. Several authors demonstrated beneficial effects of increased vascularization at the site of injury on peripheral nerves regeneration. The use of highly vascularized autologous tissues (greater omentum as a source of peripheral nerves neovascularization shows promising re-sults. We proposed a surgical technique in which injured peripheral nerves anastomosis was wrapped in a pedicled muscular flap and performed morphological assessment of the efficacy of such technique with the aid of immunohistochemistry. 14 rats (which underwent sciatic nerve transection were operated according to proposed technique. Another 14 rats, in which only end-to-end nerve anastomosis (without muscular wrapping was performed served as controls. Morphological changes were evaluated at 3 weeks and 3 months periods. Higher blood vessel and axon counts were observed in experimental groups at both checkpoints. There was also an increase in Schwann cells and macrophages counts, and less collagen content in pe-ripheral nerves of experimental groups. Axons in neuromas of experimental groups showed a higher degree of arrangement. We conclude that proposed surgical technique provides better vascularisation of injured peripheral nerves, which is beneficial for nerve regeneration.

  4. Self-assembly model, hepatocytes attachment and inflammatory response for silk fibroin/chitosan scaffolds

    Energy Technology Data Exchange (ETDEWEB)

    She Zhending; Feng Qingling [State Key Laboratory of New Ceramics and Fine Processing, Department of Materials Science and Engineering, Tsinghua University, Beijing 100084 (China); Liu Weiqiang, E-mail: biomater@mail.tsinghua.edu.c [Center for Advanced Materials and Biotechnology, Research Institute of Tsinghua University in Shenzhen, Shenzhen 518057 (China)

    2009-08-15

    Silk fibroin is an attractive natural fibrous protein for biomedical application due to its good biocompatibility and high tensile strength. Silk fibroin is apt to form a sheet-like structure during the freeze-drying process, which is not suitable for the scaffold of tissue engineering. In our former study, the adding of chitosan promoted the self-assembly of silk fibroin/chitosan (SFCS) into a three-dimensional (3D) homogeneous porous structure. In this study, a model of the self-assembly is proposed; furthermore, hepatocytes attachment and inflammatory response for the SFCS scaffold were examined. The rigid chain of chitosan may be used as a template for beta-sheet formation of silk fibroin, and this may break the sheet structure of the silk fibroin scaffold and promote the formation of a 3D porous structure of the SFCS scaffold. Compared with the polylactic glycolic acid scaffold, the SFCS scaffold further facilitates the attachment of hepatocytes. To investigate the inflammatory response, SFCS scaffolds were implanted into the greater omentum of rats. From the results of implantation, we could demonstrate in vivo that the implantation of SFCS scaffolds resulted in only slight inflammation. Keeping the good histocompatibility and combining the advantages of both fibroin and chitosan, the SFCS scaffold could be a prominent candidate for soft tissue engineering, for example, in the liver.

  5. Recurrence in a Laparoscopically Repaired Traumatic Diaphragmatic Hernia: Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Bhatt

    2016-02-01

    Full Text Available Introduction Traumatic diaphragmatic hernia (TDH develops infrequently following a traumatic diaphragmatic rupture (TDR. As TDR is frequently missed due to lack of sensitive and specific imaging modalities, a high index of suspicion for such injuries is essential, whether immediately posttraumatic, or even decades after the trauma. We describe a rare case of recurrence in a laparoscopically repaired TDH and review the current literature on the same. Case Presentation A 23-year-old male with a history of primary laparoscopic repair of left-sided TDR two years ago presented with symptoms of acute large bowel obstruction. His chest X-ray showed a left-sided pleural effusion and a loop of the bowel in the left hemithorax, but no signs of free gas. An abdominal X-ray (AXR demonstrated massively dilated large bowel with distension of the small bowel. At laparotomy, the obstructing lesion consisted of the large bowel with omentum herniated through the left hemidiaphragm, consistent with a left recurrent/chronic diaphragmatic hernia. The diaphragmatic defect was repaired with interrupted nylon. The patient made an uneventful recovery. Conclusions Recurrence after repair of TDH is a less reported condition (with only two published articles and little is known regarding the factors responsible for this. Laparoscopy is an excellent diagnostic tool, but currently management is probably best performed via an open technique using heavy non-absorbable suture material to prevent recurrence. Long term follow up of these patients should also be considered.

  6. Generalized peritonitis requiring re-operation after leakage of omental patch repair of perforated peptic ulcer

    Directory of Open Access Journals (Sweden)

    Hemmat Maghsoudi

    2011-01-01

    Full Text Available Background/Aim: Peptic ulcer perforations are a common emergency, but available literature is silent on the exact definition, incidence, management, and complications of peritonitis due to omental patch leakage. Patients and Methods: Retrospective data were collected on 422 patients who underwent omental patch repair of perforated peptic ulcer between March 20, 1999 and March 20, 2006. The definitive diagnosis of perforated peptic ulcer and omental patch leakage was obtained at surgery. Results: Seventeen (4% patients experienced generalized peritonitis due to omental patch leakage. Mean age was 60.6 years. Mortality rate was 29.4%, and the mean hospital stay was 23.6 days. Delay in surgical approach, shock on admission, and age were all significantly associated with increased mortality. Conclusions: Peritonitis due to omental patch leakage can result in significant morbidity and mortality. The most common causes of omental patch leakage and operative procedures were unknown and reinsertion of omentum, respectively. Factors such as shock on admission or delayed surgery, have significantly contributed to fatal outcomes and need careful attention.

  7. Hepatothorax due to a right diaphragmatic rupture related to duodenal ulcer perforation

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    Se-Jin Baek; Jin Kim; Sung-Ho Lee

    2012-01-01

    Here,we present the case of a 53-year-old man with a hepatothorax due to a right diaphragmatic rupture related to duodenal ulcer perforation.On admission,the patient complained of severe acute abdominal pain,with physical examination findings suspicious for a perforated peptic ulcer.Of note,the patient had no history of other medical conditions or recent trauma,and the initial chest radiography and laboratory findings were not specific.A subsequent abdominal computed tomography revealed intrathoracic displacement of the liver,gallbladder,transverse colon and omentum through a right diaphragmatic defect.The patient then underwent an explorative laparotomy that confirmed duodenal ulcer perforation.A primary repair of the duodenal perforation was performed,and the diaphragmatic defect was repaired using a polytetrafluoroethylene patch after the organs were reduced and the cavity irrigated.This particular case proves interesting as right-sided spontaneous diaphragmatic ruptures are very rare and difficult to diagnose.Additionally,the best treatment for such large diaphragmatic defects is still controversial,especially in cases of intrathoracic or intra-abdominal contamination.

  8. Ovarian endometrioid adenocarcinoma in a young woman with hemorrhagic shock due to tumor disintegration: A case report

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    Hiroyuki Takahashi

    2016-09-01

    Full Text Available Acute abdomen secondary to ovarian carcinoma is rare, especially in a young woman. A 28-year-old obese woman underwent bilateral salpingo-oophorectomy and omentectomy as emergency surgery. The specimen from the right ovarian adenocarcinoma was fragmented because the tumor had disintegrated. The largest fragment measured 14 × 8 × 2.5 cm. The left ovary had a solid adenocarcinomatous tumor measuring 6 × 5 × 3 cm. In addition, there were disseminated lesions in the greater omentum, peritoneum, pouch of Douglas and the serosal surface of the uterus. Microscopically, the specimen was a Grade 3 poorly differentiated ovarian endometrioid adenocarcinoma with focal cyst-like structures. Several moderately dilated follicular cysts were seen in addition to the adenocarcinomas but no definite endometriosis was identified in the noncancerous areas of the bilateral ovaries. The endometrium was atrophic and there was endometriosis in the serosa of the uterus, which was resected 3 months later during a second-look operation. These observations suggest that the acute abdomen in this case was caused by disintegration and bleeding right ovarian cancer. The risk factors for ovarian endometrioid adenocarcinoma in this case might have been obesity and possibly endometriosis.

  9. Primary pure squamous cell carcinoma of the endometrium: a case report.

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    Terada, Tadashi; Tateoka, Kazuhiro

    2013-01-01

    Because primary pure squamous cell carcinoma (SCC) of the endometrium is very rare and its frequency is unknown, the author reviewed 142 archival hysterectomy specimens of endometrial cancers. As the results, one case of primary pure SCC was found. Thus, the frequency of SCC of the endometrium was 0.7% of all endometrial malignancies in our institution. The patient was a 72-year-old woman presenting with uterine bleeding. Uterine curettage biopsy and uterine discharge cytology revealed SCC. No malignancy was seen in cervical biopsy. Radical hysterectomy, bilateral salpingo-oophorectomy, omentectomy and lymph node dissection were performed. The endometrial carcinoma was an infiltrative polypoid tumor composed of non-keratinizing SCC with stratification and intercellular bridges. No adenocarcinoma element was recognized. The SCC cells were immunohistochemically positive for p53 protein and showed high Ki-67 antigen (labeling, 70%). The SCC was found to invade into the deeper third of the myometrium. No tumor cells were seen in other sites including the cervix, ovaries, omentum, and lymph nodes. The patients was FIGO stage IC (pT1C, N0, M0), and was treated with radiation and adjuvant chemotherapy. The patient is now alive without recurrence and metastasis 15 months after the operation.

  10. Uterine papillary serous carcinoma following radiation therapy for carcinoma of cervix: a case report.

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    Park, M. H.; Cho, S. H.; Kang, H. J.; Kim, S. R.; Hwang, Y. Y.

    2000-05-01

    Uterine papillary serous carcinoma (UPSC) is a clinically aggressive and morphologically distinctive variant of endometrial carcinoma that has been recognized recently as a distinct entity. The association between radiation therapy (RT) and UPSC is rarely described in the literature. We describe the clinicopathologic features of a 71-year-old patient with UPSC that developed 15 years after radiation therapy for squamous cell carcinoma of cervix, stage IIB. In the subtotal hysterectomy specimen the endometrium was irregular with multifocally raised masses. Microscopically, the tumor was composed of high-grade papillary serous carcinoma focally admixed with solid transitional cell carcinomatous areas and multifocal intraepithelial carcinoma in adjacent atrophic endometrium. The tumor exhibited diffuse infiltrative growth with frequent lymphatic tumor emboli in the myometrium. Immunohistochemical staining for p53 and c-erbB-2 were positive in about 70% of the tumor cells. Carcinoembryonic antigen (CEA) was focally positive. Ki-67 positive cells were present in about 60% of the tumor cells. The tumor directly extended to the cervix and perirectal soft tissue and metastasized to the omentum. Intraoperative pelvic washing cytology was positive for papillary adenocarinoma cells. The possible etiologic role of radiation is discussed, and the literature on endometrial carcinomas developing after RT is reviewed.

  11. Bone marrow-derived stromal cells are more beneficial cell sources for tooth regeneration compared with adipose-derived stromal cells.

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    Ye, Lanfeng; Chen, Lin; Feng, Fan; Cui, Junhui; Li, Kaide; Li, Zhiyong; Liu, Lei

    2015-10-01

    Tooth loss is presently a global epidemic and tooth regeneration is thought to be a feasible and ideal treatment approach. Choice of cell source is a primary concern in tooth regeneration. In this study, the odontogenic differentiation potential of two non-dental-derived stem cells, adipose-derived stromal cells (ADSCs) and bone marrow-derived stromal cells (BMSCs), were evaluated both in vitro and in vivo. ADSCs and BMSCs were induced in vitro in the presence of tooth germ cell-conditioned medium (TGC-CM) prior to implantation into the omentum majus of rats, in combination with inactivated dentin matrix (IDM). Real-time quantitative polymerase chain reaction (RT-qPCR) was used to detect the mRNA expression levels of odontogenic-related genes. Immunofluorescence and immunohistochemical assays were used to detect the protein levels of odontogenic-specific genes, such as DSP and DMP-1 both in vitro and in vivo. The results suggest that both ADSCs and BMSCs have odontogenic differentiation potential. However, the odontogenic potential of BMSCs was greater compared with ADSCs, showing that BMSCs are a more appropriate cell source for tooth regeneration.

  12. Massive unifocal cyst of the liver in a drug abuser: case report and review of the literature.

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    Lambruschi, P G; Rudolf, L E

    1979-01-01

    A 20-year-old white male presented, complaining of abdominal fullness. His previous history was unremarkable except for the use of intravenous illicit drugs. Physical examination disclosed a mass filling the upper and lower right quadrants. We evaluated this mass through the use of barium contrast x-ray, sonography and angiography, and made the preoperative diagnosis of hepatic cystic disease. On operative exploration, a large thin-walled cyst was found on the right lobe of the liver and was shown to be free of communication with the biliary tree; 3,000 cc of chocolate colored fluid were aspirated from the cyst. Total removal of the cyst was achieved with careful dissection. The cavity was filled with omentum and closed with drainage. After a benign immediate postoperative course, the patient remains asymptomatic one year later. Although most reports from the literature describe unexpected intraoperative findings, we stress that symptomatic patients can and should be diagnosed prior to laparotomy, and that a thorough search be made for concomitant polycystic disease. Total extirpation of the cyst is the most desirable of the discussed treatments, when tempered by the age and physical condition of the patient. Thorough preoperative evaluation and awareness of different modalities of therapy allow for the correct choice of treatment.

  13. A young man with concurrent acute appendicitis and incarcerated right indirect inguinal hernia

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    Ditsatham C

    2016-01-01

    Full Text Available Chagkrit Ditsatham, Areewan Somwangprasert, Kirati Watcharachan, Phanchaporn Wongmaneerung Division of Head, Neck, and Breast, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand Objective: Acute appendicitis and incarcerated hernia rarely present in the same episode. Our study reports patient presentation, diagnosis method, and treatment of an unusual case at the Chiang Mai University Hospital. Method: Case report. Result: A 20-year-old man visited the Chiang Mai University Hospital with right lower quadrant pain and a right groin mass which could not be reduced. The computerized tomography scan showed acute appendicitis and omentum in the hernia sac. Operative treatment was an appendectomy and herniorrhaphy. The treatment was successful, and the patient was discharged from our hospital without any complications. Conclusion: Concurrent acute appendicitis and incarcerated hernia are very rare, but should be kept in mind if a patient presents with right lower quadrant pain and a right groin mass. Further investigation may be helpful if the diagnosis is uncertain. Operative priority treatment depends on each individual case. Keywords: combined acute appendicitis and incarcerated inguinal hernia

  14. Lesser omental hernia after total colectomy: report of a case.

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    Konishi, Takanori; Morita, Yasuhiro; Takanishi, Kijuro; Nitta, Jun; Matsumoto, Jun; Miyazaki, Masaru

    2014-07-01

    Lesser omental hernia is a rare type of hernia that can cause intestinal obstruction. To our knowledge, there are only 16 documented cases of lesser omental hernia, including the present case. The subject of this case report was a 42-year-old man with a history of total colectomy for colon perforation caused by Crohn's disease 15 years earlier, who presented with epigastralgia and vomiting. Abdominal computed tomography (CT) revealed a distended bowel loop ventral to the stomach and convergence of mesenteric vessels at the lesser curvature of the stomach. Based on a diagnosis of intestinal obstruction caused by a lesser omental hernia, he underwent emergency surgery, which revealed a 150-cm jejunal segment herniating through a 5-cm defect in the lesser omentum from the retrogastric space. We reduced the herniated loop and closed the hernial orifice successfully. We describe the characteristic CT findings, which allowed us to make the preoperative diagnosis, and speculate how the past total colectomy, in which the gastrocolic ligament was isolated and the transverse colon was resected, probably caused by this hernia. This case serves to demonstrate that lesser omental hernia could be a postoperative complication of total colectomy.

  15. The Effect of Omentoplasty on the Rate of Anastomotic Leakage after Intestinal Resection: A Randomized Controlled Trial.

    Science.gov (United States)

    Nasiri, Shirzad; Mirminachi, Babak; Taherimehr, Reyhaneh; Shadbakhsh, Roya; Hojat, Mohsen

    2017-02-01

    Anastomotic leakage is a major postoperative complication after intestinal surgery leading to increased risk of morbidity and mortality. Omentoplasty has been evaluated to prevent anastomotic leakage in several studies. However, there is no consensus regarding whether or not omentoplasty should be used to decrease the rate of anastomotic leakage after intestinal resection. A prospective, randomized study was conducted to evaluate the influence of omentoplasty on anastomotic leakage after intestinal resection. A total of 124 patients who underwent intestinal resection were enrolled in this prospective study. Patients were randomly assigned to receive either the omentoplasty or nonomentoplasty. In the omentoplasty group, the omentum was wrapped around the anastomotic region. Age, gender, site and type of anastomosis, duration of hospital stay, and performance of omentoplasty were recorded. This study was registered in Iranian Registry of clinical trial (number: IRCT201412316925N3). The rate of anastomotic leakage was significantly lower in the omentoplasty group (P = 0.04). Patients in the omentoplasty group developed a significantly lower rate of postoperative infection and peritonitis (P 0.05). The length of hospital stay was longer in the nonomentoplasty group, compared with that for omentoplasty patients (P < 0.05). No death occurred in the omentoplasty subjects, while six nonomentoplasty patients died (P < 0.05). Our data demonstrated that omentoplasty is useful to lower the rate of postoperative complications in patients underwent intestinal surgery.

  16. Actinomycosis Presenting as an Abdominal Mass in a Child

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    Rahsan Özcan

    2011-03-01

    Full Text Available Abdominal actinomycosis in childhood period is very rare and a relation to trauma is not well established. Herein we report a case that appeared subsequent to abdominal trauma. A 17 years old boy presented with left lower quadrant abdominal mass and signs of acute abdomen. The symptoms of abdominal discomfort began after a fall from height 3 months before admission. There were signs of acute abdomen at physical examination. Ultrasound of abdomen demonstrated a mass; CT scan findings pointed to a suspicious “internal hernia”. An emergency laparotomy was performed. During surgery, a mass located over sigmoid colon and infiltrating the lateral abdominal wall was found. It was removed en bloc with the adjacent omentum. Except for the thickened sigmoid colon, no other pathologies were present at laparotomy. The pathology specimen revealed the actinomyces infection. The patient was treated with oral penicillin after discharge and the follow-up was uneventful. We advocate, keeping the actinomyces infection in mind in cases presenting with abdominal mass of unknown origin in childhood period.

  17. Benign multicystic peritoneal mesothelioma mimicking recurrence of an ovarian borderline tumor: a case report

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    Takemoto Shuji

    2012-05-01

    Full Text Available Abstract Introduction Benign multicystic peritoneal mesothelioma is an extremely rare tumor that occurs mainly in women in their reproductive age. Its preoperative diagnosis and adequate treatment are quite difficult to attain. Case presentation Our patient was a 23-year-old Japanese woman who had a history of right oophorectomy and left ovarian cystectomy for an ovarian tumor at 20 years of age. The left ovarian tumor had been diagnosed on histology as a mucinous borderline tumor. Two years and nine months after the initial operation, multiple cysts were found in our patient. A laparotomy was performed and her uterus, left ovary, omentum and pelvic lymph nodes were removed due to suspicion of recurrence of the borderline tumor. A histological examination, however, revealed that the cysts were not a recurrence of the borderline tumor but rather benign multicystic peritoneal mesothelioma. There were no residual lesions and our patient was followed up with ultrasonography. She remains free from recurrence nine months after treatment. Conclusion We report a case of benign multicystic peritoneal mesothelioma mimicking recurrence of an ovarian borderline tumor. Benign multicystic peritoneal mesothelioma should be suspected when a multicystic lesion is present in the pelvis as in the case presented here, especially in patients with previous abdominal surgery.

  18. Abdominal tuberculosis after removal of an adjustable gastric band – report of an unusual case

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    Piotr K. Kowalewski

    2017-04-01

    Full Text Available Laparoscopic adjustable gastric banding (LAGB is the third most popular bariatric procedure. Despite its reversibility and minimal invasiveness, band infection affects 1.2% of patients. We present a case of a 25-year-old, obese woman who was experiencing malaise and feverishness 3 years after gastric band placement. Due to port site infection the port was removed, which did not improve the patient’s condition. After 2 years the band was removed via laparotomy with a minor surgical site infection reported. The patient returned 2 weeks after discharge with signs of sepsis. After ruling out pulmonary causes, an exploratory laparotomy was performed, revealing granulomatous peritonitis. Standard histopathological examinations, broncho-alveolar lavage culture and DNA tests along with microbiological cultures were inconclusive. Broad-spectrum antibiotics and antifungal and antiparasitic agents did not improve the patient’s condition. Mycobacterium tuberculosis DNA was discovered in a greater omentum specimen. The patient was treated with isoniazid, rifampicin, pyrazinamide and streptomycin for four months.

  19. Robot-assisted laparoscopic pyeloplasty in a pediatric patient with horseshoe kidney: surgical technique and review of the literature.

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    Oderda, Marco; Calleris, Giorgio; Allasia, Marco; Dalmasso, Ettore; Falcone, Marco; Catti, Massimo; Merlini, Emilio; Gontero, Paolo

    2017-02-03

    The aim of this study was to describe the technical aspects of a robotic pyeloplasty in pediatric patients with uretero-pelvic junction obstruction (UPJO) in horseshoe kidney (HSK) through the report of our recent case, and to outline the state of the art of minimally invasive pyeloplasty (MIP) with a systematic review of the literature. We describe all the steps of our surgery performed on an 11-year-old patient with left UPJO in HSK in detail. All the anatomic landmarks are clearly showed, with particular attention to trocar placement in a pediatric patient. A systematic review of the literature on the outcomes of MIP in HSK patients has been performed, including 16 articles. Our surgery was successful following a standardized approach. However, we recorded a rare complication, the herniation of a small portion of omentum through the 8 - mm defect used for the caudal robotic port. The evidence synthesis shows excellent postoperative outcomes for both laparoscopic and robot-assisted laparoscopic pyeloplasties in HSK patients. Probably, MIP should be preferred to the traditional open approach in these patients, when feasible. Transperitoneal robotic pyeloplasty is an excellent minimally invasive choice for the treatment of UPJO in HSK pediatric patients. The pediatric setting should prompt attention to every detail to avoid unfortunate complications.

  20. Peritoneal Keratin Granulomatosis Associated with Endometrioid Adenocarcinoma of the Uterine Corpus in a Woman with Polycystic Ovaries: A Potential Pitfall—A Case Report and Review of the Literature

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    Helen J. Trihia

    2017-01-01

    Full Text Available Peritoneal keratin granulomatosis is a rare condition included under granulomatous lesions of the peritoneum. It can be secondary to neoplasms of the female genital tract and can mimic carcinomatosis intraoperatively. A case of a 40-year-old woman with a history of polycystic ovaries and a chief complaint of vaginal bleeding is presented. She was diagnosed with endometrioid adenocarcinoma with squamous differentiation in endometrial curettings. Intraoperatively, many peritoneal nodules were found, interpreted as peritoneal carcinomatosis. The woman underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy, omentectomy, bilateral pelvic lymphadenectomy, and appendicectomy. Multiple biopsies were taken, as well as peritoneal washings. Microscopic examination revealed multiple keratin granulomas on the serosal surface of the ovaries, fallopian tubes, appendix, and omentum. Lymph node metastasis was not found. Peritoneal keratin granulomas (PKGs have been reported in cases of endometrioid adenocarcinoma with squamous differentiation of the uterine corpus, ovary, and atypical adenomyoma. It should be noted that the prognosis of cases of peritoneal keratin granulomas without viable tumor cells is favourable and that the histologic examination is essential for its diagnosis. We report a case of PKG in a patient with endometrial carcinoma with squamous differentiation, being the first in a woman with polycystic ovaries.

  1. Reconstruction of chest wall defects after resection of large neoplasms: ten-year experience.

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    Novoa, Nuria; Benito, Pablo; Jiménez, Marcelo F; de Juan, Ana; Luis Aranda, José; Varela, Gonzalo

    2005-06-01

    We review our experience in the treatment of complex large chest-wall defects needing a multidisciplinary approach due to primary or secondary neoplasms. Non-small cell lung cancer with chest-wall invasion cases are excluded. Fifteen patients underwent whole thickness resection of the chest wall due to lesions affecting at least three ribs, sternum, clavicle or thoracic spine and the surrounding soft tissue. Previously operated breast cancer and sarcoma were the most frequent diagnoses. Partial or total sternectomy plus rib resection was performed in 8 patients. Immediate closure of the defects was performed in all cases: 12 with single prosthesis placement and 3 with a rigid one of methylmethacrylate. Coverage was achieved using myocutaneous flaps in most cases and, in one case, using the greater omentum that supported a free split-thickness skin graft. No 30-days mortality was recorded. Three patients had a post-operative complication. Mean hospital stay was 11.7+/-9 days. All cases of primary tumours were alive at the time of review (range: 6-126 months). In conclusion, resection and immediate reconstruction of large chest wall defects can be accomplished without operative mortality and low morbidity whenever close cooperation between plastic and thoracic teams exists.

  2. A case of entero-cutaneous and vesico-enteral fistula due to radiation for uterine cervical carcinoma

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    Iwakawa, Kazuhide; Kadota, Takeshi; Kobayashi, Nobuaki [Ehime Univ., Shigenobu (Japan). School of Medicine; Ohnishi, Goro

    1994-11-01

    Late-phase complications of the intestinal and the urinary tracts due to radiation therapy are very difficult to manage, and ensuing fistulation sometimes necessitates surgrey. We report excellent surgical results for a fistula incuded by radiation therapy in a 61-years-old woman. There were previous histories of receiving combined surgical and radiation (up to 10,000 rad) therapy for a uterine cervical carcinoma at another hospital in 1990, and undergoing several surgical treatments for the consequenct vesico-enteral and vesico-colic fistulas. In January, 1993, the patient was admitted to the department of urology of this hospital because of an abdominal pain, and was transferred to the department under a diagnosis of entero-cutaneous and vesico-enteral fistulas. After local sump suction and skin care, resection of the fistula and involved small intestine conserving the urinary tract was performed, and the omentum was transferred to the resected space. Cholecystectomy was carried out for cholelithiasis. Histological studies revealed atrophy in the mucosal layer and edema in the submucosal layer. Her postoperative course has been satisfactory without any signs of fistulation as of one year after the operation. (author).

  3. Gross anatomy of the ringed seal (Pusa hispida) gastro-intestinal tract.

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    Smodlaka, H; Henry, R W

    2014-06-01

    The gross anatomical structure of the ringed seal (Pusa hispida) gastrointestinal tract is poorly described and often veterinary anatomical terminology is not used. Although the basic abdominal visceral pattern corresponded to domestic carnivores, significant differences were noted. The stomach was an elongated sharply bent tube (u-shaped) with the pylorus and fundus juxtaposed. The elongated jejunum measured up to 15.6 times body length and had 37 jejunal arteries from the cranial mesenteric artery. The pancreas was asymmetrical with a small right lobe and a large left lobe. The unusually short greater omentum negated formation of deep and superficial leaves. The most remarkable difference was the separation of the liver parenchyma into three physically separate masses, held together by hepatic ducts, veins and arteries. The topography and position of the liver was dependent on the amount of blood in the hepatic sinus (distended hepatic veins and hepatic portion of vena cava). Thus, as the hepatic sinus filled, the lateral liver masses separate from the central mass by moving caudolaterally. This was facilitated by modified coronary and triangular ligaments which did not attach directly to the liver, but instead to the hepatic sinus. These anatomical adaptations are apparently advantageous to ringed seal's survival in a deep marine environment. © 2013 Blackwell Verlag GmbH.

  4. Clinical evaluation of an air-capsule technique for the direct measurement of intra-abdominal pressure after elective abdominal surgery

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    Dembinski Rolf

    2008-10-01

    Full Text Available Abstract Background The gold standard for assessment of intraabdominal pressure (IAP is via intravesicular pressure measurement (IVP. This accepted technique has some inherent problems, e.g. indirectness. Aim of this clinical study was to assess direct IAP measurement using an air-capsule method (ACM regarding complications risks and agreement with IVP in patients undergoing abdominal surgery. Methods A prospective cohort study was performed in 30 patients undergoing elective colonic, hepatic, pancreatic and esophageal resection. For ACM a Probe 3 (Spiegelberg®, Germany was placed on the greater omentum. It was passed through the abdominal wall paralleling routine drainages. To compare ACM with IVP t-testing was performed and mean difference as well as limits of agreement were calculated. Results ACM did not lead to complications particularly with regard to organ lesion or surgical site infection. Mean insertion time of ACM was 4.4 days (min-max: 1–5 days. 168 pairwise measurements were made. Mean ACM value was 7.9 ± 2.7 mmHg while mean IVP was 8.4 ± 3.0 mmHg (n.s. Mean difference was 0.4 mmHg ± 2.2 mmHg. Limits of agreement were -4.1 mmHg to 5.1 mmHg. Conclusion Using ACM, direct IAP measurement is feasible and uncomplicated. Associated with relatively low pressure ranges (

  5. Clinical evaluation of an air-capsule technique for the direct measurement of intra-abdominal pressure after elective abdominal surgery

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    Otto, Jens; Kaemmer, Daniel; Biermann, Andreas; Jansen, Marc; Dembinski, Rolf; Schumpelick, Volker; Schachtrupp, Alexander

    2008-01-01

    Background The gold standard for assessment of intraabdominal pressure (IAP) is via intravesicular pressure measurement (IVP). This accepted technique has some inherent problems, e.g. indirectness. Aim of this clinical study was to assess direct IAP measurement using an air-capsule method (ACM) regarding complications risks and agreement with IVP in patients undergoing abdominal surgery. Methods A prospective cohort study was performed in 30 patients undergoing elective colonic, hepatic, pancreatic and esophageal resection. For ACM a Probe 3 (Spiegelberg®, Germany) was placed on the greater omentum. It was passed through the abdominal wall paralleling routine drainages. To compare ACM with IVP t-testing was performed and mean difference as well as limits of agreement were calculated. Results ACM did not lead to complications particularly with regard to organ lesion or surgical site infection. Mean insertion time of ACM was 4.4 days (min-max: 1–5 days). 168 pairwise measurements were made. Mean ACM value was 7.9 ± 2.7 mmHg while mean IVP was 8.4 ± 3.0 mmHg (n.s). Mean difference was 0.4 mmHg ± 2.2 mmHg. Limits of agreement were -4.1 mmHg to 5.1 mmHg. Conclusion Using ACM, direct IAP measurement is feasible and uncomplicated. Associated with relatively low pressure ranges (<17 mmHg), results are comparable to bladder pressure measurement. PMID:18925973

  6. Direct intra-abdominal pressure monitoring via piezoresistive pressure measurement: a technical note

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    Dembinski Rolf

    2009-04-01

    Full Text Available Abstract Background Piezoresistive pressure measurement technique (PRM has previously been applied for direct IAP measurement in a porcine model using two different devices. Aim of this clinical study was to assess both devices regarding complications, reliability and agreement with IVP in patients undergoing elective abdominal surgery. Methods A prospective cohort study was performed in 20 patients randomly scheduled to receive PRM either by a Coach®-probe or an Accurate++®-probe (both MIPM, Mammendorf, Germany. Probes were placed on the greater omentum and passed through the abdominal wall paralleling routine drainages. PRM was compared with IVP measurement by t-testing and by calculating mean difference as well as limits of agreement (LA. Results There were no probe related complications. Due to technical limitations, data could be collected in 3/10 patients with Coach® and in 7/10 patients with Accurate++®. Analysis was carried out only for Accurate++®. Mean values did not differ to mean IVP values. Mean difference to IVP was 0.1 ± 2.8 mmHg (LA: -5.5 to 5.6 mmHg. Conclusion Direct IAP measurement was clinically uneventful. Although results of Accurate++® were comparable to IVP, the device might be too fragile for IAP measurements in the clinical setting. Local ethical committee trial registration: EK2024

  7. Direct intra-abdominal pressure monitoring via piezoresistive pressure measurement: a technical note

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    Otto, Jens; Kaemmer, Daniel; Binnebösel, Marcel; Jansen, Marc; Dembinski, Rolf; Schumpelick, Volker; Schachtrupp, Alexander

    2009-01-01

    Background Piezoresistive pressure measurement technique (PRM) has previously been applied for direct IAP measurement in a porcine model using two different devices. Aim of this clinical study was to assess both devices regarding complications, reliability and agreement with IVP in patients undergoing elective abdominal surgery. Methods A prospective cohort study was performed in 20 patients randomly scheduled to receive PRM either by a Coach®-probe or an Accurate++®-probe (both MIPM, Mammendorf, Germany). Probes were placed on the greater omentum and passed through the abdominal wall paralleling routine drainages. PRM was compared with IVP measurement by t-testing and by calculating mean difference as well as limits of agreement (LA). Results There were no probe related complications. Due to technical limitations, data could be collected in 3/10 patients with Coach® and in 7/10 patients with Accurate++®. Analysis was carried out only for Accurate++®. Mean values did not differ to mean IVP values. Mean difference to IVP was 0.1 ± 2.8 mmHg (LA: -5.5 to 5.6 mmHg). Conclusion Direct IAP measurement was clinically uneventful. Although results of Accurate++® were comparable to IVP, the device might be too fragile for IAP measurements in the clinical setting. Local ethical committee trial registration: EK2024 PMID:19383161

  8. Diaphragmatic rupture with right colon and small intestine herniation after blunt trauma: a case report

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    Muroni Mirko

    2010-08-01

    Full Text Available Abstract Introduction Traumatic diaphragmatic hernias are an unusual presentation of trauma, and are observed in about 10% of diaphragmatic injuries. The diagnosis is often missed because of non-specific clinical signs, and the absence of additional intra-abdominal and thoracic injuries. Case presentation We report a case of a 59-year-old Italian man hospitalized for abdominal pain and vomiting. His medical history included a blunt trauma seven years previously. A chest X-ray showed right diaphragm elevation, and computed tomography revealed that the greater omentum, a portion of the colon and the small intestine had been transposed in the hemithorax through a diaphragm rupture. The patient underwent laparotomy, at which time the colon and small intestine were reduced back into the abdomen and the diaphragm was repaired. Conclusions This was a unusual case of traumatic right-sided diaphragmatic hernia. Diaphragmatic ruptures may be revealed many years after the initial trauma. The suspicion of diaphragmatic rupture in a patient with multiple traumas contributes to early diagnosis. Surgical repair remains the only curative treatment for diaphragmatic hernias. Prosthetic patches may be a good solution when the diaphragmatic defect is severe and too large for primary closure, whereas primary repair remains the gold standard for the closure of small to moderate sized diaphragmatic defects.

  9. Successful Surgical Treatment of a Spontaneous Rupture of the Esophagus Diagnosed Two Days after Onset

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    Hiroyuki Ando

    2012-05-01

    Full Text Available Esophageal perforation is a relatively uncommon disease with a high rate of mortality and morbidity. Delay in the diagnosis and treatment occurs in more than 50% of cases, leading to a mortality rate of 40–60%. Primary repair is generally considered the gold standard for patients who present within the first 24 h following perforation of the esophagus. In this paper, we present a case of successful surgical treatment of spontaneous rupture of the esophagus that was diagnosed 2 days after onset. The patient was a 42-year-old man admitted to internal medicine with a diagnosis of pleuritis and complaining of chest and back pain. The next day, computed tomography revealed left-sided pleural effusion and mediastinal emphysema. An esophagogram revealed extravasation of the contrast medium from the lower left esophagus to the mediastinal cavity. These results confirmed a rupture of the esophagus, and an emergency left thoracotomy was performed. The perforation was repaired with a single-layered closure and was covered with elevated great omentum obtained by laparotomy. The patient was discharged 23 days after the first surgery. In conclusion, primary repair surgery must be selected as the best treatment beyond 24 h if the patient’s general state was stable and there was no evidence of clinical sepsis.

  10. Bursectomy at radical gastrectomy

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    Cuneyt; Kayaalp

    2015-01-01

    Radical gastrectomy with extended lymph node dissec tion and prophylactic resection of the omentum, peri toneum over the posterior lesser sac, pancreas and/o spleen was advocated at the beginning of the 1960 s in Japan. In time, prophylactic routine resections of the pancreas and/or spleen were abandoned because of the high incidence of postoperative complications. However omentectomy and bursectomy continued to be standard parts of traditional radical gastrectomy. The bursaomentalis was thought to be a natural barrier against invasion of cancer cells into the posterior part of the stomach. The theoretical rationale for bursectomy was to reduce the risk of peritoneal recurrences by eliminating the peritoneum over the lesser sac, which might include free cancer cells or micrometastases. Over time, the indication for bursectomy was gradually reduced to only patients with posterior gastric wall tumors penetrating the serosa. Despite its theoretical advantages, its benefit for recurrence or survival has not been proven yet. The possible reasons for this inconsistency are discussed in this review. In conclusion, the value of bursectomy in the treatment of gastric cancer is still under debate and large-scale randomized studies are necessary. Until clear evidence of patient benefit is obtained, its routine use cannot be recommended.

  11. Mesothelial cyst of the round ligament of the liver

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    Fabio Carboni

    2016-01-01

    Full Text Available A 34-year-old man was admitted in our department with a 3 months history of epigastric pain, abdominal distension and tenderness. Helical computed tomography scan and magnetic resonance imaging showed a 10 cm low-density fluid-filled polilobate cystic lesion with internal septations and calcifications located between the left lobe of the liver, shorter gastric curvature, pancreas and mesocolon. Laparoscopic exploration was performed. Macroscopically the lesion was a unilocular serous cyst with a thick fibrous wall. Histopathology revealed a thin fibrous wall with a single layer of flattened to cuboidal mesothelial cell lining lacking any cellular atypia. The patient is currently alive without evidence of recurrence at 6 months. Cysts of mesothelial origin are rare lesions seen more frequently in young and middle-aged women, mostly benign and located in the mesenteries or omentum. Diagnosis is usually based on clinical examination and radiographic imaging. Immunohistochemistry is used to differentiate histologic type, with simple mesothelial cysts being positive for cytokeratins and calretinin and negative for CD31. The laparoscopic approach appears safe, feasible and less-invasive without compromising surgical principles and today should be considered the gold standard in most cases.

  12. Pancreatic Resections for Advanced M1-Pancreatic Carcinoma: The Value of Synchronous Metastasectomy

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    S. K. Seelig

    2010-01-01

    Materials and Methods. From January 1, 2004 to December, 2007 a total of 20 patients with pancreatic malignancies were retrospectively evaluated who underwent pancreatic surgery with synchronous resection of hepatic, adjacent organ, or peritoneal metastases for proven UICC stage IV periampullary cancer of the pancreas. Perioperative as well as clinicopathological parameters were evaluated. Results. There were 20 patients (9 men, 11 women; mean age 58 years identified. The primary tumor was located in the pancreatic head (n=9, 45%, in pancreatic tail (n=9, 45%, and in the papilla Vateri (n=2, 10%. Metastases were located in the liver (n=14, 70%, peritoneum (n=5, 25%, and omentum majus (n=2, 10%. Lymphnode metastases were present in 16 patients (80%. All patients received resection of their tumors together with metastasectomy. Pylorus preserving duodenopancreatectomy was performed in 8 patients, distal pancreatectomy in 8, duodenopancreatectomy in 2, and total pancreatectomy in 2. Morbidity was 45% and there was no perioperative mortality. Median postoperative survival was 10.7 months (2.6–37.7 months which was not significantly different from a matched-pair group of patients who underwent pancreatic resection for UICC adenocarcinoma of the pancreas (median survival 15.6 months; P=.1. Conclusion. Pancreatic resection for M1 periampullary cancer of the pancreas can be performed safely in well-selected patients. However, indication for surgery has to be made on an individual basis.

  13. Giant Serous Cystadenoma of the Pancreas (⩾10 cm: The Clinical Features and CT Findings

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    Qing-Yu Liu

    2016-01-01

    Full Text Available Purpose. To report the clinical features and CT manifestations of giant pancreatic serous cystadenoma (≥10 cm. Methods. We retrospectively reviewed the clinical features and CT findings of 6 cases of this entity. Results. All 6 patients were symptomatic. The tumors were 10.2 cm–16.5 cm (median value, 13.0 cm. CT imaging revealed that all 6 cases showed microcystic appearances (n=5 or mixed microcystic and macrocystic appearances (n=1. Five patients with tumors at the distal end of the pancreas received distal pancreatectomy. Among these 5 patients, 2 patients underwent partial transverse colon resection or omentum resection due to close adhesion. One patient whose tumor was located in the pancreatic head underwent pancreaticoduodenectomy; however, due to encasement of the portal and superior mesenteric veins, the tumor was incompletely resected. One patient had abundant draining veins on the tumor surface and suffered large blood loss (700 mL. After 6–49 months of follow-up the 6 patients showed no tumor recurrence or signs of malignant transformation. Conclusions. Giant pancreatic serous cystadenoma necessitates surgical resection due to large size, symptoms, uncertain diagnosis, and adjacent organ compression. The relationship between the tumors and the neighboring organs needs to be carefully assessed before operation on CT image.

  14. Performance of collagen sponge as a 3-D scaffold for tooth-tissue engineering.

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    Sumita, Yoshinori; Honda, Masaki J; Ohara, Takayuki; Tsuchiya, Shuhei; Sagara, Hiroshi; Kagami, Hideaki; Ueda, Minoru

    2006-06-01

    Tooth structure can be regenerated by seeding dissociated tooth cells onto polyglycolic acid fiber mesh, although the success rate of tooth production is low. The present study was designed to compare the performance of collagen sponge with polyglycolic acid fiber mesh as a 3-D scaffold for tooth-tissue engineering. Porcine third molar teeth at the early stage of crown formation were enzymatically dissociated into single cells, and the heterogeneous cells were seeded onto collagen sponge or the polyglycolic acid fiber mesh scaffolds. Scaffolds were then cultured to evaluate cell adhesion and ALP activity in vitro. An in vivo analysis was performed by implanting the constructs into the omentum of immunocompromised rats and evaluating tooth production up to 25 weeks. After 24h, there were a significantly higher number of cells attached to the collagen sponge scaffold than the polyglycolic acid fiber mesh scaffold. Similarly, the ALP activity was significantly higher for the collagen sponge scaffold was than the polyglycolic acid fiber mesh scaffold after 7 days of culture. The area of calcified tissue formed in the collagen sponge scaffold was also larger than in the polyglycolic acid fiber mesh scaffold. The results from in vivo experiments show conclusively that a collagen sponge scaffold allows tooth production with a higher degree of success than polyglycolic acid fiber mesh. Taken together, the results from this study show that collagen sponge scaffold is superior to the polyglycolic acid fiber mesh scaffold for tooth-tissue engineering.

  15. Humanized mouse model of ovarian cancer recapitulates patient solid tumor progression, ascites formation, and metastasis.

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    Richard B Bankert

    Full Text Available Ovarian cancer is the most common cause of death from gynecological cancer. Understanding the biology of this disease, particularly how tumor-associated lymphocytes and fibroblasts contribute to the progression and metastasis of the tumor, has been impeded by the lack of a suitable tumor xenograft model. We report a simple and reproducible system in which the tumor and tumor stroma are successfully engrafted into NOD-scid IL2Rγ(null (NSG mice. This is achieved by injecting tumor cell aggregates derived from fresh ovarian tumor biopsy tissues (including tumor cells, and tumor-associated lymphocytes and fibroblasts i.p. into NSG mice. Tumor progression in these mice closely parallels many of the events that are observed in ovarian cancer patients. Tumors establish in the omentum, ovaries, liver, spleen, uterus, and pancreas. Tumor growth is initially very slow and progressive within the peritoneal cavity with an ultimate development of tumor ascites, spontaneous metastasis to the lung, increasing serum and ascites levels of CA125, and the retention of tumor-associated human fibroblasts and lymphocytes that remain functional and responsive to cytokines for prolonged periods. With this model one will be able to determine how fibroblasts and lymphocytes within the tumor microenvironment may contribute to tumor growth and metastasis, and will make it possible to evaluate the efficacy of therapies that are designed to target these cells in the tumor stroma.

  16. Taenia hydatigena cysticercosis in slaughtered pigs, goats, and sheep in Tanzania.

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    Braae, Uffe Christian; Kabululu, Mwemezi; Nørmark, Michelle Elisabeth; Nejsum, Peter; Ngowi, Helena Aminel; Johansen, Maria Vang

    2015-12-01

    Few studies have been carried out in Africa to estimate the prevalence of Taenia hydatigena. With the aim to determine the prevalence of T. hydatigena in slaughtered pigs and small ruminants (goats and sheep) in Mbeya, Tanzania, two cross-sectional surveys were carried out investigating pigs in April to May 2014 and small ruminants in September 2012. In total, 243 pigs were examined post-mortem for T. hydatigena cysts which were found in 16 (6.6 %) pigs. The majority (80 %) of cysts were found on the omentum and the rest on the liver (20 %), all on the visceral surface. Two pigs were also found infected with Taenia solium but showed no signs of other infections. A total of 392 goats and 27 sheep were examined post-mortem, and the prevalence of T. hydatigena was similar in goats and sheep with 45.7 and 51.9 %, respectively. DNA sequencing of the mitochondrial cytochrome c oxidase subunit 1 gene (cox1) from a subsample of metacestodes from goats and sheep confirmed the T. hydatigena infection. The prevalence found in small ruminants was comparable to other studies conducted in Africa, but for pigs, it is one of the highest recorded to date. The present study also confirms the occurrence of T. hydatigena and T. solium in pigs from Mbeya. Further studies are needed to determine the impact of T. hydatigena on production under sub-Saharan conditions and the financial consequences for smallholder farmers.

  17. Acute direct inguinal hernia resulting from blunt abdominal trauma: Case Report

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    Hipkins Gabrielle

    2010-06-01

    Full Text Available Abstract We report a case of traumatic inguinal hernia following blunt abdominal trauma after a road traffic accident and describe the circumstances and technique of repair. The patient suffered multiple upper limb fractures and developed acute swelling of the right groin and scrotum. CT scan confirmed the acute formation of a traumatic inguinal hernia. Surgical repair was deferred until resolution of the acute swelling and subcutaneous haematoma. The indication for surgery was the potential for visceral strangulation or ischaemia with the patient describing discomfort on coughing. At surgery there was complete obliteration of the inguinal canal with bowel and omentum lying immediately beneath the attenuated external oblique aponeurosis. A modified prolene mesh hernia repair was performed after reconstructing the inguinal ligament and canal in layers. To our knowledge, this is the first documented case of the formation of an acute direct inguinal hernia caused as a result of blunt abdominal trauma with complete disruption of the inguinal canal. Surgical repair outlines the principles of restoration of normal anatomy in a patient who is physiologically recovered from the acute trauma and whose anatomy is distorted as a result of his injuries.

  18. Addisonian Crisis due to Metastatic Adenocarcinoma in a Pygmy Goat

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    Nora Nogradi

    2013-01-01

    Full Text Available A 15-year-old Pygmy doe was evaluated for acute onset of lethargy, anorexia, and weakness. Adrenal insufficiency was diagnosed based on physical exam findings, blood work abnormalities (hyponatremia, hyperkalemia, azotemia, and hypoglycemia, and lack of cortisol response to the ACTH stimulation test. Abdominal ultrasound exam revealed an intact urinary tract and multiple bilateral peri-renal masses. The doe was treated with intravenous fluid therapy aimed at correcting the electrolyte abnormalities and intravenous corticosteroids. She responded favorably to medical therapy in 24 hours, with dramatic improvement in attitude and appetite. Fluid therapy was discontinued, and the doe was discharged from the hospital on steroid supplementation. She deteriorated rapidly and died at home 36 hours after discharge. Necropsy results revealed metastatic adenocarcinoma originating from the uterus that infiltrated the urinary bladder, the region of the adrenal glands, the left and right renal lymph nodes, the left kidney, the caudal vena cava, the submandibular lymph nodes, the diaphragm, the lungs, and the omentum. Addison’s syndrome in ruminants should be considered as an uncommon sequel of intra-abdominal neoplastic processes.

  19. Intraperitoneal tuberculous abscess: computed tomography features

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    Peng; Dong; Jing-Jing; Chen; Xi-Zhen; Wang; Ya-Qin; Wang

    2015-01-01

    AIM: To evaluate the computed tomography(CT) features of intraperitoneal tuberculous abscess(IPTA). METHODS: Eight patients with IPTA confirmed by pathology were analyzed retrospectively. The clinical symptoms, medical images, and surgical findings were evaluated. Involvement of the intestine, peritoneum, viscera, and lymph nodes was also assessed. RESULTS: All 8 patients had a history of abdominal discomfort for 1 to 6 mo. Physical examination revealed a palpable abdominal mass in 6 patients. Three patients had no evidence of pulmonary tuberculosis(TB). All IPTAs(11 abscesses) were seen as a multiseptated, peripherally enhanced, hypodense mass with enlarged, rim-enhanced lymph nodes. The largest abscess diameter ranged from 4.5 cm to 12.2 cm. CT showed 2 types of IPTA: Lymph node fusion and encapsulation. Of the 8 patients, one had liver tuberculosis and one had splenic and ovarian tuberculosis. Two cases showed involvement of the terminal ileum and ileocecal junction. Ascites were found in 4 cases. Three patients had peritonitis and mesenteritis. Three patients showed involvement of the omentum. Three patients had histological evidence of caseating granuloma, and 5 had histological evidence of acid-fast bacilli. CONCLUSION: CT is crucial in the detection and characterization of IPTA. Certain CT findings are necessary for correct diagnosis.

  20. Fluorescense laparoscopy in patients with gastric cancer

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    V. A. Lukin

    2013-01-01

    Full Text Available The results of fluorescence laparoscopy in 60 patients with gastric cancer in P.A.Herzen MCRI are represented in the article. All patients had gastric cancer stage III. Undifferentiated cancer was diagnosed in 3 (5% patients, signet ring cell carcinoma – in 42 (70%, low differentiated adenocarcinoma – in 15 (25%. Fluorescence diagnosis was performed using fluorescence laparoscope by Carl Storz (Germany with wavelengths 380-460 nm and alasens given per os at a dose of 30 mg/kg body weight 3 h before study. During the investigation the examination of parietal and visceral peritoneum, great omentum with instrumental revision of pelvic organs was made. The technique of fluorescence diagnosis and assessment of its results are described. According to results of the study occult tumor microdissemination over peritoneum was detected in 10 (16.7% patients. The sensitivity of fluorescence laparoscopy in patients with gastric cancer accounted for 87.5%, specificity – 76%. The data of fluorescence diagnosis allowed to perform staging of tumor process and influenced on following management. 

  1. Expression profiling of primary and metastatic ovarian tumors reveals differences indicative of aggressive disease.

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    Alexander S Brodsky

    Full Text Available The behavior and genetics of serous epithelial ovarian cancer (EOC metastasis, the form of the disease lethal to patients, is poorly understood. The unique properties of metastases are critical to understand to improve treatments of the disease that remains in patients after debulking surgery. We sought to identify the genetic and phenotypic landscape of metastatic progression of EOC to understand how metastases compare to primary tumors. DNA copy number and mRNA expression differences between matched primary human tumors and omental metastases, collected at the same time during debulking surgery before chemotherapy, were measured using microarrays. qPCR and immunohistochemistry validated findings. Pathway analysis of mRNA expression revealed metastatic cancer cells are more proliferative and less apoptotic than primary tumors, perhaps explaining the aggressive nature of these lesions. Most cases had copy number aberrations (CNAs that differed between primary and metastatic tumors, but we did not detect CNAs that are recurrent across cases. A six gene expression signature distinguishes primary from metastatic tumors and predicts overall survival in independent datasets. The genetic differences between primary and metastatic tumors, yet common expression changes, suggest that the major clone in metastases is not the same as in primary tumors, but the cancer cells adapt to the omentum similarly. Together, these data highlight how ovarian tumors develop into a distinct, more aggressive metastatic state that should be considered for therapy development.

  2. Preliminary study of tissue-engineered odontogenesis in the canine jaw.

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    Honda, Masaki J; Ohara, Takayuki; Sumita, Yoshinori; Ogaeri, Takunori; Kagami, Hideaki; Ueda, Minoru

    2006-02-01

    We previously reported a method for the development of tissue-engineered tooth. However, 1 drawback of the procedure was the inability to determine whether the tooth would function when transplanted in the jaw because it was formed in the omentum of the abdomen. Therefore, the present study was designed to evaluate whether transplantation of dissociated odontogenic cells could induce tissue-engineered odontogenesis in the canine jaw. Cells were harvested from canine first molar tooth buds and the resulting heterogeneous cell population was seeded on a biodegradable polymer. These constructs were then transplanted into the same sockets after extracting the tooth buds. After transplantation, we evaluated the transplanted constructs using dental x-ray, micro-computed tomography, histology, and immunohistochemistry. After 24 weeks, micro-x-ray computed tomography showed regenerated hard tissues in the jaw, and hematoxylin and eosin staining showed tubular dentin and bone. In the regenerated tissue, osteopontin, osteonectin, and osteocalcin antibodies stained the dentinal matrix. However, enamel tissue and dental-root formation were not observed. These data show for the first time the formation of dentin and bone from dissociated odontogenic cells in the canine jaw.

  3. Asymptomatic peritoneal carcinomatosis originating from benign cystic peritoneal mesothelioma.

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    Iacoponi, S; Calleja, J; Hernandez, G; de la Cuesta, R Sainz

    2015-01-01

    Benign multicystic mesothelioma is a rare tumour that originates from the abdominal peritoneum with a predisposition to the pelvic peritoneum. It typically affects women of reproductive age. There have been less than 200 cases of this rare neoplasia reported to date. We present the case of a 35-year-old woman who was referred to our centre because of the detection of a peritoneal carcinomatosis during a gynaecological exam. A diagnostic laparoscopy was performed. The findings included multiple cysts appearing as 'a bunch of grapes' occupying the omentum. Biopsies were taken during the surgery and the results showed benign multicystic peritoneal mesothelioma. Benign multicystic mesothelioma can simulate other conditions, such as malignant ovarian tumours or cystic lymphangioma. It is often diagnosed accidentally during surgery performed for another reason. The diagnosis is interoperative, observing multicystic structures grouped as a 'bunch of grapes' containing clear fluid with thin walls made of connective tissue. Immunohistochemistry confirmed mesothelial origin. Surgery is considered the treatment of choice and is based on the removal of the cysts from the abdominal cavity. Hyperthermic intraperitoneal chemotherapy can be considered as a primary treatment in patients with recurrences or even as a part of primary treatment associated with surgery. Survival at 5 years is 100% and invasive or malignant progression is extraordinary. The treatment approach should be multidisciplinary, and the patient should be referred to a referral centre.

  4. [Systemic lymphoma cells with T precursor condition of extreme female genital tract. A case report and literature review].

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    Butrón Valdez, Karla; Ramírez Galves, Miguel; Germes Piña, Fernando; Ramos Martínez, Ernesto; Zamora Perea, Arturo

    2009-06-01

    Primary female genital tract non Hodgkin's lymphoma is a rare presentation for a common disease in the childhood, and its classification as primary extranodal lymphoma is still controversial. There are a few cases reported as a primary precursor B-cell lymphoblastic lymphoma of the female genital tract, but there is not any case reported as primary precursor T-cell lymphoblastic lymphoma of the ovary in childhood. Herein we describe a 16 years old young woman with bilateral ovarian tumors, paraaortic lymphoadenophaty and disseminate disease to the female genital tract including extension of the tumor to neighboring organs like the omentum and the appendix. Exploratory laparatomy were performed with bilateral salpingo-oophorectomy, hysterectomy, omentectomy, appendectomy, pelvic and para-aortic lymphadenectomy, pelvic washings and with biopsy of vaginal vault. The chemotherapy regimen comprised of CHOP (Cyclophosphamide, Hydroxydaunorubicin, Oncovin, Prednisone/Prednisolone) and methotrexate, 3 months later presents left facial hemiparesia follow by right facial hemiparesia, 7 months later presents more Central Nervous System (CNS) complications and apparently was complicated with acute lymphocitic leukemia and after 16 months from the diagnosis, following by a torpid evolution, the pacient finally died.

  5. Impact of the Type of Continuous Insulin Administration on Metabolism in a Diabetic Rat Model

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    A. Schaschkow

    2016-01-01

    Full Text Available Exogenous insulin is the only treatment available for type 1 diabetic patients and is mostly administered by subcutaneous (SC injection in a basal and bolus scheme using insulin pens (injection or pumps (preimplanted SC catheter. Some divergence exists between these two modes of administration, since pumps provide better glycaemic control compared to injections in humans. The aim of this study was to compare the impacts of two modes of insulin administration (single injections of long-acting insulin or pump delivery of rapid-acting insulin at the same dosage (4 IU/200 g/day on rat metabolism and tissues. The rat weight and blood glucose levels were measured periodically after treatment. Immunostaining for signs of oxidative stress and for macrophages was performed on the liver and omental tissues. The continuous insulin delivery by pumps restored normoglycaemia, which induced the reduction of both reactive oxygen species and macrophage infiltration into the liver and omentum. Injections controlled the glucose levels for only a short period of time and therefore tissue stress and inflammation were elevated. In conclusion, the insulin administration mode has a crucial impact on rat metabolic parameters, which has to be taken into account when studies are designed.

  6. Mitochondrial respiration in subcutaneous and visceral adipose tissue from patients with morbid obesity.

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    Kraunsøe, Regitze; Boushel, Robert; Hansen, Christina Neigaard; Schjerling, Peter; Qvortrup, Klaus; Støckel, Mikael; Mikines, Kári J; Dela, Flemming

    2010-06-15

    Adipose tissue exerts important endocrine and metabolic functions in health and disease. Yet the bioenergetics of this tissue is not characterized in humans and possible regional differences are not elucidated. Using high resolution respirometry, mitochondrial respiration was quantified in human abdominal subcutaneous and intra-abdominal visceral (omentum majus) adipose tissue from biopsies obtained in 20 obese patients undergoing bariatric surgery. Mitochondrial DNA (mtDNA) and genomic DNA (gDNA) were determined by the PCR technique for estimation of mitochondrial density. Adipose tissue samples were permeabilized and respirometric measurements were performed in duplicate at 37 degrees C. Substrates (glutamate (G) + malate (M) + octanoyl carnitine (O) + succinate (S)) were added sequentially to provide electrons to complex I + II. ADP ((D)) for state 3 respiration was added after GM. Uncoupled respiration was measured after addition of FCCP. Visceral fat contained more mitochondria per milligram of tissue than subcutaneous fat, but the cells were smaller. Robust, stable oxygen fluxes were found in both tissues, and coupled state 3 (GMOS(D)) and uncoupled respiration were significantly (P subcutaneous (0.76 +/- 0.04 and 0.98 +/- 0.05 pmol O(2) s(1) mg(1), respectively) adipose tissue. Expressed per mtDNA, visceral adipose tissue had significantly (P subcutaneous adipose tissue. We conclude that visceral fat is bioenergetically more active and more sensitive to mitochondrial substrate supply than subcutaneous fat. Oxidative phosphorylation has a higher relative activity in visceral compared with subcutaneous adipose tissue.

  7. Infection with the strobilocercus of Taenia taeniaeformis in a Malagasy giant jumping rat (Hypogeomys antimena).

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    Widmer, Dimitri; Jurczynski, Kerstin

    2012-12-01

    An adult male Malagasy giant jumping rat (Hypogeomys antimena) kept at Zoo Duisburg was presented for clinical examination because of a distended abdomen and a history of lethargy and weakness. General examination findings consisted of an enlarged soft and fluctuating abdomen, suggestive of ascites. Digital radiography revealed multiple cloud-like radiopaque lesions in the cranial abdominal area, as well as an overall decrease in visibility of detail of the abdominal organs. Ultrasound examination showed circumscribed hypo- to anechogenic areas in the liver, measuring from 1 to 3 cm in diameter, some containing irregular, convoluted structures. Exploratory laparotomy confirmed the presence of a large amount of clear, pale-yellow fluid in the peritoneal cavity, as well as multiple cystic lesions in the liver and in the greater omentum. Extirpated cysts placed in sterile saline solution or fixed in formalin were sent to the Institut für Parasitologie der Tierärztlichen Hochschule, Hannover, Germany, and were identified as larval stages of the cestode Taenia taeniaeformis. Unfortunately, the rat died a few hours after surgery. To the authors' knowledge, this is the first report of infection with strobilocerci of T. taeniaeformis in a Malagasy giant jumping rat.

  8. INTRAPERITONEAL LYSIS OF TUBERCLE BACILLI.

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    Manwaring, W H; Bronfenbrenner, J

    1913-12-01

    1. Tubercle bacilli injected into the peritoneal cavities of tuberculous guinea pigs, rats, rabbits, dogs, and monkeys, rapidly disappear from the peritoneal fluids, while persisting in the peritoneal fluids of normal control animals. 2. This disappearance is in part due to an adhesion of the injected bacilli to the peritoneal leucocytes and a fixation of the leucocytes on the omentum. 3. The injected tubercle bacilli can be recovered quantitatively from the peritoneal cavities of normal guinea pigs from one and one half to two hours after the injection, while from tuberculous guinea pigs only 65 per cent. of the bacilli can be recovered at this time. 4. Isolated peritoneal tissues from tuberculous guinea pigs have the power of destroying tubercle bacilli in vitro. 5. A second factor reducing the number of tubercle bacilli free in the peritoneal fluid is therefore an actual lysis of the bacilli. 6. The intraperitoneal lysis is not due solely to substances present in the circulating fluids, since the phenomenon cannot be produced by these fluids in vitro, and since a lytic power cannot be passively conferred even by a direct transfusion of blood from tuberculous to normal animals. 7. The intraperitoneal lysis is apparently due to specific changes in the fixed peritoneal cells of the tuberculous animals.

  9. Visceral organ resection during femoral hernia surgery is a predictor of morbidity.

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    Calik, Bulent; Karaman, Kerem; Atci, Recep; Cetindag, Ozhan; Ugurlu, Levent; Aydin, Cengiz; Akbulut, Gokhan

    2015-03-01

    Reports on the outcomes of emergency and elective femoral hernia surgery are scarce. Most studies do not distinguish femoral hernia from other types of groin hernia; studies of femoral hernia alone are few in number. The main objective of the present study was to identify factors affecting morbidity of femoral hernia patients. We retrospectively analyzed data on 80 patients who underwent femoral hernia surgery between June 2009 and June 2013. Patients who did and did not experience morbidity were compared in terms of age, sex, hernia location, the presence of any comorbid disease, the type of anesthesia employed, the operative technique used, the type of surgical intervention, and performance of small bowel resection. Forty-three patients (53.8%) underwent emergency surgery because of incarceration. Of these, 18 (41.9%) experienced strangulation and underwent resection. Postoperative complications developed in 11 patients (13.8%). Upon multiple logistic regression analysis, visceral organ resection (of the small bowel and/or omentum) was the only independent predictor of significant morbidity (P femoral hernias should be electively repaired as soon as possible. The cumulative probability of strangulation rises over time. A requirement for bowel resection seems to significantly increase morbidity.

  10. Non-obstructed femoral hernia containing ascending colon, caecum, appendix and small bowel with concurrent bilateral recurrent inguinal hernia.

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    Patel, R B; Vasava, N; Hukkeri, S

    2012-04-01

    Femoral hernias, which are less common than inguinal hernias and more often found in females, occasionally contain more than just small intestine and omentum. Uncommon contents reported in femoral hernia sacs include caecum, appendix, Meckel's diverticulum (Littre hernia), testis, ovary, transverse colon and even stomach or kidney. Strangulation of femoral hernias containing appendix, small intestine and caecum, and Meckel's diverticulum are well reported in the literature. Here, we report a case of a male patient having bilateral femoral hernia with bilateral recurrent inguinal hernia. A huge, right-sided femoral hernia contained terminal ileum, appendix, caecum and ascending colon, which were irreducible but neither obstructed nor strangulated. The patient was operated on with a Pfannenstiel incision together with an infrainguinal incision. For reduction of content, an inguinal ligament was also incised. Bilateral preperitoneal, polypropylene mesh hernioplasty was performed along with rolled plug placement in the right femoral canal. The patient had an uneventful post operative recovery and no recurrence in 6 months of follow up.

  11. Morfologia e função fagocitária de implante esplênico autógeno regenerado em ratos Morphology and phagocytic function of regenerated autogenous splenic implant in rats

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    Ruy Garcia Marques

    2004-12-01

    autotransplantation in the greater omentum of slices of the whole mass of spleen. Sixteen weeks later animals were intravenously inoculated with a suspension of Escherichia coli AB1157, and twenty minutes later killed with lethal dose of halothane and submitted to laparotomy for splenic autotransplants retrieval. Data were analyzed statistically by de Student-t test, with emphasis on the comparison of the extent level of autotransplanted splenic mass regeneration between young and adult animals of both sexes. Results: There was regeneration of autotransplanted splenic tissue in all animals. Young males and adult females presented greater regeneration. A similar morphological aspect among all animals was observed, with splenic tissue showing red and white pulps with a moderate architectural disarrangement, as well as lymphoid follicles. Blood vessels showed preserved walls, with no signs of vasculitis or thrombosis. Macrophages containing bacterial aggregates were observed, as well as macrophages with hemosiderin pigments inside the cytoplasm. Conclusion: The present results suggest that splenic autotransplant in the greater omentum of the rat acquires the macro- and microscopic architecture of a normal spleen, with reduced dimensions, and preserves bacterial phagocyte function.

  12. Influence of omentoplasty on colonic anastomosis in animals submitted to hemorrhagic shock in rats Influência da omentoplastia na anastomose cólica de animais submetidos a choque hemorrágico em ratos

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    Ricardo Bolzam-Nascimento

    2009-06-01

    Full Text Available PURPOSE: To analyze influence of omentoplasty on anastomosis in descending colon of rats. Rats were submitted to the hypovolemic shock of the hemorrhagic type by the Biomechanical Test of Pressure of Rupture by Liquid Distension (BTPRLD. In addition, establish a type of acute anemia in rats that are provided to the study. METHODS: Comparative study between two groups of animals with ten rats in each one, all submitted to hemorrhagic shock for 30% volemic removal by the carotid artery. An anastomosis was performed in left colon. An anastomosis was performed in the left colon. Group 1 took place anastomosis with Polyvinyl Chloride (P.V.C film to prevent the adhesions formation on sature line. Group 2 placed the great omentum around the anastomosis. Euthanasia occurred on the fifth day, when the anastomoses were submitted to the biomechanical test of pressure of rupture by liquid distension (BTPRLD. RESULTS: High rupture pressure was gained with omentoplasty group in relation to the group in which anastomosis was protected from adhesions formation. A statistical significance was noted. CONCLUSION: Protection by great omentum has increased the anastomosis resistance of the shocked animals. Also, the proposed hemorrhagic shock type has proven to be useful for this study.OBJETIVO: Analisar a influência da omentoplastia sobre anastomose realizada em cólon descendente de ratos que foram submetidos a choque hipovolêmico do tipo hemorrágico, por meio do Teste Biomecânico de Pressão de Ruptura à Distensão por Líquido. Além disso, estabelecer modelo de anemia aguda em rato que se preste ao referido estudo. MÉTODOS: Estudo comparativo entre dois grupos de animais com 10 ratos em cada, todos submetidos a choque hemorrágico por retirada volêmica de 30% através da artéria carótida, sendo realizada anastomose em cólon esquerdo. No grupo 1 realizou-se proteção da anastomose com película de polivinilcloreto para impedir a formação de ader

  13. Avaliação da função fagocitária em remanescentes de esplenectomia subtotal e auto-implante esplênico autógeno Assessment of phagocytic function in remnants of subtotal spleen implantation

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    Andy Petroianu

    2003-03-01

    Full Text Available Para diminuir os efeitos adversos da esplenectomia total, abordagens conservadoras devem ser tentadas, quando for possível. Esplenectomia subtotal e auto-implantes esplênicos são boas alternativas nessa situação. O objetivo do presente estudo foi comparar as funções fagocitárias do pólo superior remanescente de esplenectomia subtotal e de tecido esplênico implantado no omento maior. Esta investigação foi conduzida em 35 ratos Holtzman adultos de ambos os sexos. Todos os animais foram submetidos a esplenectomia subtotal preservando o pólo superior suprido pelos vasos esplenogástricos e a auto-implante do segmento esplênico removido, no omento maior. A função fagocitária foi verificada por dois métodos diferentes: cintilografia com enxofre coloidal marcado com 99mTc e contagem, ao microscópio, de macrófagos que continham carbono coloidal. Durante os três primeiros meses, a fagocitose foi maior no pólo superior remanescente. Após esse período, não houve diferença entre o pólo superior e o auto-implante. Concluindo, o remanescente de esplenectomia subtotal e o auto-implante esplênico mantêm a função de filtração do baço mediante remoção de partículas coloidais do sangue.In order to diminish the adverse effects of total splenectomy, a conservative approach must be performed whenever possible. Subtotal splenectomy and splenic autotransplantation are good alternatives in such cases. The purpose of the present study was to compare the phagocytic function of the upper pole remnant of subtotal splenectomy and of autologous spleen tissue implanted into the greater omentum. This investigation was carried out on 35 adult Holtzman rats of both sexes. All animals were submitted to subtotal splenectomy, preserving the upper pole supplied by the splenogastric vessels and autotransplantation of the removed splenic segment on the greater omentum. The phagocytic function of the splenic remnants was verified by two different

  14. Effect of different-frequency electroacupuncture on lipid metabolism in obesity rats%不同频率电针对实验性肥胖大鼠脂代谢的影响

    Institute of Scientific and Technical Information of China (English)

    赵志国; 肖红玲; 孙立虹; 吴中秋; 张书义

    2011-01-01

    Objective: To observe the effect of different-frequency electroacupuncture on lipid metabolism in obesity rats, and to analyze the regulation mechanism of frequency to the disorder of Lipid Metabolism.Methods: The hypothalamus obesity rat model was induced by sodium glutaminic acid and high lipoprotein diet, adopt 2Hz, 50Hz and 100Hz frequency to acupuncture quchi, fenglong, sanyingjiao, housanli, zhongwan and guanyuan.To determine the rat's weight index (Lee's index), the wet weight of left kidney cycle and big omentum; Bioodsamples were collected for assaying serumtriglyceride (TG), total cholesterol (TC) with cholesterol oxidase phenol 4-aminoantipyrine peroxidese (CHOD-PAP) method, glycerol phosphate oxidasep-aminophenazone (GPO-PAP)methods, high density lipid-cholesterol (HDL-C) with phosphotungstic acid- Mg2+ method, low density lipid-cholesterol (LDL-C) with polyvingel suffate (PVS) sedimentation method.Results: Compared with model group, Lee's index, the wet weight of left kidney cycle and big omentum, serum TG, TC and LDL-C contents of 3 electric needle groups decreased considerably (P<0.05 or P<0.01), serum HDL-C content increased (P<0.05).Conclusion: There is a gradually decreased tendency of 2Hz, 50Hz and 100Hz electric needle to reduces the Lee's indexand lipid metabolism, compared with 2Hz and 100Hz electric needles, there is a relatively advantage of 50Hz electric needle in reducing fat weight.%目的:通过观察不同频率的电针对实验性肥胖大鼠脂代谢的影响,探讨频率调节脂代谢异常的作用机制.方法:采用谷氨酸钠和高脂饮食诱导的下丘脑性肥胖大鼠模型,选取大鼠曲池、丰隆、三阴交、后三里、中脘和关元穴,采用2Hz、50Hz、100Hz频率针刺.测定大鼠体质量指数(Lee's指数)、左肾周脂肪和大网膜脂肪湿重;用酶学终点法测血清三酰甘油(TG)、胆固醇(TC)的含量;用磷钨酸-镁沉淀法测血清高密度脂蛋白胆固醇(HDL-C)含量;用聚乙

  15. 石棉相关性恶性腹膜间皮瘤的CT 诊断%CT diagnosis of asbestos-related malignant peritoneal mesothelioma

    Institute of Scientific and Technical Information of China (English)

    杨汉卿; 姚伟根; 黄国来; 张建丰

    2011-01-01

    目的 分析石棉相关性恶性腹膜间皮瘤的CT 表现,以期提高认识.方法 17 例病理证实的石棉相关性恶性腹膜间皮瘤患者纳入研究,男1 例,女16 例,年龄36~79 岁,平均53 岁.螺旋CT 全腹部扫描,层厚5 mm,平扫后以3 ml/s 注射非离子型碘对比剂90 ml,动脉期(延迟30 s)和门脉期(延迟70s)采集.2 位资深CT 诊断医生共同回顾性评价分析.结果 全部病例出现肠系膜增厚、混浊和腹水(100%),其中10 例为中大量,3 例包裹;大网膜增厚16 例(94%),其中14 例呈饼状,10 例显示增粗血管影,3 例形成大网膜肿块,明显强化;腹膜结节状及条状增厚12 例(82%);5 例形成盆腔肿块(29%),其中2 例部分囊性;伴淋巴结增大8 例(47%).同时在膈面层面范围内显示胸膜斑15 例(88%)、胸腔积液5 例以及合并恶性胸膜间皮瘤1 例.结论 石棉相关性恶性腹膜间皮瘤的CT 表现有一定特征性,广泛的网膜、系膜、腹膜增厚及腹水,结合胸膜斑和石棉接触史病史,有助于诊断.%Objective To study the CT diagnostic features of asbestos-related malignant peritoneal mesothelioma (AR -MPM). Methods Seventeen patients (1 male,16 female;age range;36-79 years, mean 53 years) with pathologically proved AR-MPM were enrolled in our study. Spiral CT with slice-thickness of 5mm was acquired in the 30 sec delayed arterial phase and 70 sec delayed portal phase after intravenous administration of 90 mL of nonionic iodinated contrast media at 3 mL/s injection rate. The CT images were reviewed by two experienced radiologists. Results Mesentery thickening and cloudiness with ascites were seen in all patients (100%). There were omentum thickenning in 16 patients (94%), nodular or linear peritoneal thickening in 12 patients (71%), and pelvic masses in 5 patients (29%). Pleural plaques were also noted in 15 patients (88%), pleural effusions in 5 patients, and malignant pleural masses in one patient (6%). Conclusion CT findings of

  16. Adipose-derived mesenchymal stem cells promote cell proliferation and invasion of epithelial ovarian cancer

    Energy Technology Data Exchange (ETDEWEB)

    Chu, Yijing; Tang, Huijuan; Guo, Yan; Guo, Jing; Huang, Bangxing; Fang, Fang; Cai, Jing, E-mail: caijingmmm@hotmail.com; Wang, Zehua, E-mail: zehuawang@163.net

    2015-09-10

    Adipose-derived mesenchymal stem cell (ADSC) is an important component of tumor microenvironment. However, whether ADSCs have a hand in ovarian cancer progression remains unclear. In this study, we investigated the impact of human ADSCs derived from the omentum of normal donors on human epithelial ovarian cancer (EOC) cells in vitro and in vivo. Direct and indirect co-culture models including ADSCs and human EOC cell lines were established and the effects of ADSCs on EOC cell proliferation were evaluated by EdU incorporation and flow cytometry. Transwell migration assays and detection of MMPs were performed to assess the invasion activity of EOC cells in vitro. Mouse models were established by intraperitoneal injection of EOC cells with or without concomitant ADSCs to investigate the role of ADSCs in tumor progression in vivo. We found that ADSCs significantly promoted proliferation and invasion of EOC cells in both direct and indirect co-culture assays. In addition, after co-culture with ADSCs, EOC cells secreted higher levels of matrix metalloproteinases (MMPs), and inhibition of MMP2 and MMP9 partially relieved the tumor-promoting effects of ADSCs in vitro. In mouse xenograft models, we confirmed that ADSCs promoted EOC growth and metastasis and elevated the expression of MMP2 and MMP9. Our findings indicate that omental ADSCs play a promotive role during ovarian cancer progression. - Highlights: • Omental adipose derived stem cells enhanced growth and invasion properties of ovarian cancer cells. • Adipose derived stem cells promoted the growth and metastasis of ovarian cancer in mice models. • Adipose derived stem cells promoted MMPs expression and secretion of ovarian cancer cells. • Elevated MMPs mediated the tumor promoting effects of ADSCs.

  17. Congenital retrosternal hernias of Morgagni: Manifestation and treatment in children

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    Slepov, Oleksii; Kurinnyi, Sergii; Ponomarenko, Oleksii; Migur, Mikhailo

    2016-01-01

    Background: Due to scarcity of congenital diaphragmatic hearnias of Morgagni (CDHM), non-specific clinical presentation in the pediatric age group, we aimed to investigate the incidence, clinical manifestations, anatomical characteristics, and develop diagnostic algorithm and treatment of CDHM in children. Materials and Methods: The patients’ records of children with CDHM treated in our hospital during past 20 years were retrospectively reviewed for the age at diagnosis, gender, clinical findings, anatomical features, operative details and outcome. Results: Since 1995 to 2014 we observed 6 (3 boys, 3 girls) patients with CDHM, that comprise 3.2% of all congenital diaphragmatic hernia cases (n = 185). Age at diagnosis varied from 3 mo. to 10y.o. Failure to thrive was main symptom in 4 patients, followed by recurrent respiratory infections (n = 3), dyspnea (n = 3), and gastrointestinal manifestations: constipation (n = 2), abdominal pain (n = 1). Work-up consisted of plain X-ray for all (n = 6), upper GI (n = 3), barium enema (n = 2), sonography (n = 6) and CT (n = 2). Abdominal approach used in 5 patients, and thoracotomy in one. Herniated contents were: liver lobes (n = 4), transverse colon (n = 3) and greater omentum (n = 1). 5 had right-sided lesion, 1- left-sided. Defect repaired using local tissues. Post-operative course was uneventful; all patients appeared well during follow-up. Conclusion: CDHM is very uncommon anomaly, very occasionally diagnosed at the early age. Failure to thrive and recurrent respiratory infections are most frequent clinical manifestations. In suspected CDHM we advocate the following work-up: plain chest and abdominal X-ray, contrast study (upper GI series or barium enema), ultrasonographic screen and CT scan. Surgical repair via abdominal approach, using local tissues and hernia sac removal is preferred. PMID:27251653

  18. Congenital retrosternal hernias of Morgagni: Manifestation and treatment in children

    Directory of Open Access Journals (Sweden)

    Oleksii Slepov

    2016-01-01

    Full Text Available Background: Due to scarcity of congenital diaphragmatic hearnias of Morgagni (CDHM, non-specific clinical presentation in the pediatric age group, we aimed to investigate the incidence, clinical manifestations, anatomical characteristics, and develop diagnostic algorithm and treatment of CDHM in children. Materials and Methods: The patients′ records of children with CDHM treated in our hospital during past 20 years were retrospectively reviewed for the age at diagnosis, gender, clinical findings, anatomical features, operative details and outcome. Results: Since 1995 to 2014 we observed 6 (3 boys, 3 girls patients with CDHM, that comprise 3.2% of all congenital diaphragmatic hernia cases (n = 185. Age at diagnosis varied from 3 mo. to 10y.o. Failure to thrive was main symptom in 4 patients, followed by recurrent respiratory infections (n = 3, dyspnea (n = 3, and gastrointestinal manifestations: constipation (n = 2, abdominal pain (n = 1. Work-up consisted of plain X-ray for all (n = 6, upper GI (n = 3, barium enema (n = 2, sonography (n = 6 and CT (n = 2. Abdominal approach used in 5 patients, and thoracotomy in one. Herniated contents were: liver lobes (n = 4, transverse colon (n = 3 and greater omentum (n = 1. 5 had right-sided lesion, 1- left-sided. Defect repaired using local tissues. Post-operative course was uneventful; all patients appeared well during follow-up. Conclusion: CDHM is very uncommon anomaly, very occasionally diagnosed at the early age. Failure to thrive and recurrent respiratory infections are most frequent clinical manifestations. In suspected CDHM we advocate the following work-up: plain chest and abdominal X-ray, contrast study (upper GI series or barium enema, ultrasonographic screen and CT scan. Surgical repair via abdominal approach, using local tissues and hernia sac removal is preferred.

  19. Obesity-associated insulin resistance is correlated to adipose tissue vascular endothelial growth factors and metalloproteinase levels

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    Tinahones Francisco

    2012-04-01

    Full Text Available Abstract Background The expansion of adipose tissue is linked to the development of its vasculature, which appears to have the potential to regulate the onset of obesity. However, at present, there are no studies highlighting the relationship between human adipose tissue angiogenesis and obesity-associated insulin resistance (IR. Results Our aim was to analyze and compare angiogenic factor expression levels in both subcutaneous (SC and omentum (OM adipose tissues from morbidly obese patients (n = 26 with low (OB/L-IR (healthy obese and high (OB/H-IR degrees of IR, and lean controls (n = 17. Another objective was to examine angiogenic factor correlations with obesity and IR. Here we found that VEGF-A was the isoform with higher expression in both OM and SC adipose tissues, and was up-regulated 3-fold, together with MMP9 in OB/L-IR as compared to leans. This up-regulation decreased by 23% in OB/-H-IR compared to OB/L-IR. On the contrary, VEGF-B, VEGF-C and VEGF-D, together with MMP15 was down-regulated in both OB/H-IR and OB/L-IR compared to lean patients. Moreover, MMP9 correlated positively and VEGF-C, VEGF-D and MMP15 correlated negatively with HOMA-IR, in both SC and OM. Conclusion We hereby propose that the alteration in MMP15, VEGF-B, VEGF-C and VEGF-D gene expression may be caused by one of the relevant adipose tissue processes related to the development of IR, and the up-regulation of VEGF-A in adipose tissue could have a relationship with the prevention of this pathology.

  20. Laparoscopic retrieval of retained intraperitoneal drains in the immediate postoperative period.

    Science.gov (United States)

    Liao, Chih-Szu; Shieh, Min-Chieh

    2011-03-01

    Retained intraperitoneal Penrose drain secondary to fracture and adhesions in the immediate postoperative period happens on occasion. Most are unreported because of the fear of medico-legal problems. Previous management of such iatrogenic complications requires repeated laparotomy or wound exploration. Two patients who underwent appendectomy for ruptured appendicitis, with retained intraabdominal drains in the immediate postoperative period, managed eventually by laparoscopic retrieval are presented. Both patients had right low transverse incisions and intraabdominal drains exiting through a separate right lateral abdomen skin opening. Patient 1 had a stuck intraabdominal drain unable to be removed up to the second week. Patient 2's drain retracted intraperitoneally after its mobilization on the sixth post-op day. Both were managed by laparoscopy under general anesthesia with successful removal of both drains. Patient 1 underwent the procedure 3 weeks after the appendectomy, whereas Patient 2 had the procedure on her sixth post-op day. An additional new 1-cm wound in the periumbilical area was done for the introduction of pneumoperitoneum and 10-mm port for which the laparoscope was inserted. The second 5-mm port was inserted through the old drain site wound with peritoneal entry opening separate from the previous peritoneal defect viewed from laparoscope. Both drains had some marked adhesions from ingrowth of omentum to the side holes of the drain, causing it to get stuck in the pelvic cavity. This laparoscopic approach in the management of such iatrogenic complication, besides being cosmetically acceptable, contributes to early recovery and discharge of the patient, and helps to lessen the friction in the recently worsening doctor-patient relationship in Taiwan. Copyright © 2011. Published by Elsevier B.V.

  1. Primary omental Gastrointestinal stromal tumor (GIST

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    Hirahara Nobutsune

    2007-06-01

    Full Text Available Abstract Background We report herein a rare case of primary omental gastrointestinal stromal tumor (GIST. Case presentation A 65 year-old man was referred to our hospital with a huge abdominal mass occupying the entire left upper abdomen as shown by sonography. On computed tomography (CT, this appeared as a heterogeneous low-density mass with faint enhancement. Abdominal angiography revealed that the right gastroepiploic artery supplied the tumor. With such an indication of gastric GIST, liposarcoma, leiomyosarcoma or mesothelioma laparotomy was performed and revealed that this large mass measured 20 × 17 × 6 cm, arising from the greater omentum. It was completely resected. Histopathologically, it was composed of proliferating spindle and epithelioid cells with an interlacing bundle pattern. Immunohistochemically, the tumor was positive for myeloid stem cell antigen (CD34, weakly positive for c-KIT (CD117 and slightly positive for neuron-specific enolase (NSE, but negative for cytokeratin (CK, alpha-smooth muscle actin (SMA and S-100 protein. A mutation was identified in the platelet-derived growth factor alpha (PDGFRA juxtamembrane domain (exon 12, codon561 and the tumor was diagnosed as an omental GIST. The postoperative course was uneventful. The patient is treated by Glevec® and is alive well with no sign of relapse. Conclusion Our case demonstrated a weak immunohistochemical expression of c-kit (CD117 and a point mutation in PDGFRA exon 12 resulting in an Asp for Val561 substitution. Imatinib therapy as an adjuvant to complete resection has been carried out safely. Because of the rarity of primary omental GISTs, it is inevitable to analyze accumulating data from case reports for a better and more detailed understanding of primary omental GISTs.

  2. Sclerosing epithelioid fibrosarcoma as a rare cause of ascites in a young man: a case report

    Directory of Open Access Journals (Sweden)

    Smith Philip J

    2008-07-01

    Full Text Available Abstract Introduction Sclerosing epithelioid fibrosarcoma is a rare but distinct variant of fibrosarcoma that not only presents as a deep-seated mass on the limbs and neck but can also occur adjacent to the fascia or peritoneum, as well as the trunk and spine. We report the case of an intra-abdominal sclerosing epithelioid fibrosarcoma, which to best of the authors' knowledge has not been described previously. The patient discussed here developed lung metastases but is still alive 1-year post-diagnosis. Case presentation A 29-year-old man presented with a 2-week history of progressive abdominal distension and pain and was found to have marked ascites. A full liver screen was unremarkable with abdominal and chest computed tomography scans only confirming ascites. After a diagnostic laparotomy, biopsies were taken from the greater omentum and peritoneal nodules. Histopathology revealed a malignant tumour composed of sheets and cords of small round cells set in collagenized stroma. After further molecular investigation at the Mayo Clinic, USA, the diagnosis of a high-grade sclerosing epithelioid fibrosarcoma was confirmed. Conclusion Sclerosing epithelioid fibrosarcoma is an extremely rare tumour, which is often difficult to diagnose and which few pathologists have encountered. This case is particularly unusual because of the intra-abdominal origin of the tumour. Owing to the rarity of sclerosing epithelioid fibrosarcoma, there is no clear evidence regarding the prognosis of such a tumour, although sclerosing epithelioid fibrosarcoma is able to metastasize many years post-presentation. It is important that physicians and pathologists are aware of this unusual tumour.

  3. Multiple repeated cesarean deliveries: operative complications in the fourth and fifth surgeries in urgent and elective cases.

    Science.gov (United States)

    Gedikbasi, Ali; Akyol, Alpaslan; Bingol, Banu; Cakmak, Demet; Sargin, Akif; Uncu, Remzi; Ceylan, Yavuz

    2010-12-01

    To evaluate the maternal and neonatal risk related with multiple repeated cesarean sections. A case control study was conducted in a single tertiary maternity and children's center. The outcome of a study group including 122 pregnant women undergoing cesarean section for the fourth or fifth time was compared with a control group comprising 146 women sectioned for the second and third time. All multiple repeated cesarean sections were divided into urgent and elective groups to compare the outcome measures of demographic, neonatal, intra- and post-operative data. Compared with the control group, the study group had significantly lower birth weights (p=0.026), lower Apgar scores at 1 minute (p=0.0001) and 5 minutes (p=0.042), higher numbers of fetal death (p=0.03), higher rate of omentum adhesions (p =0.0001) and peritoneal adhesions (p=0.008), increased risk of cesarean hysterectomy (p = 0.014), increased need for transfusion (p = 0.018), and an increase in hospitalization days (p=0.005). Compared with the elective group, preterm birth incidence was higher (p = 0.01) and birth weight was lower (p=0.004) in the urgent group. The risk for myometrium herniation (p=0.018), need for drainage during operation (p=0.018), and post-operative fever (p =0.001) was also more common in the urgent group. Multiple repeated cesarean sections increase the risks for operative complications and poor perinatal outcomes. Patients must be informed about the related risks of multiple repeated cesarean sections and tubal ligation needs to be encouraged. Copyright © 2010 Taiwan Association of Obstetric & Gynecology. Published by Elsevier B.V. All rights reserved.

  4. Application of laparoscopy in surgical repair of gastrointestinal ulcer perforation%腹腔镜在胃十二指肠溃疡穿孔修补术中的应用

    Institute of Scientific and Technical Information of China (English)

    张军伟; 赵传印; 胡卫东

    2012-01-01

    Objective To investigate the value of laparoscopic technique in the treatment of gastrointestinal ulcer perforation.Methods The clinical datas of 33 patients underwent laparoscopic repair treatment from March 2007 to February 2010 were retrospectively analyzed.Results Among the 33 cases,pathological diagnosis of cancer ulcer perforation in 2 cases,and transit to laparotomy,the other 31 cases all underwent laparoscopic repairment,omentum covering fixation.All patients were followed up for 6-18 months,total cure rate was 93.9%.Conclusions Laparoscopic repairment can be carried out safely and effectively in the treatment of gastric ulcer perforation,and worthy of clinical application.%目的 探讨腹腔镜技术在治疗急性胃十二指肠溃疡穿孔中的应用价值.方法 回顾性分析我院2007年3月至2010年2月间在腹腔镜下修补治疗33例胃十二肠溃疡穿孔患者的临床资料.结果 33例中,2例术中病理检查诊断为癌性溃疡穿孔中转开腹手术,余31例患者均在腹腔镜下施行了溃疡穿孔修补、网膜覆盖固定术.6~18个月随访,总治愈率为93.9%.结论 腹腔镜下修补缝合术治疗急性胃、十二指肠溃疡穿孔安全易行、疗效可靠、值得推广应用.

  5. Characterization and assessment of hyperelastic and elastic properties of decellularized human adipose tissues.

    Science.gov (United States)

    Omidi, Ehsan; Fuetterer, Lydia; Reza Mousavi, Seyed; Armstrong, Ryan C; Flynn, Lauren E; Samani, Abbas

    2014-11-28

    Decellularized adipose tissue (DAT) has shown potential as a regenerative scaffold for plastic and reconstructive surgery to augment or replace damaged or missing adipose tissue (e.g. following lumpectomy or mastectomy). The mechanical properties of soft tissue substitutes are of paramount importance in restoring the natural shape and appearance of the affected tissues, and mechanical mismatching can lead to unpredictable scar tissue formation and poor implant integration. The goal of this work was to assess the linear elastic and hyperelastic properties of decellularized human adipose tissue and compare them to those of normal breast adipose tissue. To assess the influence of the adipose depot source on the mechanical properties of the resultant decellularized scaffolds, we performed indentation tests on DAT samples sourced from adipose tissue isolated from the breast, subcutaneous abdominal region, omentum, pericardial depot and thymic remnant, and their corresponding force-displacement data were acquired. Elastic and hyperelastic parameters were estimated using inverse finite element algorithms. Subsequently, a simulation was conducted in which the estimated hyperelastic parameters were tested in a real human breast model under gravity loading in order to assess the suitability of the scaffolds for implantation. Results of these tests showed that in the human breast, the DAT would show similar deformability to that of native normal tissue. Using the measured hyperelastic parameters, we were able to assess whether DAT derived from different depots exhibited different intrinsic nonlinearities. Results showed that DAT sourced from varying regions of the body exhibited little intrinsic nonlinearity, with no statistically significant differences between the groups. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. Human omental adipose-derived mesenchymal stem cell-conditioned medium alters the proteomic profile of epithelial ovarian cancer cell lines in vitro

    Directory of Open Access Journals (Sweden)

    Zhang YL

    2017-03-01

    Full Text Available Yanling Zhang,1,* Weihong Dong,1,* Junjie Wang,2 Jing Cai,1 Zehua Wang1 1Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 2Department of Obstetrics and Gynecology, Renhe Hospital, China Three Gorges University, Yichang, People’s Republic of China *These authors contributed equally to this work Abstract: Mesenchymal stem cells (MSCs have been reported to participate in the formation of supportive tumor stroma. The abilities of proliferation and invasion of human epithelial ovarian cancer (EOC cells were significantly enhanced when indirectly cocultured with human omental adipose-derived MSCs (O-ADSCs in vitro. However, the underlying mechanisms remain poorly understood. In this study, EOC cells were cultured with conditioned medium (CM from O-ADSCs (O-ADSC, and the effect of O-ADSC CM on the proteomic profile of EOC cells was assessed by two-dimensional gel electrophoresis (2-DE, followed by liquid chromatography and tandem mass spectrometry. The 2-DE assays revealed a global increase in protein expression in the EOC cells treated with CM. Nine proteins were identified from 11 selected protein spots with differential expression after treatment with CM from O-ADSCs. All the nine proteins have been linked to carcinoma and apoptosis, and the migration ability of tumor cells can be regulated by these proteins. Moreover, the upregulation of prohibitin and serine/arginine-rich splicing factor 1 in EOC cells treated with CM was further confirmed by quantitative real-time polymerase chain reaction. These results suggest that O-ADSCs affect the proteomic profile of EOC cells via paracrine mechanism in favor of EOC progression. Keywords: ovarian cancer, mesenchymal stromal cells, mesenchymal stem cells, omentum, proteomic

  7. Mesothelium expression of vascular cell adhesion molecule-1 (VCAM-1) is associated with an unfavorable prognosis in epithelial ovarian cancer (EOC).

    Science.gov (United States)

    Scalici, Jennifer M; Arapovic, Sanja; Saks, Erin J; Atkins, Kristen A; Petroni, Gina; Duska, Linda R; Slack-Davis, Jill K

    2017-05-15

    Mesothelium vascular cell adhesion molecule-1 (VCAM-1) expression in the metastatic epithelial ovarian cancer (EOC) microenvironment is induced by tumor and mediates tumor cell invasion. VCAM-1 imaging suggests expression during treatment is an indicator of platinum resistance. Here, we assess the potential prognostic significance of mesothelium VCAM-1 expression and prospectively evaluate whether soluble VCAM-1 (sVCAM-1) is a surrogate for mesothelium expression. A retrospective review of EOC patients was performed to evaluate outcomes with mesothelium VCAM-1 expression determined by immunohistochemistry of peritoneum or omentum specimens. A prospective cohort of EOC patients was identified and followed through primary treatment. Serum for sVCAM-1 evaluation, which was performed via enzyme-linked immunosorbent assay, was collected before surgery or neoadjuvant chemotherapy and at each treatment cycle. Peritoneal specimens were obtained during debulking to assess mesothelial VCAM-1 expression. A retrospective review identified 54 advanced-stage EOC patients. Patients expressing mesothelium VCAM-1 had shortened overall survival (44 vs 79 months, P = 0.035) and progression-free survival (18 vs 67 months, P = 0.010); the median time to platinum resistance was 36 months for VCAM-1-expressing patients and not yet determined for the VCAM-1-negative group. In our prospective observational cohort, 18 EOC patients completed primary treatment; 3 were negative for mesothelium VCAM-1 expression, and sVCAM-1 did not vary between groups. Mesothelium VCAM-1 expression is negatively associated with progression-free and overall survival in EOC. This is especially compelling in light of previous data suggesting that persistent VCAM-1 expression during treatment is an indicator of platinum resistance. Our pilot study had insufficient cases to determine whether sVCAM-1 would substitute for mesothelium expression. Cancer 2017;123:977-84. © 2016 American Cancer Society. © 2016

  8. Abdominal cystic lymphangiomas in pediatrics: surgical approach and outcomes.

    Science.gov (United States)

    Méndez-Gallart, R; Bautista, A; Estévez, E; Rodríguez-Barca, P

    2011-01-01

    Abdominal Cystic lymphangiomas (ACL) are uncommon benign masses usually presented during infancy. Although extremely rare, they may cause complications; therefore, the recommended therapy is surgical excision. The purpose of this study is to report our experience with the diagnosis and surgical treatment of ACL in pediatric population. From January 1994 to December 2009, 10 patients (6 females; 4 males) with diagnostic confirmation of ACL were retrospectively included in study. Children's age ranged between 9 months and 8 years (mean age at diagnosis was 2.5 years). Clinical presentation, cyst location, imaging studies employed, surgical approach and pathologic features were analyzed. The most common symptom was abdominal pain but three cases were incidentally detected. One case had presented with acute abdomen after traumatic haemorrhage of the tumor. All patients were diagnosed with ultrasonography as first-line radiological study. MRI was used in last three cases. At surgery, concomitant bowel resection was necessary in 3 children. Location of the lesion (omentum, mesentery) did not influence the outcome but surgery was more difficult (operative time over three hours) in patients with lymphangioma affecting mesentery of the jejunum. Mean hospital stay after surgery was 6.7 days. Mean follow-up was 5.1 years. No recurrence of the cystic lymphangioma was noticed during follow-up. One case developed an intestinal occlusion due to bowel adhesions 1 year after surgery. ACL usually affect infants and young children and may present with spectrum of symptoms from an incidental finding to an acute life-threatening abdominal obstruction. Complete excision of the tumor is a safe and effective method in the management of ACL in pediatric population. Surgery is mandatory to avoid potential complications.

  9. Separating the roles of nitrogen and oxygen in high pressure-induced blood-borne microparticle elevations, neutrophil activation, and vascular injury in mice.

    Science.gov (United States)

    Yang, Ming; Bhopale, Veena M; Thom, Stephen R

    2015-08-01

    An elevation in levels of circulating microparticles (MPs) due to high air pressure exposure and the associated inflammatory changes and vascular injury that occur with it may be due to oxidative stress. We hypothesized that these responses arise due to elevated partial pressures of N2 and not because of high-pressure O2. A comparison was made among high-pressure air, normoxic high-pressure N2, and high-pressure O2 in causing an elevation in circulating annexin V-positive MPs, neutrophil activation, and vascular injury by assessing the leakage of high-molecular-weight dextran in a murine model. After mice were exposed for 2 h to 790 kPa air, there were over 3-fold elevations in total circulating MPs as well as subgroups bearing Ly6G, CD41, Ter119, CD31, and CD142 surface proteins-evidence of neutrophil activation; platelet-neutrophil interaction; and vascular injury to brain, omentum, psoas, and skeletal muscles. Similar changes were found in mice exposed to high-pressure N2 using a gas mixture so that O2 partial pressure was the same as that of ambient air, whereas none of these changes occurred after exposures to 166 kPa O2, the same partial pressure that occurs during high-pressure air exposures. We conclude that N2 plays a central role in intra- and perivascular changes associated with exposure to high air pressure and that these responses appear to be a novel form of oxidative stress.

  10. GAINT INGUINOSCROTAL HERNIA – LICHTENSTEIN’S TENSION FREE REPAIR WITHOUT LOSS OF DOMAIN: CASE REPORT

    Directory of Open Access Journals (Sweden)

    Sreekant

    2015-03-01

    Full Text Available Inguinal hernia is one of the most surgical common diseases in clinical practice. The history of inguinal hernia repair originated in the ancient times and the treatment has evolved, developed and changed since. [1] The most recent one is the concept of tension - free repair which remains popular among surgeons today. It is interesting to note, though, that numerous literatures have been published on this disease in the small anatomical space despite its simplicity. In the past couple of years, most publications focused on laparoscopic surgery and the different types of prosthetic mesh. Giant inguinal hernia, however, is more unusual and significantly challenging in terms of surgical management. It is defined as an ingu inal hernia that extends below the midpoint of inner thigh when the patient is in standing position. [2] No treatment has been adopted as standard procedure for this uncommon disease and several repair techniques are suggested by published articles and case reports. Further, the absence of large scale comparative study is expected to continue due to the relatively low number of cases. As a result, choosing a surgical procedure is made difficult and the decision must be made intraoperatively. A 55 - year - old ma le patient presented with Left Giant inguinal hernia and compromised quality of life due to pain and sexual discomfort. Lichtenstein’s polypropylene mesh repair was done after reducing the sac contents (omentum and ileum with partial omentectomy. There wa s no loss of intra - abdominal domain. Postoperative period was uneventful. In literature many techniques are available to increase the intra - abdominal cavity (a Creating progressive preoperative pneumoperitoneum (b Creation of ventral wall defect (c surg ical debulking of hernia contents. Recurrence is prevented by reconstruction of the abdominal wall using Marlex mesh and a Tensor fasciae lata flap. Laparoscopic repair is associated with more recurrence

  11. Sinus cut-off sign: A helpful sign in the CT diagnosis of diaphragmatic rupture associated with pleural effusion

    Energy Technology Data Exchange (ETDEWEB)

    Kaya, Seyda Ors [Pamukkale University Medical School, Department of Thoracic Surgery, Denizli (Turkey)]. E-mail: skaya@pamukkale.edu.tr; Karabulut, Nevzat [Pamukkale University Medical School, Department of Radiology, Denizli (Turkey); Yuncu, Gokhan [Pamukkale University Medical School, Department of Thoracic Surgery, Denizli (Turkey); Sevinc, Serpil [Pamukkale University Medical School, Department of Thoracic Surgery, Denizli (Turkey); Kiroglu, Yilmaz [Pamukkale University Medical School, Department of Radiology, Denizli (Turkey)

    2006-08-15

    The objective of our study was to describe the 'sinus cut-off' sign at CT in the diagnosis of diaphragmatic rupture in patients with blunt abdominal trauma complicated with pleural effusion, and evaluate its utility in an experimental model. Between January 2004 and March 2005, we observed an unusual interruption of costophrenic sinus at CT in three patients with blunt abdominal trauma accompanied with pleural effusion. This observation prompted us to evaluate the utility of this sign in an experimental model. Laparotomically, we created 2 cm diapragmatic lacerations at each hemidiaphragm in two rabbits and pushed up the abdominal viscera with omentum through the defect. To simulate hemothorax, we also injected 5-10 mL of diluted contrast material into the pleural space. Using a dual-slice helical CT scanner, limited thoracoabdominal CT examination was performed before and after injection of intrapleural contrast material. The images were analyzed for the presence of CT signs for diaphragmatic injury. The left posterior costophrenic sulcus was interrupted in all of the three patients with left pleural effusion. While it was associated with other findings of diaphragmatic injury, the 'sinus cut-off sign' was the sole finding in one patient. The sinus cut-off sign was observed on the CT scans of 100% of the rabbits with a left and right sided diaphragmatic rupture. The 'sinus cut-off sign' is useful and can increase the CT detection of acute diaphragmatic injury associated with pleural effusion.

  12. Gastric remnant twist in the immediate post-operative period following laparoscopic sleeve gastrectomy

    Science.gov (United States)

    Subhas, Gokulakkrishna; Gupta, Anupam; Sabir, Mubashir; Mittal, Vijay K

    2015-01-01

    Twist of stomach remnant post sleeve gastrectomy is a rare entity and difficult to diagnose pre-operatively. We are reporting a case of gastric volvulus post laparoscopic sleeve gastrectomy, which was managed conservatively. A 38-year-old lady with a body mass index of 54 underwent laparoscopic sleeve gastrectomy. Sleeve gastrectomy was performed over a 32 French bougie using Endo-GIA tri-stapler. On post-operative day 1, patient had nausea and non-bilious vomiting. An upper gastrointestinal gastrografin study on post-operative days 1 and 2 revealed collection of contrast in the fundic area of stomach with poor flow distally, and she vomited gastrograffin immediately post procedure. With the suspicion of a stricture in the mid stomach as the cause, the patient was taken back for a exploratory laparoscopy and intra-operative endoscopy. We found a twist in the gastric tube which was too tight for the endoscope to pass through. This was managed conservatively with a long stent to keep the gastric tube straight and patent. The stent was discontinued in 7 d and the patient did well. In laparoscopic sleeve gastrectomy the stomach is converted into a tube and is devoid of its supports. If the staples fired are not aligned appropriately, it can predispose this stomach tube to undergo torsion along its long axis. Such a twist can be avoided by properly aligning the staples and by placing tacking sutures to the omentum and new stomach tube. This twist is a functional obstruction rather than a stricture; thus, it can be managed by endoscopy and stent placement. PMID:26649158

  13. 'Mrs L.'s case': a celebrated South Australian surgical case.

    Science.gov (United States)

    Elmslie, R G

    1991-10-01

    This paper concerns a dispute at the Adelaide Hospital in September 1896 between Professor Archibald Watson, Pathologist, Honorary Consulting Surgeon and sole remaining University teacher at the hospital, and Alexander Disney Leith Napier, who had arrived from England to fill the place of the honorary surgeons who had resigned from the hospital. Watson accused Napier of incompetence in his management of 'Mrs L.', who died after a femoral hernia operation. Mrs L had a form of internal hernia causing intestinal obstruction, whereas all the medical attendants, including Watson, originally thought an old femoral hernia was the cause of her illness. By fortuitous coincidence the operation on the femoral hernia could have cured the internal hernia if the band of omentum attached to the femoral hernia had been divided. Watson became aware of the band at the post-mortem and then asserted that the operation should have taken it into account. Napier complained to the Board of the Hospital, alleging that Watson had misrepresented the facts when he conducted the post-mortem on the patient and that he was disloyal to the hospital. The Board found the complaint proved and invited Watson to resign; he declined and was dismissed. Undaunted, Watson circulated a privately printed pamphlet (entitled 'Mrs L.'s case'), which re-stated the events of the case and graphically described his post-mortem findings. It was submitted to the Chairman of a Select Committee of the Legislative Council of South Australia established to review the running of the hospital. The Committee recommended the setting up of a Royal Commission but the Government let the matter lapse.(ABSTRACT TRUNCATED AT 250 WORDS)

  14. The FAT expandability (FATe) Project: Biomarkers to determine the limit of expansion and the complications of obesity.

    Science.gov (United States)

    Torres-Perez, Elena; Valero, Monica; Garcia-Rodriguez, Beatriz; Gonzalez-Irazabal, Yolanda; Calmarza, Pilar; Calvo-Ruata, Luisa; Ortega, Carmen; Garcia-Sobreviela, Maria Pilar; Sanz-Paris, Alejandro; Artigas, Jose Maria; Lagos, Javier; Arbones-Mainar, Jose M

    2015-04-22

    Obesity is an excessive accumulation of fat frequently, but not always, associated with health problems, mainly type 2 diabetes and cardiovascular disease. During a positive energy balance, as caused by excessive intake or sedentary lifestyle, subcutaneous adipose tissue expands and accumulates lipids as triglycerides. However, the amount of adipose tissue per se is unlikely to be the factor linking obesity and metabolic complications. The expandability hypothesis states that, if this positive energy balance is prolonged, a point is eventually reached where subcutaneous adipose tissue can not further expand and energy surplus no longer can be safely stored. Once the limit on storage capacity has been exceeded, the dietary lipids start spilling and accumulate ectopically in other organs (omentum, liver, muscle, pancreas) forming lipid byproducts toxic to cells. FATe is a multidisciplinary clinical project aimed to fill gaps that still exist in the expandability hypothesis. Imaging techniques (CT-scan), metabolomics, and transcriptomics will be used to identify the factors that set the limit expansion of subcutaneous adipose tissue in a cohort of caucasian individuals with varying degrees of adiposity. Subsequently, a set of biomarkers that inform the individual limits of expandability will be developed using computational and mathematical modeling. A different validation cohort will be used to minimize the risk of false positive rates and increase biomarkers' predictive performance. The work proposed here will render a clinically useful screening method to predict which obese individuals will develop metabolic derangements, specially diabetes and cardiovascular disease. This study will also provide mechanistic evidence that promoting subcutaneous fat expansion might be a suitable therapy to reduce metabolic complications associated with positive energy balance characteristic of Westernized societies.

  15. Realtime ultrasonographic findings in gallbladder carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Y. T.; Woo, S. K.; Suh, I. J.; Lim, J. H.; Kim, H. K.; Kim, S. Y.; Ahn, C. Y. [Kyung Hee University Hospital, Seoul (Korea, Republic of)

    2010-05-15

    It is well known that realtime ultrasonography is the primary diagnostic modality to evaluate gallbladder diseases. The authors studied ultrasonographic findings of 10 pathologically proven gallbladder carcinoma patients, and it was compared with the findings of 4 cases of ERCP and 2 cases of CT which were performed at the same period. The results were as follows: 1. They were 6 males and 4 females with over 50 years of age except a 41 year old female. 2. The ultrasonographic classifications of the cases were 4 of fungating mass types, 3 of mass filling gallbladder types, 2 wall thickening types and 1 of mixed type, wall thickening and fungating mass. 3. Seven cases of cholecystitis, 6 cases of intrahepatic biliary duct dilatation, 5 cases of gallstone, 4 cases of common bile duct dilatation, 4 cases of sludge bile, 2 cases of gallbladder dilatation, 1 case of right sub phrenic and pericholecystic abscess due to perforated gallbladder. 4. Five cases of mesenteric infiltrations, 3 cases of hepatic infiltration adjacent to gallbladder, 2 cases of lymphatic metastasis to right lobe of liver and 2 cases of pericholedochal and pericaval lymph node metastasis. 5. The indistinct margin between gallbladder and surrounding organ adjacent to gallbladder mass or gallbladder wall thickening suggest cancer infiltration to adjacent organ such as liver or omentum. 6. If gallstone is engulfed in thickened gallbladder wall, the wall thickening suggests gallbladder carcinoma. 7. The differentiation between fungating mass and sludge bile, and the determination of mass could be done by positional change. 8. The preoperative ultrasonic diagnositc accuracy was in 9 out of 10 cases (90%). 9. Because of the frequent cystic duct obstruction by associated inflammation, the diagnostic accuracy of ERCP for gallbladder carcinoma was low.

  16. Do adipose tissue-derived mesenchymal stem cells ameliorate Parkinson's disease in rat model?

    Science.gov (United States)

    Ahmed, Hh; Salem, Am; Atta, Hm; Ghazy, Ma; Aglan, Ha

    2014-12-01

    Parkinson's disease (PD) is a common neurodegenerative disorder in middle-aged and elderly people. This study aimed to elucidate the role of mesenchymal stem cells (MSCs) in management of PD in ovariectomized rat model. MSCs were excised from adipose tissue of both the omentum and the inguinal fat pad of male rats, grown, and propagated in culture; then characterized morphologically; and by the detection of surface markers gene expression. In this study, 40 ovariectomized animals were classified into 5 groups; group 1 was ovariectomized control, groups 2 to 5 were subcutaneously administered with rotenone for 14 days after 1 month of ovariectomy for induction of PD. Group 2 was left untreated; groups 3, 4, and 5 were treated with Sinemet(®), Cerebrolysin(®), and a single dose of adipose tissue-derived MSCs (ADMSCs), respectively. Y-chromosome gene (sry) was assessed by polymerase chain reaction (PCR) in brain tissue of the female rats. Serum transforming growth factor β (TGF-β), monocyte chemoattractant protein 1 (MCP-1), and brain-derived neurotrophic factor (BDNF) levels were assayed using enzyme-linked immunosorbent assay technique. Brain dopamine level was assayed fluorometrically, while brain tyrosine hydroxylase (TH) gene expression was detected by semiquantitative real-time PCR. The PD group showed significant increase in serum TGF-β and MCP-1 levels associated with significant decrease in serum BDNF, brain dopamine, and brain TH gene expression levels. In contrast, all treatments produce significant decrease in serum TGF-β and MCP-1 levels in concomitant with significant increase in serum BDNF, brain dopamine, and brain TH gene expression levels. In conclusion, the observed improvements in the studied biomarkers due to ADMSCs infusion might be attributed to their immunomodulatory, anti-inflammatory, and neurotrophic effects. © The Author(s) 2014.

  17. Paniculite mesentérica (PM e fibromatose mesentérica (FM: relato de casos Mesenteric panniculitis (MP and mesenteric fibromatosis (MF: report of cases

    Directory of Open Access Journals (Sweden)

    Antônio Balestrim Filho

    2009-09-01

    Full Text Available A paniculite mesentérica (PM e a fibromatose mesentérica (FM são doenças fibróticas de etiologia incerta. São mais frequentes no mesentério do intestino delgado, no grande omento e nos mesocólons. Clinicamente a FM pode apresentar-se de forma aguda na qual uma complicação da doença é sua primeira expressão. Na forma crônica é caracterizada por sintomas abdominais vagos e/ou massa abdominal palpável. A comprovação diagnóstica, assim como na PM, é feita através de laparotomia exploradora ou videolaparoscopia diagnóstica e biopsia. Os autores relatam dois casos sendo um de PM e outro de FM, apresentam um paralelo dos aspectos clínicos, tomográficos, diagnóstico, histopatológico e terapêutico destacando as semelhanças e as diferenças entre essas duas patologias.Mesenteric panniculitis (MP and mesenteric fibromatosis (MF are fibrotic diseases of uncertain aetiology. Both occur most frequently in the mesentery of the small intestine, the greater omentum and the mesocolons. In its acute form, the first clinical symptoms of MF are complications of the disease. Chronic MF is characterized by vague abdominal symptoms and/or a palpable abdominal mass. Like mesenteric panniculitis, mesenteric fibromatosis can be diagnostically verified by exploratory laparotomy, or diagnostic video-laparoscopy and biopsy. Here, we present two cases, one of MP and the other of MF, with resembling clinical and tomographic aspects, as well as similarities in diagnosis, histopathology and therapy. With our case report, we want to emphasise both similarities and differences between these two pathologies.

  18. Prognostic factors and sites of metastasis in unresectable locally advanced pancreatic cancer.

    Science.gov (United States)

    Peixoto, Renata D'Alpino; Speers, Caroline; McGahan, Colleen E; Renouf, Daniel J; Schaeffer, David F; Kennecke, Hagen F

    2015-08-01

    Due to differences in natural history and therapy, clinical trials of patients with advanced pancreatic cancer have recently been subdivided into unresectable locally advanced pancreatic cancer (LAPC) and metastatic disease. We aimed to evaluate prognostic factors in LAPC patients who were treated with first-line chemotherapy and describe patterns of disease progression. Patients with LAPC who initiated first-line palliative chemotherapy, 2001-2011 at the BC Cancer Agency were included. A retrospective chart review was conducted to identify clinicopathologic variables, treatment, and subsequent sites of metastasis. Kaplan-Meier and Cox-regression survival analyses were performed. A total of 244 patients were included in this study. For the majority of patients (94.3%), first-line therapy was single-agent gemcitabine. About 144 (59%) patients developed distant metastatic disease and the most frequent metastatic sites included peritoneum/omentum (42.3%), liver (41%), lungs (13.9%), and distant lymph nodes (9%). Median overall survival (OS) for the entire cohort was 11.7 months (95% CI, 10.6-12.8). Development of distant metastases was associated with significantly inferior survival (HR 3.56, 95% CI 2.57-4.93), as was ECOG 2/3 versus 0/1 (HR 1.69, 95% CI 1.28-2.23), CA 19.9 > 1000 versus ≤ 1000 (HR 1.59, 95% CI 1.19-2.14) and female gender, (HR 1.57, 95% CI 1.19-2.08). In this population-based study, 41% of LAPC patients treated with first-line chemotherapy died without evidence of distant metastases. Prognostic factors for LAPC were baseline performance status, elevated CA 19.9, gender, and development of distant metastasis. Results highlight the heterogeneity of LAPC and the importance of locoregional tumor control.

  19. Proximal gastric vagotomy: effects of two operative techniques on clinical and gastric secretory results.

    Science.gov (United States)

    Hallenbeck, G A; Gleysteen, J J; Aldrete, J S; Slaughter, R L

    1976-01-01

    PGV performed in 39 patients by separating the lesser omentum from the stomach beginning 6 or 7 cm proximal to the pylorus and skeletonizing the distal 1 to 2 cm of esophagus was followed by 15.4% of proven and 10.2 of suspected recurrent ulcers. Insulin tests were done during the first 3 months postoperatively on 31 of the patients, including the 6 with proven and the 4 with suspected recurrent ulcers. The peak acid output to insulin minus tha basal acid output (PAOI-BAO) was less than 5 mEq/hr in 16 cases (52%) and from 5 to 25 mEq/hr in the remaining 15 cases. In 6 patients with proven recurrent ulcer, PAOI-BAO averaged 21.9 mEq/hr (range, 11.3 to 41.8); in the 4 patients with suspected recurrence, 9.5 (range, 4.4 to 11.8).The operative technique was changed in one respect; the distal 5 to 7.5 cm of the esophagus was skeletonized. In 14 patients, the mean PAOI-BAO +/- S.E. within 3 months of PGV was 1985 +/- 0.7 mEq/hr, and 13 of 14 values were less than 5 mEq/hr. One patient developed recurrent ulcer and required re-operation; this patient's value for PAO-BAO was 1.8 mEq/hr. The results show quantitatively that great differences in the completeness of PGV result from differences in the periesophageal dissection and emphasize its importance if optimal results are to be obtained and, especially, if the efficacy of the operation is to be judged. PMID:1015889

  20. Length of warm ischemic tolerance for epithelial regeneration in heterotopic rat tracheal isografts%大鼠气管上皮耐受热缺血时限的研究

    Institute of Scientific and Technical Information of China (English)

    韩敬泉; 张凯; 崔键; 刘成; 赵桂彬; 辛衍忠; 郭庆凤

    2011-01-01

    Objective To determine the length of warm ischemic (WI) tolerance in bronchial graft from non-heart-beating donors. Methods Forty-eight rats were randomly divided into 4 groups (each group having 12 rats) according to different WI durations including WI-0 min (group A), WI-30 min (group B), WI-45 min (group C) and WI-60 min (group D). In each group, the tracheae from 6 rats were respectively imbedded in greater omentum of other 6 rats, and 14 days later, the transplanted tracheae were taken from recipients to evaluate epithelial thickness and regeneration. Results Epithelial thickness and the degree of epithelial regeneration had no significant difference (P >0. 05) between the syngeneic control group and the WI-30 minutes group. All of the grafts with WI duration of 45 min were viable, but the epithelium was significantly thinner than that in the syngeneic control group (P0.05);虽然45 min组与对照组相比,上皮厚度的差异有统计学意义(P<0.05),但45 min组的气管上皮有正常黏膜结构,并且与对照组相比,上皮细胞层数差异无统计学意义(P<0.05);而热缺血60min组,看不到正常的上皮结构,上皮也仅由1~2层黏膜上皮细胞覆盖.结论 气管耐受热缺血的时限可能为45 min.

  1. Gastric remnant twist in the immediate post-operative period following laparoscopic sleeve gastrectomy

    Institute of Scientific and Technical Information of China (English)

    Gokulakkrishna; Subhas; Anupam; Gupta; Mubashir; Sabir; Vijay; K; Mittal

    2015-01-01

    Twist of stomach remnant post sleeve gastrectomy is a rare entity and difficult to diagnose pre-operatively. We are reporting a case of gastric volvulus post laparoscopic sleeve gastrectomy, which was managed conservatively. A 38-year-old lady with a body mass index of 54 underwent laparoscopic sleeve gastrectomy. Sleeve gastrectomy was performed over a 32 French bougie using Endo-GIA tri-stapler. On post-operative day 1, patient had nausea and non-bilious vomiting. An upper gastrointestinal gastrografin study on postoperative days 1 and 2 revealed collection of contrast in the fundic area of stomach with poor flow distally, and she vomited gastrograffin immediately post procedure. With the suspicion of a stricture in the mid stomach as the cause, the patient was taken back for a exploratory laparoscopy and intra-operative endoscopy. We found a twist in the gastric tube which was too tight for the endoscope to pass through. This was managed conservatively with a long stent to keep the gastric tube straight and patent. The stent was discontinued in 7 d and the patient did well. In laparoscopic sleeve gastrectomy the stomach is converted into a tube and is devoid of its supports. If the staples fired are not aligned appropriately, it can predispose this stomach tube to undergo torsion along its long axis. Such a twist can be avoided by properly aligning the staples and by placing tacking sutures to the omentum and new stomach tube. This twist is a functional obstruction rather than a stricture; thus, it can be managed by endoscopy and stent placement.

  2. Laparoscopic resection of submucosal tumor on posterior wall of gastric fundus

    Institute of Scientific and Technical Information of China (English)

    Zhong-Wei Ke; Cheng-Zhu Zheng; Ming-Gen Hu; Dan-Lei Chen

    2004-01-01

    AIM: Laparoscopic resection of tumors on the posterior wall of gastric fundus, especially when they are next to the esophagocardiac junction (ECJ), is both difficult and timeconsuming. Furthermore, it can lead to inadvertent esophagus stenosis and injury to the spleen. In order to overcome these difficulties, laparoscopically extraluminal resection of gastric fundus was designed to manage submucosal tumors located on the posterior wall of gastric fundus and next to ECJ.METHODS: From January 2001 to September 2003,laparoscopically extraluminal resection of gastric fundus was successfully carried out on 15 patients. There were11 males and 4 females with an average age of 58 years(range, 38 to 78 years). The mean diameter of the tumors was 4.8 cm. The distance of the tumor border from ECJ was about 1.5-2.5 cm. The four-portal operation procedures were as follows: localization of the tumor, dissection of the omentum, mobilization of the gastric fundus and the upper polar of spleen, exposure of ECJ, and resection of the gastric fundus with Endo GIA.RESULTS: The laparoscopic operation time averaged(66.2±10.4) min, the average amount of bleeding was(89.4±21.7) mL. The mean post-operative hospital stay was (5.3±1.1) d. Within 36 h post-operation, 73.3% of all the patients recovered their gastrointestinal function and began to eat something and to walk. In all the operations,no apparent tumor focus was left and no complication or conversion to open surgery occurred.CONCLUSION: Our newly designed procedure,laparoscopically extraluminal resection of the gastric fundus, can avoid contamination of the abdominal cavity,injury to the spleen and esophageal stenosis. The procedure seems to be both safe and effective.

  3. Calcium phosphate cement delivering zoledronate decreases bone turnover rate and restores bone architecture in ovariectomized rats.

    Science.gov (United States)

    Wu, Chang-Chin; Wang, Chen-Chie; Lu, Dai-Hua; Hsu, Li-Ho; Yang, Kai-Chiang; Lin, Feng-Huei

    2012-06-01

    Patients sustaining bony fractures frequently require the application of bone graft substitutes to fill the bone defects. In the meantime, anti-osteoporosis drugs may be added in bone fillers to treat osteoporosis, especially in postmenopausal women and the elderly. The effects of zoledronate-impregnated calcium phosphate cement (ZLN/CPC) on ovariectomized (OVX) rats were evaluated. OVX rats were implanted with ZLN/CPC, containing 0.025 mg ZLN in the greater omentum. Afterward the clinical sign of toxicity was recorded for eight weeks. The rats were sacrificed and blood samples were collected for hematology and serum bone turnover markers analyses. The four limbs of the rats were harvested and micro-computer tomography (micro-CT) scanning and bone ash analyses were performed. No clinical toxicity was observed in the treated rats. Compared to the OVX rats, levels of bone resorption markers (fragments of C-telopeptides of type I collagen) and bone formation markers (alkaline phosphatase and osteocalcin) decreased significantly in the treated rats. Osteopontin, which mediates the anchoring of osteoclasts to the mineral matrix of bones, also decreased significantly. Micro-CT scanning and histologic examinations of the distal femoral metaphyses showed that the cancellous bone architectures were restored, with a concomitant decrease in bone porosity. The bone mineral content in the bone ashes also increased significantly. This study indicates that ZLN-impregnated CPC reduces bone turnover rate and restores bone architecture in OVX rats. CPC may be an appropriate carrier to deliver drugs to treat osteoporosis, and this approach may also reduce rates of post-dosing symptoms for intravenous ZLN delivery.

  4. Ovarian tumor attachment, invasion and vascularization reflect unique microenvironments in the peritoneum:Insights from xenograft and mathematical models

    Directory of Open Access Journals (Sweden)

    Mara P. Steinkamp

    2013-05-01

    Full Text Available Ovarian cancer relapse is often characterized by metastatic spread throughout the peritoneal cavity with tumors attached to multiple organs. In this study, interaction of ovarian tumor cells with the peritoneal tumor microenvironment was evaluated in a xenograft model based on intraperitoneal injection of fluorescent SKOV3.ip1 ovarian cancer cells. Intra-vital microscopy of mixed GFP-RFP cell populations injected into the peritoneum demonstrated that tumor cells aggregate and attach as mixed spheroids, emphasizing the importance of homotypic adhesion in tumor formation. Electron microscopy provided high resolution structural information about local attachment sites. Experimental measurements from the mouse model were used to build a three-dimensional cellular Potts ovarian tumor model (OvTM that examines ovarian tumor cell attachment, chemotaxis, growth and vascularization. OvTM simulations provide insight into the relative influence of tumor cell-cell adhesion, oxygen availability, and local architecture on tumor growth and morphology. Notably, tumors on the mesentery, omentum or spleen readily invade the open architecture, while tumors attached to the gut encounter barriers that restrict invasion and instead rapidly expand into the peritoneal space. Simulations suggest that rapid neovascularization of SKOV3.ip1 tumors is triggered by constitutive release of angiogenic factors in the absence of hypoxia. This research highlights the importance of cellular adhesion and tumor microenvironment in the seeding of secondary ovarian tumors on diverse organs within the peritoneal cavity. Results of the OvTM simulations indicate that invasion is strongly influenced by features underlying the mesothelial lining at different sites, but is also affected by local production of chemotactic factors. The integrated in vivo mouse model and computer simulations provide a unique platform for evaluating targeted therapies for ovarian cancer relapse.

  5. Definition of a dynamic laparoscopic model for the prediction of incomplete cytoreduction in advanced epithelial ovarian cancer: proof of a concept.

    Science.gov (United States)

    Petrillo, M; Vizzielli, G; Fanfani, F; Gallotta, V; Cosentino, F; Chiantera, V; Legge, F; Carbone, V; Scambia, G; Fagotti, A

    2015-10-01

    To develop an updated laparoscopy-based model to predict incomplete cytoreduction (RT>0) in advanced epithelial ovarian cancer (AEOC), after the introduction of upper abdominal surgery (UAS). The presence of omental cake, peritoneal extensive carcinomatosis, diaphragmatic confluent carcinomatosis, bowel infiltration, stomach and/or spleen and/or lesser omentum infiltration, and superficial liver metastases was evaluated by staging laparoscopy (S-LPS) in a consecutive series of 234 women with newly diagnosed AEOC, receiving laparotomic PDS after S-LPS. Parameters showing a specificity≥75%, PPV≥50%, and NPV≥50% received 1 point score, with an additional one point in the presence of an accuracy of ≥60% in predicting incomplete cytoreduction. The overall discriminating performance of the LPS-PI was finally estimated by ROC curve analysis. No-gross residual disease at PDS was achieved in 135 cases (57.5%). Among them, UAS was required in 72 cases (53.3%) for a total of 112 procedures, and around 25% of these patients received bowel resection, excluding recto-sigmoid resection. We observed a very high overall agreement between S-LPS and laparotomic findings, which ranged from 74.7% for omental cake to 94.8% for stomach infiltration. At a LPS-PIV≥10 the chance of achieving complete PDS was 0, and the risk of unnecessary laparotomy was 33.2%. Discriminating performance of LPS-PI was very high (AUC=0.885). S-LPS is confirmed as an accurate tool in the prediction of complete PDS in women with AEOC. The updated LPS-PI showed improved discriminating performance, with a lower rate of inappropriate laparotomic explorations at the established cut-off value of 10. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Intraperitoneal ectopic infestation of parasites invading through gastrointestinal tract : CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jeong Kon; Rha, Sung Eun; Ha, Hyun Kwon; Kim, Pyo Nyun; Lee, Moon Gyu; Auh, Yong Ho [Asan Medical Center, Ulsan Univ., Ulsan (Korea, Republic of); Choi, Byung Ihn [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of); Shim, Jae Chul [Inje Univ. College of Medicine, Kimhae (Korea, Republic of); Kim, Hyun [St. Mary' s Hospital, The Catholic Univ. of Korea, Seoul (Korea, Republic of); Lee, Jong Hwa; Ham, Soo Youn [Ulsan Univ. Hospital, Ulsan (Korea, Republic of)

    1999-03-01

    The purpose of this study was to evaluate the CT findings of parasitic ectopic infestation in the peritoneal cavity, a transitional route for parasites invading the gastrointestinal tract, to migrate to various target organs. CT scans of nine patients with pathologically(n=8) or serologically(n=1) proven intraperitoneal involvement of parasitic infestation were retrospectively reviewed. The primary causes of parasitic infestation in nine patients were Paragonimus westermani(n=5), Sparganosis(n=2), and hepatic fascioliasis(n=2). We analyzed the CT findings with regard to the sites and patterns of lesions in the peritoneal cavity and gastrointestinal track, as well as in other solid organs. The clinical features of these patients were also evaluated. The clinical symptoms and signs were chronic abdominal pain and general weakness in seven patients, while peripheral blood eosinophilia was observed in four. The CT features of these nine patients included multiseptated cystic masses of 2-6cm, diameter (mean 4.1{+-}1.7cm) in the omentum or mesentery in six(67%), omental or mesenteric infiltration in seven(78%), focal peritoneal thickening in seven(78%), 1ymphadenopathy in five(56%), and ascites in four(44%). In six of the nine patients, the gastrointestinal tract(stomach in four, colon in one, both stomach and colon in one) was concomitantly involved with focal wall thickening. Branching patterns of hypoattenuating lesions were noted in the liver of three patients; two of these had hepatic fascioliasis and one had paragonimiasis. Ectopic parasitic infestation in the peritoneal cavity manifests as mass formation, adjacent gastrointestinal wall thickening, and focal peritonitis. An understanding of these image features is important for both early diagnosis and adequate treatment.

  7. Ethnic differences in resistance artery contractility of normotensive pregnant women.

    Science.gov (United States)

    Brewster, L M; Taherzadeh, Z; Volger, S; Clark, J F; Rolf, T; Wolf, H; Vanbavel, E; van Montfrans, G A

    2010-08-01

    Black women are at a greater risk to develop hypertension during pregnancy, with a 4.5 times higher rate of fatal preeclampsia than white women. Therefore, it is important to identify factors that may affect this risk. Our group previously proposed that high activity of the central regulatory enzyme of energy metabolism, creatine kinase (CK), may increase ATP-buffering capacity and lead to enhanced vascular contractility and reduced nitric oxide bioavailability. Therefore, we assessed microvascular contractility characteristics in isolated resistance arteries from self-defined black and white normotensive pregnant women using a Mulvany-Halpern myograph. Additionally, morphology was assessed with electron microscopy. Resistance-sized arteries obtained from omentum donated during cesarean sections (11 black women and 20 white women, mean age: 34 yr) studied in series showed similar morphology but significantly greater maximum contractions to norepinephrine (10(-5) M) in blacks [14.0 mN (1.8 SE)] compared with whites [8.9 mN (1.4 SE), P = 0.02]. Furthermore, we found greater residual contractility after the specific CK inhibitor dinitrofluorobenzene (10(-6) M) in black women [55% (6 SE)] compared with white women [28% (4 SE), P = 0.001] and attenuated vasodilation after bradykinin (10(-7) M) in black women [103% (6 SE)] compared with white women [84% (5 SE), P = 0.023], whereas responses to sodium nitroprusside (10(-4) M) and amlodipine (10(-6) M) were similar. We conclude that compared with white women, normotensive pregnant black women display greater resistance artery contractility and evidence of higher vascular CK activity with attenuated nitric oxide synthesis. These findings in normotensives may imply that the black population is at risk for a further incline in pregnancy-related hypertensive disorders.

  8. Late-presenting congenital diaphragmatic hernia in children: a literature review

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    Baglaj, Maciej [Wroclaw Medical University, Department of Pediatric Surgery, Wroclaw (Poland); Dorobisz, Urszula [Wroclaw Medical University, Department of Radiology, Wroclaw (Poland)

    2005-05-01

    This is a review of 122 articles published until December 2003 that describe 349 children with late-presenting postero-lateral congenital diaphragmatic hernia (CDH). Data regarding pre-operative diagnostic work-up were adequately reported in 177 patients with left CDH and in 41 with a right-sided defect. Chest radiography was the only diagnostic study in 92 (51.9%) children from the former group and in 17 (43.9%) from the latter group. In other patients, diagnostic work-up encompassed various combinations of two or more imaging modalities. Apart from chest radiography, contrast study of the upper gastrointestinal tract was the most frequently performed imaging modality. In 88 (25.2%) children, initial radiographic features of CDH were misinterpreted. Pneumothorax and pleural effusion were the most common initial findings. Analysis of the hernial content in this group of patients has shown that herniation of the stomach, spleen or omentum should be regarded as risk factors for misdiagnosis of left CDH, whereas for right CDH, the risk factor is the presence of liver in the chest. Late-presenting CDH may pose a significant diagnostic problem because of the great variability of radiographic appearance. Chest radiography following passage of a nasogastric tube and contrast studies of the gastrointestinal tract seem to be the most useful investigations for the diagnosis of left CDH. For patients with right CDH, owing to the high probability of liver herniation, a chest radiograph with liver scintigraphy or CT seems to be the best diagnostic option. (orig.)

  9. Pediatric case of acute right-sided abdominal pain: diagnosis is not always appendicitis

    Directory of Open Access Journals (Sweden)

    Elgharbawy F

    2017-06-01

    Full Text Available Fawzia Elgharbawy,1 Khalil Salameh,1 Talal Al Rayes,2 Ibtihal S Abdelgadir3 1Pediatrics Division, Al Wakra Hospital, 2Hamad Medical Corporation, 3Sidra Medical and Research Centre, Doha, Qatar Abstract: Omental infarction (OI is a rare cause of acute abdominal pain occurring in 0.1% of children, which is typically diagnosed during surgery for suspected appendicitis. We present the case of a 7-year-old Pakistani girl. She presented with acute, severe, progressive, right-sided abdominal pain, which was present for 12 hours before presentation. No constitutional symptoms such as fever, anorexia, nausea or vomiting were present. Clinical examination revealed an adequately growing child following the 50th centile. She had severe generalized abdominal tenderness with rebound tenderness and guarding, mainly on the right lower abdominal quadrant, with all other system examinations normal. She had mildly increased inflammatory markers, and her initial abdominal ultrasound scan result was within normal limits. She had laparoscopic surgery following a diagnosis of suspected acute appendicitis; however, an intraoperative diagnosis of OI was made. This was later confirmed by histopathology. This case report highlights the importance of including OI in the differential diagnosis list of acute abdominal pain in children, in addition to the importance of computed tomography (CT as the gold standard tool to aid diagnosis. In the presence of typical symptoms and signs of OI, a CT scan can assist and guide the management of similar cases. This course of action is suggested for the reason that OI typically runs a self-limited course and conservative care may be the most appropriate recommended course of action. Consequently, unnecessary operations could be avoided due to the diagnosis confirmation of studying images. Keywords: omentum, infarction, abdominal pain, child

  10. Inhibition of H3K9 methyltransferase G9a ameliorates methylglyoxal-induced peritoneal fibrosis

    Science.gov (United States)

    Maeda, Kazuya; Doi, Shigehiro; Nakashima, Ayumu; Nagai, Takuo; Irifuku, Taisuke; Ueno, Toshinori; Masaki, Takao

    2017-01-01

    Activity of H3K9 histone methyltransferase G9a is reportedly induced by transforming growth factor-β1 (TGF-β1) and plays an important role in the progression of cancer and fibrosis. In this study, we investigated whether inhibition of G9a-mediated H3K9 methylation attenuates peritoneal fibrosis in mice and human peritoneal mesothelial cells (HPMCs). Nonadherent cells of peritoneal dialysis (PD) patients were isolated from PD effluent to examine expression of G9a. Peritoneal fibrosis was induced by peritoneal injection of methylglyoxal (MGO) in male C57/B6 mice for 3 weeks. BIX01294, a G9a inhibitor, was administered by subcutaneous injection. Effects of BIX01294 on MGO-induced pathological and functional changes in mice were evaluated by immunohistochemistry and a peritoneal equilibration test. HPMCs were isolated from human omentum, and the inhibitory effect of BIX01294 on TGF-β1-induced fibrotic changes was investigated in the HPMCs by western blotting. G9a was upregulated in nonadherent cells of human PD effluent, the peritoneum of MGO-injected mice, and TGF-β1-stimulated HPMCs. BIX01294 significantly reduced the submesothelial zone thickness and cell density in MGO-injected mice. Immunohistochemical staining revealed that BIX01294 treatment decreased not only mono-methylation of H3K9 (H3K9me1), but also the number of mesenchymal cells, accumulation of collagen, and infiltration of monocytes. In addition to the pathological changes, BIX01294 reduced the level of TGF-β1 in peritoneal fluid and improved peritoneal functions. Furthermore, BIX01294 inhibited TGF-β1-induced fibrotic changes along with suppression of H3K9me1 in HPMCs. Therefore, inhibition of H3K9 methyltransferase G9a suppresses peritoneal fibrosis through a reduction of H3K9me1. PMID:28278257

  11. Molecular characterization of Cysticercus tenuicollis of slaughtered livestock in Upper Egypt governorates

    Institute of Scientific and Technical Information of China (English)

    Mosaab Adl Eldin Omar; Layla Omran Elmajdoub; Mohammad Saleh Al-Aboody; Ahmed Mahmoud Elsify; Ahmed Osman Elkhtam; Abdelnasser A.Hussien

    2016-01-01

    Objective: To present the molecular characterization of Cysticercus tenuicollis(C. tenuicollis) of Taenia hydatigena(T. hydatigena) from livestock isolates in Egypt, and to introduce a detailed image of C. tenuicollis infection in ruminant animals in Upper Egypt.Methods: The prevalence rates of C. tenuicollis infections among the slaughtered animals from different organs were determined using the amplification of sequencing of the MT-CO1 gene.Results: In the present study the infection rates of C. tenuicollis were found to be 16%and 19% in sheep and goat samples respectively. Firstly we report one larval stage of T. hydatigena detected in the camel liver in Egypt. C. tenuicollis infection manifested a higher prevalence in females than in males. Those above two years of age manifested a higher infection rate than younger animals. The preferred site for the infection was the omentum: a 70% preference in sheep and a 68% preference in goats. The molecular characterization using the MT-CO1 gene of isolates from sheep, goats and camels corresponded to T. hydatigena. For this study, molecular characterizations of T. hydatigena were done for the first time in Egypt. Molecular tools are of great assistance in characterizing the C. tenuicollis parasite especially when the morphological character cannot be detected, because the metacestodes are frequently confused with infection by the hydatid cyst, especially when these occur in the visceral organs. In the present study,C. tenuicollis manifested high identity in the goat and sheep samples, while differences were found more frequently in the camel samples(10 base pair).Conclusions: Clearly molecular diagnosis for C. tenuicollis infection significantly helps to differentiate it from such other metacestodes as hydatidosis, which manifests a completely different pathogenicity and requires different control programs.

  12. Subsequent abdominal surgery after laparoscopic ventral and incisional hernia repair with an expanded polytetrafluoroethylene mesh: a single institution experience with 72 reoperations.

    Science.gov (United States)

    Wassenaar, E B; Schoenmaeckers, E J P; Raymakers, J T F J; Rakic, S

    2010-04-01

    Laparoscopic ventral and incisional hernia repair (LVIHR) carries a risk of adhesion formation and can influence subsequent abdominal operations (SAOs). We performed a retrospective study of findings during reoperations of patients who had previously had an LVIHR by using an expanded polytetrafluoroethylene mesh (DualMesh; WL Gore, Flagstaff, AZ, USA). The medical records of all 695 patients who had LVIHR at our hospital were reviewed. Patients who underwent SAO for various indications were identified (n = 72) and analyzed. Seven LVIHR patients (1%) had early SAO (within a few days). In six patients (86%), removal of the mesh was required. Intra-operatively, in all six of these patients with peritonitis, there were no adhesions against the implant identified. Late SAOs (after more than 1 month) were performed in 65 patients (9.4%). Only one patient required acute surgical intervention due to an LVIHR-related adhesion (0.15%). Laparoscopy was performed in 83% and laparotomy in 17% of patients. Adhesions against the implant were present in 83% of patients; in 65%, the adhesions involved omentum only, and in 18%, they involved the bowel. Adhesiolysis was always easy and caused no inadvertent enterotomies. SAOs were devoid of postoperative complications. In this largest series of reoperations after LVIHR, the majority of patients had mild or moderate adhesions against the implant. The specific observations that: (1) no relaparoscopies had to be converted, (2) no inadvertent enterotomies were made during adhesiolysis, and (3) SAOs have practically been devoid of peri- and postoperative complications indicate that SAOs can be safely performed after previous LVIHR with DualMesh.

  13. Colgajo de omento para tratamiento de dehiscencia de herida esternal Omental flap for management of sternal wound dehiscence

    Directory of Open Access Journals (Sweden)

    A. Pérez García

    2013-03-01

    Full Text Available La mediastinitis es una de las complicaciones más graves de la cirugía cardíaca. Aparece en el 0,5-5 % de las esternotomías y esta incidencia es mucho mayor en pacientes diabéticos, obesos, inmunodeprimidos, con enfermedad pulmonar obstructiva crónica (EPOC, etc. Presentamos el caso de una paciente diabética, obesa mórbida, que sufre mediastinitis tras doble by-pass coronario. Para la cobertura del defecto se empleó un colgajo de epiplon tunelizado transdiafragmático. El colgajo omental permite cubrir grandes defectos además de que posee capacidad antimicrobiana y favorece la revascularización tisular. Las características de este colgajo hacen que actualmente deba considerarse como primera elección en pacientes con grandes defectos esternales y trastornos de la inmunidad y la cicatrización.Mediastinitis is one of the most serious complications from cardiac surgery. It is reported to occur in 0'5-5 % of sternotomy incisions, and this incidence is much higher in diabetic patients, obese, immunocompromised, COPD, etc. We report a case of a diabetic and morbid obese woman suffering mediastinitis after double coronary bypass surgery. For the reconstruction a transdiaphragmatic tunnelled omental flap was used. The omentum is useful to cover large defects. It has antiinfective properties and promotes revascularization of neighbouring tissues. Omental flap can be a highly effective treatment for patients with large sternal wounds and immune disorders and wound healing disorders.

  14. Autotransplantation of spleen tissue in children with mansonic schistosomiasis who underwent splenectomy: Evaluation of splenic residual functions

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    Brandt Carlos Teixeira

    1998-01-01

    Full Text Available Autotransplantation of spleen tissue is an attempt for maintenance of splenic functions when splenectomy is indicated in children. It minimizes the risks of overwhelming postsplenectomy infection and it has been done in children with severe portal hypertension due to hepatosplenic mansonic schistosomiasis that underwent splenectomy. The purposes of this investigation were to study the morphology of the residual splenic tissue; to evaluate the residual filtration function of this splenosis; and to assess the immune response to polyvalent pneumococcal vaccine of these patients. Twenty-three children with portal hypertension from mansonic schistosomiasis who underwent splenectomy, ligature of the left gastric vein, autotransplantation of spleen tissue into an omental pouch were evaluated for residual splenic parenchyma and functions. Tc-99m sulfur colloid liver-spleen scans were used for detection of splenic nodules. The search for Howell Jolly bodies were used for assessing the filtration function and Enzyme-linked immunosorbent assay was used for measuring the relative rise in titter of specific pneumococcal antibodies. Splenosis was evident in all children; however, in two there were less than five splenic nodules in the greater omentum, which was considered insufficient. Howell-Jolly bodies were found in the peripheral blood only in these two patients with less evident splenosis. The immune response was adequate in 15 patients; it was intermediate in 4 patients and inadequate in 4 patients. Autotransplantation of spleen tissue into an omental pouch is efficient in maintaining the filtration splenic function in more than 90% of the cases and the immune response to pneumococcal vaccination in approximately 65% of the children.

  15. Retinoic acid improves morphology of cultured peritoneal mesothelial cells from patients undergoing dialysis.

    Directory of Open Access Journals (Sweden)

    Carmen Retana

    Full Text Available Patients undergoing continuous ambulatory peritoneal dialysis are classified according to their peritoneal permeability as low transporter (low solute permeability or High transporter (high solute permeability. Factors that determine the differences in permeability between them have not been fully disclosed. We investigated morphological features of cultured human peritoneal mesothelial cells from low or high transporter patients and its response to All trans retinoic Acid (ATRA, vitamin A active metabolite, as compared to non-uremic human peritoneal mesothelial cells. Control cells were isolated from human omentum. High or low transporter cells were obtained from dialysis effluents. Cells were cultured in media containing ATRA (0, 50, 100 or 200 nM. We studied length and distribution of microvilli and cilia (scanning electron microscopy, epithelial (cytokeratin, claudin-1, ZO-1 and occludin and mesenchymal (vimentin and α-smooth muscle actin transition markers by immunofluorescence and Western blot, and transforming growth factor β1 expression by Western blot. Low and high transporter exhibited hypertrophic cells, reduction in claudin-1, occludin and ZO-1 expression, cytokeratin and vimentin disorganization and positive α-smooth muscle actin label. Vimentin, α-smooth muscle actin and transforming growth factor-β1 were overexpressed in low transporter. Ciliated cells were diminished in low and high transporters. Microvilli number and length were severely reduced in high transporter. ATRA reduced hypertrophic cells number in low transporter. It also improved cytokeratin and vimentin organization, decreased vimentin and α-smooth muscle actin expression, and increased claudin 1, occludin and ZO-1 expression, in low and high transporter. In low transporter, ATRA reduced transforming growth factor-β1 expression. ATRA augmented percentage of ciliated cells in low and high transporter. It also augmented cilia length in high transporter

  16. Alterations of intercellular junctions in peritoneal mesothelial cells from patients undergoing dialysis: effect of retinoic Acid.

    Science.gov (United States)

    Retana, Carmen; Sanchez, Elsa; Perez-Lopez, Alejandro; Cruz, Armando; Lagunas, Jesus; Cruz, Carmen; Vital, Socorro; Reyes, Jose L

    2015-01-01

    Dialysis patients are classified according to their peritoneal permeability as low transporter (LT, low solute permeability) or high transporter (HT, high solute permeability). Tight junction (TJ) proteins are critical to maintain ions, molecules and water paracellular transport through peritoneum. Exposure to peritoneal dialysis solutions causes damage to TJ in human peritoneal mesothelial cells (HPMCs). We analyzed the quantity, distribution and function of TJ proteins: claudin-1, -2 and -8, ZO-1 and occludin, in HPMC cultures from LT and HT patients. Since all-trans retinoic acid (ATRA) might modify the expression of TJ proteins, we studied its effect on HPMCs. Control HPMCs were isolated from human omentum, while HT or LT cells were obtained from dialysis effluents. Cells were cultured in presence of ATRA 0, 50 or 100 nM. Transepithelial electrical resistance (TER) measurement, immunostaining and Western blot analyses were performed. HT exhibited lower TER than control and LT monolayers. Immunofluorescence for TJ was weak and discontinuous along the cell contour, in LT and HT. Furthermore, claudin-1, occludin and ZO-1 expressions were decreased. In all groups, claudin-2 was localized at nuclei. We observed that ATRA improved TJ distribution and increased TJ expression in HT. This retinoid did not modify claudin-2 and -8 expressions. All-trans retinoic acid decreased TER in HT, but had no effect in LT. Tight junctions were altered in HPMCs from dialyzed patients. The HT monolayer has lower TER than LT, which might be associated with the peritoneal permeability in these patients. ATRA might be a therapeutic alternative to maintain mesothelial integrity, since it improved TJ localization and expression. Copyright © 2015 International Society for Peritoneal Dialysis.

  17. Combined laparoscopic and open extraperitoneal approach to scrotal hernias.

    Science.gov (United States)

    Ferzli, G S; Rim, S; Edwards, E D

    2013-04-01

    Laparoscopic repair of scrotal hernias is often a difficult endeavor to successfully complete. The longstanding nature of these hernias often results in significant adhesions and anatomic distortion of the inguinal floor. These two issues make reduction of the hernia arduous and subsequent reinforcement of the parietal sac difficult. We have previously described techniques to increase the chances of success when attempting laparoscopic repair of scrotal hernias. Here, we describe some of those techniques as well as a combined laparoscopic and open approach to achieve a robust preperitoneal repair of incarcerated scrotal hernias when the usual totally extraperitoneal approach does not work. We performed a retrospective review of 1890 TEP hernia repairs we performed from 1990 to 2010. Rate of conversion to an open approach or a combined laparoscopic and open approach was examined. Incidence of complications or recurrences was assessed over a 12-month follow-up period. Among the 1890 TEP repairs, 94 large scrotal hernias were identified. Of these, nine cases (9.5 %) required conversion to an open procedure due to an incarcerated and indurated omentum. Three were completed with a conventional open preperitoneal whereas six patients (6.4 %) underwent repair with the combined approach. In this group, no recurrences or complications were found over a 12-month period. In cases where a large scrotal hernia may be difficult or dangerous to reduce laparoscopically, immediate conversion to an open repair may not be necessary. A combined laparoscopic and open approach can greatly assist in the visualization and dissection of the preperitoneal space, thereby facilitating reduction of the hernia and placement of the mesh.

  18. Internal Hernias in the Era of Multidetector CT: Correlation of Imaging and Surgical Findings.

    Science.gov (United States)

    Doishita, Satoshi; Takeshita, Tohru; Uchima, Yasutake; Kawasaki, Masayasu; Shimono, Taro; Yamashita, Akiyoshi; Sugimoto, Michiko; Ninoi, Teruhisa; Shima, Hideki; Miki, Yukio

    2016-01-01

    Clinical diagnosis of internal hernias is challenging because of their nonspecific signs and symptoms. Many types of internal hernias have been defined: paraduodenal, small bowel mesentery-related, greater omentum-related, lesser sac, transverse mesocolon-related, pericecal, sigmoid mesocolon-related, falciform ligament, pelvic internal, and Roux-en-Y anastomosis-related. An internal hernia is a surgical emergency that can develop into intestinal strangulation and ischemia. Accurate preoperative diagnosis is crucial for appropriate management. Multidetector computed tomography (CT), with its thin-section axial images, high-quality multiplanar reformations, and three-dimensional images, currently plays an essential role in preoperative diagnosis of internal hernias. The diagnostic approach to internal hernias at multidetector CT includes detecting an intestinal closed loop, identifying the hernia orifice, and analyzing abnormal displacement of surrounding structures and key vessels around the hernia orifice and hernia sac. At each step, multidetector CT can depict pathognomonic findings. A saclike appearance suggests an intestinal closed loop in several types of internal hernias. Convergence, engorgement, and twisting of mesenteric vessels in the hernia orifice can be seen clearly at multidetector CT, especially with use of multiplanar reformations. For definitive diagnosis of an internal hernia, analysis of displacement of anatomic landmarks around the hernia orifice is particularly important, and thin-section images provide the required information. Detailed knowledge of the anatomy, etiology, and imaging landmarks of the various hernia types is also necessary. Familiarity with the appearances of internal hernias at multidetector CT allows accurate and specific preoperative diagnosis. (©)RSNA, 2015.

  19. Hepatocellular Carcinoma with Blood Supply from Parasitized Omental Artery: Angiographic Appearance And Chemoembolization

    Institute of Scientific and Technical Information of China (English)

    Song Gao; Ren-jie Yang; Jia-hong Dong

    2012-01-01

    Objective:To analyze angiographic appearance of hepatocellular carcinoma (HCC) with blood supply from parasitized omental artery (POA),and evaluate the technical feasibility,safety and therapeutic efficacy of chemoembolization via the POAs.Methods:A total of 1,221 HCC patients who had undergone chemoembolization procedures were evaluated retrospectively.The evaluated indexes included the incidence rate of POAs,success rate of superselective catheterization,post-reaction after chemoembolization,and the cumulative survival rates.Results:Totally 1,221 HCC patients had undergone 3,639 chemoembolization procedures,and 32 patients with POAs were enrolled,with 97 POAs found in 76 angiography procedures,giving an incidence rate of 2.09%.POA was observed mostly at the right lobe and left medial lobe except the segment Ⅱ,and 62 POAs underwent superselective catheterization with microcatheter,giving a success rate of 63.9%.The angiographic appearance was:(1) hypertrophic POAs participating in tumor staining (n=28); (2) stiff and distorted POA (n=11),displaced due to tumor's oppression (n=8); and (3) defective tumor staining close to either gastrocolic omentum distribution or liver capsule (n=7).In 19 patients,chemoembolization via POAs was performed successfully (A group),while the remaining 13 patients failed (B group).Except 1 acute edema pancreatitis case,no serious complication was recorded.The cumulative survival rates of 6-,12-,18-and 24-month were 78.9%,47.4%,31.6% and 21.1% respectively for A group; correspondingly,61.5%,30.g%,15.4% and 7.7%% for B group,in which 2 patients died of ruptured HCC.Conclusion:Chemoembolization with microcatheter via POAs is a relatively safe,feasible and valuable method.

  20. Primary peritoneal serous papillary carcinoma (PSPC involving ovary and colon: Management and Treatment

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    Leanza V

    2013-05-01

    Full Text Available We present a case report of a 47-year-old woman who was admitted to our University-Hospital following diagnosis of pelvic mass. Abdominal examination revealed a tender, palpable mass on the right iliac region. At the gynecological examination uterus was regular in size. On the left side of the uterus a mass of 9 cm was observed; its surface was irregular and no mobility was found. Abdominal CT and NMR revealed massive ascites, omental cake and increased volume of both ovaries. Patient underwent longitudinal suprombelical-pubic laparotomy. After opening abdominal cavity, a free-fluid sample was taken and the results were positive for malignant cells. Typical neoplastic localizations on both ovaries, Douglas’ peritoneum, rectum, sigmoid colon and omentum were observed. Extemporaneous histological examination diagnosed a peritoneal serous papillary carcinoma. Hysterectomy with salpingo oophorectomy, total omentectomy, appendectomy, pelvic and lumbo-aortic lymphadenectomy was performed. Retroperitoneal approach to remove the whole Douglas’ peritoneum together with the pouch malignant localizations was done. Sigmoid colon and rectum were resected. A latero-terminal anastomosis with stapler was performed. All the visible abdominal maligant lesions were cut out. No transfusion was necessary. The postoperative course was regular and after seven days the patient was discharged. Chemotherapy ended the therapeutic management (six cycles of carboplatin and paclitaxel. After one year the patient is in good health and instrumental investigations (Ultrasounds, TC and NMR are negative for recurrence. Such a case is very interesting for the discrepancy between slight symptoms and severity of the disease, the solution of which was very complex requiring a skillful polyspecialized oncological team.

  1. Perforated Gastric Ulcer Associated with Anti-Angiogenic Therapy

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    Diogo Libânio

    2017-08-01

    Full Text Available Anti-angiogenic therapy with bevacizumab, an inhibitor of vascular endothelial growth factor, is commonly used in metastatic colorectal cancer and is rarely associated with gastrointestinal perforation, perforation being more frequent in the primary tumor site or at the anastomotic level. We present the case of a 64-year-old male with stage IV rectal adenocarcinoma who was on palliative chemotherapy with FOLFOX and bevacizumab. After the 4th chemotherapy cycle, our patient started fever and epigastric pain. He was hemodynamically stable, and signs of peritoneal irritation were absent. There were no alterations in the abdominal X-ray, and C-reactive protein was markedly elevated. A CT scan revealed a de novo thickness in the gastric antrum. Upper digestive endoscopy showed an ulcerated 40-mm lesion in the angulus, with a 20-mm orifice communicating with an exsudative cavity revested by the omentum. A conservative approach was decided including fasting, broad-spectrum intravenous antibiotics, and proton-pump inhibitors. Subsequent gastroduodenal series showed no contrast extravasation, allowing the resumption of oral nutrition. Esophagogastroduodenoscopy after 8 weeks showed perforation closure. Biopsies did not show neoplastic cells or Heliobacter pylori infection. Although the success in the conservative management of perforation allowing the maintenance of palliative chemotherapy (without bevacizumab, the patient died after 4 months due to liver failure. The reported case shows an uncommon endoscopic finding due to a rare complication of anti-angiogenic therapy. Additionally, it reminds clinicians that a history of gastroduodenal ulcers should be actively sought before starting anti-angiogenic treatment and that suspicion for perforation should be high in these cases.

  2. Pathobiological implications of MUC16 expression in pancreatic cancer.

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    Dhanya Haridas

    Full Text Available MUC16 (CA125 belongs to a family of high-molecular weight O-glycosylated proteins known as mucins. While MUC16 is well known as a biomarker in ovarian cancer, its expression pattern in pancreatic cancer (PC, the fourth leading cause of cancer related deaths in the United States, remains unknown. The aim of our study was to analyze the expression of MUC16 during the initiation, progression and metastasis of PC for possible implication in PC diagnosis, prognosis and therapy. In this study, a microarray containing tissues from healthy and PC patients was used to investigate the differential protein expression of MUC16 in PC. MUC16 mRNA levels were also measured by RT-PCR in the normal human pancreatic, pancreatitis, and PC tissues. To investigate its expression pattern during PC metastasis, tissue samples from the primary pancreatic tumor and metastases (from the same patient in the lymph nodes, liver, lung and omentum from Stage IV PC patients were analyzed. To determine its association in the initiation of PC, tissues from PC patients containing pre-neoplastic lesions of varying grades were stained for MUC16. Finally, MUC16 expression was analyzed in 18 human PC cell lines. MUC16 is not expressed in the normal pancreatic ducts and is strongly upregulated in PC and detected in pancreatitis tissue. It is first detected in the high-grade pre-neoplastic lesions preceding invasive adenocarcinoma, suggesting that its upregulation is a late event during the initiation of this disease. MUC16 expression appears to be stronger in metastatic lesions when compared to the primary tumor, suggesting a role in PC metastasis. We have also identified PC cell lines that express MUC16, which can be used in future studies to elucidate its functional role in PC. Altogether, our results reveal that MUC16 expression is significantly increased in PC and could play a potential role in the progression of this disease.

  3. Analysis of laparoscopic port site complications: A descriptive study

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    Somu Karthik

    2013-01-01

    Full Text Available Context: The rate of port site complications following conventional laparoscopic surgery is about 21 per 100,000 cases. It has shown a proportional rise with increase in the size of the port site incision and trocar. Although rare, complications that occur at the port site include infection, bleeding, and port site hernia. Aims: To determine the morbidity associated with ports at the site of their insertion in laparoscopic surgery and to identify risk factors for complications. Settings and Design: Prospective descriptive study. Materials and Methods: In the present descriptive study, a total of 570 patients who underwent laparoscopic surgeries for various ailments between August 2009 and July 2011 at our institute were observed for port site complications prospectively and the complications were reviewed. Statistical Analysis Used: Descriptive statistical analysis was carried out in the present study. The statistical software, namely, SPSS 15.0 was used for the analysis of the data. Results: Of the 570 patients undergoing laparoscopic surgery, 17 (3% had developed complications specifically related to the port site during a minimum follow-up of three months; port site infection (PSI was the most frequent (n = 10, 1.8%, followed by port site bleeding (n = 4, 0.7%, omentum-related complications (n = 2; 0.35%, and port site metastasis (n = 1, 0.175%. Conclusions: Laparoscopic surgeries are associated with minimal port site complications. Complications are related to the increased number of ports. Umbilical port involvement is the commonest. Most complications are manageable with minimal morbidity, and can be further minimized with meticulous surgical technique during entry and exit.

  4. Malignant PEComa: a case report with emphasis on clinical and morphological criteria

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    Legnini Margherita

    2011-01-01

    Full Text Available Abstract Background Malignant perivascular epitheliod cell tumor (PEComa is a very rare entity composed of distinctive perivascular epitheliod cells with variable immunoreactivity for melanocytic and muscle markers. At present this neoplasm does not have a known normal cellular counterpart and the natural history is often unpredictable. Up to now, few cases of PEComa have been described and treatment modalities are still controversial, particularly in advanced conditions. Case presentation We handled the case of a 42-year-old man with unresectable PEComa of the abdomen. A 7 cm hepatic hypodense lesion between segment V and VIII of the liver and diffuse intraperitoneal nodules of 0,3-3,5 cm along the right subcapsular hepatic region, were documented by a CT scan. Radiological images showed abnormal lymph nodes of the right internal mammary chain and anterior mediastinum. The patient underwent an explorative laparotomy for uncontrolled intrabdominal hemorrhage without a well-defined preoperative tumor diagnosis. At surgery, multiple lobulated nodules containing hemorrhagic fluid on the liver surface, peritoneum and omentum were confirmed. The procedure had a palliative intent and consisted of hemostasis, hematomas evacuation and omentectomy. The diagnosis of PEComa was made after surgery on the basis of morphological and immunohystochemical criteria. Radiological and intra operative findings suggest that the mass has an hepatic origin with diffuse involvement of hepatic capsule and suspensory ligaments. The patient received medical support care with blood and plasma transfusions. In our experience, PEComa was clinically malignant, leading to a fatal outcome 25 days after hospital admission of patient. Conclusions Here we report and discuss the peculiar clinical, radiological and morphological presentation of unresectable PEComa. Although in the majority of the reported series, PEComas show a more better prognosis, our case presents with a

  5. Visualising androgen receptor activity in male and female mice.

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    D Alwyn Dart

    Full Text Available Androgens, required for normal development and fertility of males and females, have vital roles in the reproductive tract, brain, cardiovascular system, smooth muscle and bone. Androgens function via the androgen receptor (AR, a ligand-dependent transcription factor. To assay and localise AR activity in vivo we generated the transgenic "ARE-Luc" mouse, expressing a luciferase reporter gene under the control of activated endogenous AR. In vivo imaging of androgen-mediated luciferase activity revealed several strongly expressing tissues in the male mouse as expected and also in certain female tissues. In males the testes, prostate, seminal vesicles and bone marrow all showed high AR activity. In females, strong activity was seen in the ovaries, uterus, omentum tissue and mammary glands. In both sexes AR expression and activity was also found in salivary glands, the eye (and associated glands, adipose tissue, spleen and, notably, regions of the brain. Luciferase protein expression was found in the same cell layers as androgen receptor expression. Additionally, mouse AR expression and activity correlated well with AR expression in human tissues. The anti-androgen bicalutamide reduced luciferase signal in all tissues. Our model demonstrates that androgens can act in these tissues directly via AR, rather than exclusively via androgen aromatisation to estrogens and activation of the estrogen receptor. Additionally, it visually demonstrates the fundamental importance of AR signalling outside the normal role in the reproductive organs. This model represents an important tool for physiological and developmental analysis of androgen signalling, and for characterization of known and novel androgenic or antiandrogenic compounds.

  6. Trauma no reciente en abdomen cerrado Non-recent abdominal closed trauma

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    Jesús Enrique Montejo Saínz

    2011-09-01

    Full Text Available Entre las urgencias atendidas por traumatismos diversos, en el Centro Diagnóstico Integral "Dr. Salvador Allende", en Caracas, Venezuela, se destacó el caso que se expone, luego de estar 60 días procurando atención médica en diferentes instituciones hospitalarias, sin recibir credibilidad la joven enferma. Se expone la historia de la paciente, y sus eventualidades con los hallazgos laparotómicos. Se corrobora la necesidad laparotómica con la presunción inicial por juicio clínico y se logra el consentimiento informado familiar. Como refuerzo de la praxis se efectuó el procedimiento omentun mayus, que combate la sepsis futura y garantiza la integridad subfrénica. Este caso -"trauma visceral" circunscrito al lóbulo derecho del hígado- favorece, por su carácter y modo, la enseñanza a educandos y especialistas, en caso de afrontar traumas no recientes.Among all the emergencies seen due to different traumata in the "Dr. Salvador Allende" Integral Diagnosis Center in Caracas Venezuela is emphasized the present case, after 60 days seeking medical in different hospital institutions without to receive medical care. Her history is exposed and its eventualities with the laparotomy findings. Laparotomy need is corroborated according an early clinical criterion and the achievement of the family informed consent. As a praxis effort, the omentum mayus procedure was carried out preventing the future sepsis and to guarantee the subfrenic integrity. Present case -"visceral trauma" restricted to liver right lobule, due to its character and mode, favors the teaching to students and specialists when they to face non-recent traumata.

  7. [THE EXCESS OF PALMITIC FATTY ACID IN FOOD AS MAIN CAUSE OF LIPOIDOSIS OF INSULIN-DEPENDENT CELLS: SKELETAL MYOCYTES, CARDIO-MYOCYTES, PERIPORTAL HEPATOCYTES, KUPFFER MACROPHAGES AND B-CELLS OF PANCREAS].

    Science.gov (United States)

    Titov, V N

    2016-02-01

    transferring to insulin-dependent cells. The insulin can't both to decrease content of exogenous palmitic fatty acid and inhibit lipolysis in visceral fatty cells of omentum.

  8. 胃癌干细胞研究概况%Advanced in Gastric Cancer Stem Cells

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    武慧军; 欧阳晓晖; 苏秀兰

    2014-01-01

    Gastric cancer stem cells in gastric cancer tissues, the stomach may originate from adult stem cells, bone marrow cells or by other stem cells transformed. At present, gastric cancer stem cell identification, separation methods mainly depend on gastric cancer stem cell markers, side group cells (side population cells, sP cells). Greater omentum milk spot and epithelial interstitial transformation helps to gastric cancer cell identification separation. Gastric cancer stem cells and gastric cancer treatment and prognosis were significantly related. in this paper the origin of gastric cancer stem cells, the identification of separation and the treatment of gastric cancer were summarized in this review.%胃癌干细胞(gastric cancer stem cell)存在于胃癌组织中,可能来源于胃成体干细胞、骨髓细胞或由其他干细胞转化而来。目前胃癌干细胞的鉴定、分离方法主要依靠胃癌干细胞标志物,侧群细胞(side population cells,sP)细胞。大网膜乳斑及上皮间质转化有助于胃癌细胞的鉴定分离。胃癌干细胞与胃癌的治疗和预后明显相关。本文就胃癌干细胞的起源、鉴定分离与胃癌的治疗作一综述。

  9. Anatomic and tissue characteristics in goats fed for extended periods with residue of castor biodiesel production

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    Cláudio Henrique de Almeida Oliveira

    2013-12-01

    Full Text Available Twenty-five adult crossbred goats, divided in two groups, were fed over a period of 16 months with diets based on Tifton hay and concentrate feed with (DCO or without (WDCO detoxified castor bean meal as a substitute for soybean meal. Throughout 480 days, blood samples were taken to measure lactate dehydrogenase, aspartate aminotransferase, alanine aminotransferase, urea, albumin and creatinine. The animals were euthanized, and the anatomical components (lungs, heart, spleen, liver, kidneys, tongue, empty stomach, empty intestines, omentum, cardiac and renal adipose tissue, carcass and commercial cuts (shoulder, ham, loin, ribs and neck were weighed. Thereafter, an anatomic dissection of the loin was performed, separating the muscle, adipose and bone tissues. On the muscular part of the loin, longissimus dorsi, the proximate composition, fatty acid profile and the expression of SEW-1, IGF-I and IGF-II were analyzed. A higher incidence of bone tissue was observed in the anatomical dissections of the loin and a lower incidence of fat in the proximate composition of the longissimus dorsi of the DCO group compared to the WDCO group (p<0.05. The expression of the IGF-II and SEW-1 genes was higher (p<0.001 for each in the muscle tissue of the DCO animals. Thus, using detoxified castor bean meal for long periods does not produce significant changes in the anatomical composition of the loin or the proximate composition of the longissimus dorsi. However, the differences in gene expression suggest the need for new investigations and care when using this product for animal feeding.

  10. Possible application of urinary analysis to estimate dissolution of some man-made vitreous fibers.

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    Wastiaux, A; Blanchard, O; Honnons, S

    1994-10-01

    A preliminary study at the institut National de l'Environnement Industriel et des Risques (INERIS) examined the dissolution of three man-made vitreous fiber samples (glasswool, rockwool, glass microfibers: JM 100) after intraperitoneal injections in male Wistar rats. The chemical composition of the original fibers was determined by inductively coupled plasma spectrometry (ICP). The urine of the rats was collected at fixed times between day 1 and day 204, and the ICP was used to look for elements known to be present in the original fibers. At day 204, a piece of omentum was removed at autopsy, ashed and analyzed by energy dispersive X-ray analysis (EDXA) to identify the elements remaining in the fibers. Silicon and aluminium were retained in the fibers from all samples at day 204. Losses in calcium, sodium, magnesium, and sulfur were observed, but these elements were not studied in the urine samples because they are naturally present in relatively high concentrations in rat cells and biological fluids. Although there was a loss of zinc from the glass microfibers, no corresponding difference was observed between the zinc levels excreted by the treated animals and by the controls. Similarly, despite the loss of manganese from the rockwool fibers at day 204, none was detectable in the urine samples. Titanium, present at the 0.3% level in rockwool, was not detectable by EDXA at day 204, but small quantities were detected in the first 2 weeks in the urine samples of rats treated with rockwool.(ABSTRACT TRUNCATED AT 250 WORDS)

  11. Application of a hormonal intrauterine device causing uterine perforation: A case report

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    Žižić Vojislav

    2011-01-01

    Full Text Available Introduction. The last decade of the usage of intrauterine contraception has been marked by the application of levonorgestrel-releasing hormonal devices. A hormonal intrauterine device (IUD releases a certain amount of progestogen, whose effect on endometrium is such that, apart from preventing unwanted pregnancy, also regulates the menstrual bleeding by reducing the quantity and the duration of haemorrhage. This effect of hormonal IUDs has led to their additional indications and use, so that nowadays these IUDs are used not only as contraceptives but for therapeutic purposes as well. Case Outline. After examination and treatment in an out-patient department, a 38-year-old woman was referred to our hospital due to suspected spontaneous uterine perforation caused by hormonal IUD (Mirena® one month after its application. Clinical and sonographic examinations were unable to determine the uterine perforation or the exact IUD location. Radiographic examination confirmed the presence of the IUD in the abdomen, so it was decided to operate on the patient. Perforation in the isthmus of the uterus and to the right was identified intraoperatively. By exploration of the genital organs and the abdominal cavity, the IUD was finally located in the omentum. Conclusion. Even in cases of adequate indications for hormonal IUD application, the doctor’s experience and complying with all the principles of appropriate insertion, we should always consider the possibility of the occurrence of serious complications, which sometimes may even require surgery. The extragenital position of IUD, as in this case, may create serious difficulties in the detection of location. A possible development of asymptomatic complications additionally emphasizes the necessity of regular check-ups of all IUD users.

  12. PU.1 antisense lncRNA against its mRNA translation promotes adipogenesis in porcine preadipocytes.

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    Wei, N; Wang, Y; Xu, R-X; Wang, G-Q; Xiong, Y; Yu, T-Y; Yang, G-S; Pang, W-J

    2015-04-01

    Antisense long non-coding RNAs (AS lncRNAs) play important roles in refined regulation of animal gene expression. However, their functions and molecular mechanisms for domestic animal adipogenesis are largely unknown. Here, we found a novel AS lncRNA transcribed from the porcine PU.1 gene (also known as SPI1) by strand-specific RT-PCR. Results showed that PU.1 AS lncRNA was expressed and generally lower than the level of PU.1 mRNA in porcine subcutaneous adipose, heart, liver, spleen, lympha, skeletal muscle and kidney tissues. We further found that the levels of PU.1 mRNA and PU.1 protein were significantly lower in subcutaneous and intermuscular adipose than in mesenteric and greater omentum adipose, whereas the levels of PU.1 AS lncRNA showed no difference in porcine adipose tissues from four different parts of the body. During porcine adipogenesis, levels of PU.1 mRNA increased at day 2 and then gradually decreased. Meanwhile, PU.1 AS lncRNA exhibited an expression trend similar to PU.1 mRNA but sharply decreased after day 2. Interestingly, PU.1 protein level rose during differentiation. In addition, at day 6 after differentiation, knockdown of endogenous PU.1 promoted adipogenesis, whereas knockdown of endogenous PU.1 AS lncRNA had the opposite effect. Moreover, peroxisome proliferator-activated receptor gamma (PPARG) and fatty acid synthase (FASN) were significantly upregulated in the PU.1 shRNA treatment group (P PU.1 AS shRNA treatment group (P PU.1 mRNA/PU.1 AS lncRNA duplex was detected by an endogenous ribonuclease protection assay combined with RT-PCR. Based on the above results, we suggest that PU.1 AS lncRNA (vs. its mRNA translation) promotes adipogenesis through the formation of a sense-antisense RNA duplex with PU.1 mRNA.

  13. A combination of an anti-SLAMF6 antibody and ibrutinib efficiently abrogates expansion of chronic lymphocytic leukemia cells

    Science.gov (United States)

    Yigit, Burcu; Halibozek, Peter J.; Chen, Shih-Shih; O'Keeffe, Michael S.; Arnason, Jon; Avigan, David; Gattei, Valter; Bhan, Atul; Cen, Osman; Longnecker, Richard; Chiorazzi, Nicholas; Wang, Ninghai; Engel, Pablo; Terhorst, Cox

    2016-01-01

    The signaling lymphocyte activation molecule family [SLAMF] of cell surface receptors partakes in both the development of several immunocyte lineages and innate and adaptive immune responses in humans and mice. For instance, the homophilic molecule SLAMF6 (CD352) is in part involved in natural killer T cell development, but also modulates T follicular helper cell and germinal B cell interactions. Here we report that upon transplantation of a well-defined aggressive murine B220+CD5+ Chronic Lymphocytic Leukemia (CLL) cell clone, TCL1-192, into SCID mice one injection of a monoclonal antibody directed against SLAMF6 (αSlamf6) abrogates tumor progression in the spleen, bone marrow and blood. Similarly, progression of a murine B cell lymphoma, LMP2A/λMyc, was also eliminated by αSlamf6. But, surprisingly, αSLAMF6 neither eliminated TCL1-192 nor LMP2A/λMyc cells, which resided in the peritoneal cavity or omentum. This appeared to be dependent upon the tumor environment, which affected the frequency of sub-populations of the TCL1-192 clone or the inability of peritoneal macrophages to induce Antibody Dependent Cellular Cytotoxicity (ADCC). However, co-administering αSlamf6 with the Bruton tyrosine kinase (Btk) inhibitor, ibrutinib, synergized to efficiently eliminate the tumor cells in the spleen, bone marrow, liver and the peritoneal cavity. Because an anti-human SLAMF6 mAb efficiently killed human CLL cells in vitro and in vivo, we propose that a combination of αSlamf6 with ibrutinib should be considered as a novel therapeutic approach for CLL and other B cell tumors. PMID:27029059

  14. Comparison of icodextrin- and glucose-based peritoneal dialysis fluids in their acute and chronic effects on human peritoneal mesothelial cells.

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    Bender, T O; Witowski, J; Ksiazek, K; Jörres, A

    2007-12-01

    Icodextrin-based peritoneal dialysis fluids (PDFs) display several features that may potentially improve their biocompatibility compared to conventional glucose-containing solutions. So far, however, the studies assessing the biocompatibility profile of icodextrin toward human peritoneal mesothelial cells (HPMC) has produced mixed results. The present study was performed to examine the acute and chronic impact of icodextrin on HPMC in vitro in comparison with standard glucose-based PDF. Omentum-derived HPMC were either acutely pre-exposed to or incubated chronically (for up to 10 days) in the presence of icodextrin-PDF. Parallel cultures were treated with conventional PDFs containing either 1.5% or 4.25% glucose. All fluids were tested at neutral pH. HPMC were assessed for viability, proliferation, IL-6 secretion and generation of reactive oxygen species (ROS). Incubation in the presence of icodextrin-PDF significantly reduced HPMC proliferation in a manner similar to that of 1.5% glucose-PDF. In addition, exposure to icodextrin-PDF impaired viability and IL-6 release from HPMC. This effect occurred both after the short pre-treatment with neat icodextrin-PDF for 1-4 hours and after prolonged incubation (up to 10 days) in media supplemented with icodextrin-PDF (1:1). The dysfunction of icodextrin-treated HPMC was of the magnitude that was between the effects exerted by 1.5%- and 4.25%-glucose PDF. Furthermore, exposure of HPMC to icodextrin-PDF induced a dose-dependent increase in ROS generation which was comparable to that produced by 1.5%-glucose PDF. Exposure to icodextrin-PDF may impair viability and function of HPMC. The detrimental effects of icodextrin-PDF are at least as serious as those produced by conventional heat-sterilized low glucose-based PDF.

  15. 多排螺旋CT在胃肠道肿瘤及并发症的诊断价值%Multi-slice Spiral CT in the Diagnosis of Gastrointestinal Tumor and Complications

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    高云; 郑晓林; 尹昌媛

    2013-01-01

    目的 探讨多排螺旋CT在胃肠道肿瘤及并发症的诊断价值. 材料和方法 回顾性分析43例胃肠道肿瘤的多排螺旋CT表现,观察分析胃肠道肿瘤的直接CT征象及并发症征象.结果 CT可以直接发现胃肠道肿块的32例,肠管壁增厚11例,肠梗阻18例,肠套叠3例,肠扭转5例,消化道出血1例,肠系膜血管增粗26,肠系膜淋巴结肿大15例,肝脏转移7例,大网膜转移3例.结论 多排螺旋CT在消化道肿瘤的诊断方面有较高的临床实用价值,值得推广应用.%Objective To investigate diagnostic value of multi-slice spiral CT on the gastrointestinal tumor and complications.Materials and methods Multi-slice spiral CT performance of 43 patients with gastrointestinal tumors were retrospectively analyzed,to observe and analyze direct CT findings and complications CT findings of gastrointestinal tumors.Results 32 cases of the gastrointestinal masses could be directly found by multislice spiral CT; 11 cases of bowel wall thickening; 27 cases of intestinal obstruction; 3 cases of intussusception; 5 cases of volvulus; 1 case of gastrointestinal bleeding; 26 cases of mesenteric vascular thickening; 15 cases of mesenteric lymph nodes; 7 cases of liver metastases; 3 cases of omentum metastasis.Conclusion Multi-slice spiral CT in the diagnosis of gastrointestinal tumors had higher clinical value,should be widely applied.

  16. Fgf10 overexpression enhances the formation of tissue-engineered small intestine.

    Science.gov (United States)

    Torashima, Yasuhiro; Levin, Daniel E; Barthel, Erik R; Speer, Allison L; Sala, Frédéric G; Hou, Xiaogang; Grikscheit, Tracy C

    2016-02-01

    Short bowel syndrome (SBS) is a morbid and mortal condition characterized in most patients by insufficient intestinal surface area. Current management strategies are inadequate, but tissue-engineered small intestine (TESI) offers a potential therapy. A barrier to translation of TESI is the generation of scalable mucosal surface area to significantly increase nutritional absorption. Fibroblast growth factor 10 (Fgf10) is a critical growth factor essential for the development of the gastrointestinal tract. We hypothesized that overexpression of Fgf10 would improve the generation of TESI. Organoid units, the multicellular donor tissue that forms TESI, were derived from Rosa26(rtTA/+), tet(o)Fgf10/(-) or Fgf10(Mlc-nlacZ-v24) (hereafter called Fgf10(lacZ)) mice. These were implanted into the omentum of NOD/SCID γ-chain-deficient mice and induced with doxycycline in the case of tet(o)Fgf10/(-). Resulting TESI were explanted at 4 weeks and studied by histology, quantitative RT-PCR and immunofluorescence. Four weeks after implantation, Fgf10 overexpressing TESI was larger and weighed more than the control tissues. Within the mucosa, the villus height was significantly longer and crypts contained a greater percentage of proliferating epithelial cells. A fully differentiated intestinal epithelium with enterocytes, goblet cells, enteroendocrine cells and Paneth cells was identified in the Fgf10-overexpressing TESI, comparable to native small intestine. β-Galactosidase expression was found in both the epithelium and the mesenchyme of the TESI derived from the Fgf10(LacZ) duodenum. However, this was not the case with TESI generated from jejunum and ileum. We conclude that Fgf10 enhances the formation of TESI.

  17. Levels of feline infectious peritonitis virus in blood, effusions, and various tissues and the role of lymphopenia in disease outcome following experimental infection.

    Science.gov (United States)

    Pedersen, Niels C; Eckstrand, Chrissy; Liu, Hongwei; Leutenegger, Christian; Murphy, Brian

    2015-02-25

    Twenty specific pathogen free cats were experimentally infected with a virulent cat-passaged type I field strain of FIPV. Eighteen cats succumbed within 2-4 weeks to effusive abdominal FIP, one survived for 6 weeks, and one seroconverted without outward signs of disease. A profound drop in the absolute count of blood lymphocytes occurred around 2 weeks post-infection (p.i.) in cats with rapid disease, while the decrease was delayed in the one cat that survived for 6 weeks. The absolute lymphocyte count of the surviving cat remained within normal range. Serum antibodies as measured by indirect immunofluorescence appeared after 2 weeks p.i. and correlated with the onset of disease signs. Viral genomic RNA was either not detectable by reverse transcription quantitative real-time PCR (RT-qPCR) or detectable only at very low levels in terminal tissues not involved directly in the infection, including hepatic and renal parenchyma, cardiac muscle, lung or popliteal lymph node. High tissue virus loads were measured in severely affected tissues such as the omentum, mesenteric lymph nodes and spleen. High levels of viral genomic RNA were also detected in whole ascitic fluid, with the cellular fraction containing 10-1000 times more viral RNA than the supernatant. Replicating virus was strongly associated with macrophages by immunohistochemistry. Virus was usually detected at relatively low levels in feces and there was no evidence of enterocyte infection. Viral genomic RNA was not detected at the level of test sensitivity in whole blood, plasma, or the white cell fraction in terminal samples from the 19 cats that succumbed or in the single survivor. These studies reconfirmed the effect of lymphopenia on disease outcome. FIPV genomic RNA was also found to be highly macrophage associated within diseased tissues and effusions as determined by RT-qPCR and immunohistochemistry but was not present in blood.

  18. Femoral hernia: a review of 83 cases.

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    Alimoglu, O; Kaya, B; Okan, I; Dasiran, F; Guzey, D; Bas, G; Sahin, M

    2006-03-01

    We evaluate the factors that affect morbidity and mortality in patients who underwent surgery due to femoral hernia. The medical records of 83 patients who underwent femoral hernia repair between January 1996 and June 2004 were retrospectively analyzed. The femoral hernias were repaired either with McVay or mesh plug hernioplasty. Sex, age, surgical repair technique, presence of incarceration/strangulation, incarcerated/strangulated organs, postoperative complications, duration of hospitalization, recurrence rate, and factors that affect mortality and morbidity were studied. There were 83 patients with femoral hernia in our study. Patients' age ranged from 10 to 75 years (mean age was 46.84) with a predominance of female (71%). Thirty-six patients (40%) underwent emergency surgery with the diagnosis of strangulation or incarceration of femoral hernia. Seventeen patients had strangulation and underwent resection; eleven of these patients had omentum in the hernial sac, whereas six patients had intestines. Four of these patients underwent laparotomy. The remaining 19 patients had incarceration and underwent simple reduction of hernial sac content without resection. Forty-seven (60%) patients underwent elective surgery. McVay technique was used for 79 patients, while the other four patients were treated with mesh-plug. Twelve patients (15%) developed a variety of complications (nine patients (25%) in emergency, three patients (6%) in elective group). There was one mortality. Recurrences occurred in two patients. Femoral hernia is an important surgical pathology with high rates of incarceration/strangulation and intestinal resection. Emergency surgery can increase morbidity and mortality especially in the elderly. Early elective surgery may reduce complication.

  19. Preperitoneal Mesh Placement with Anterior Approach in Incarcerated Femoral Hernia (Our Experiences with 23 Cases

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    Mikail Çakır

    2015-09-01

    Full Text Available Aim: To investigate the effectiveness of preperitoneal mesh placement with anterior approach in incarcerated femoral hernia and to reveal morbidity and recurrence rates. Methods: Twenty-three patients with incarcerated inguinal hernia, who were admitted to our emergency surgery clinic between the years 2009 and 2012 and found to have incarcerated femoral hernia during exploration, were included in the study. All patients underwent inguinal transverse incision suitable for anterior approach. By cutting transversalis fascia, polypropylene mesh was placed preperitoneally between Cooper‘s ligament and the conjoint tendon. Results: The mean age was 54.2 (39-85 years; 16 (69% subjects were men, 7 (31% were women. Five patients had no complaints related to hernia before being admitted to the hospital. Six (26% patients underwent bowel resection and anastomosis. Small intestines or omentum incarcerated in the hernia sac were reduced into the abdomen in 17 (74% patients. There was no complication during surgical interventions. Average length of hospital stay in patients with resection and anastomosis were 5.3 days, and 2.1 days in patients with no resection. In follow-up, 3 (13% patients had hematoma-seroma and 2 (8% patients had wound infection. In 2-4 years follow-up, no recurrence was detected. Chronic pain related to nerve damage was not observed. Conclusion: Preperitoneal mesh placement with anterior approach in incarcerated femoral hernia as an emergency is safe in terms of complications and recurrence either with or without intestinal resection. (The Medical Bulletin of Haseki 2015; 53: 196-8

  20. Surgical hepatosplenic mansonic schistosomiasis in adolescents: repercussions of the post-treatment schistosomotic burden on the hepatic functional reserve

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    Carlos Teixeira Brandt

    2001-09-01

    Full Text Available Schistosomiasis mansoni affects the hepatic functional reserve. Clinical treatment with oxamniquine is not 100% effective and there has been found strain of this parasite resistant to this drug. The aims of this investigation were: (1 to examine the presence of residual parasite burden after medical and surgical treatment on adolescents with surgical schistosomiasis mansoni and (2 to assess the effect on the hepatic functional reserve in patients with and without residual infection. Twenty nine children with hepatosplenic schistosomiasis mansoni and bleeding esophageal varices were treated with oxamniquine. They underwent splenectomy, ligature of the left gastric vein and autologous implantation of spleen tissue into the greater omentum. After a mean post-operative follow up of five years they underwent rectal biopsy for schistosomotic egg search. They were divided in patients with and without infection. In 20 patients the submucosal egg search was negative, however, in 9 it was positive. The hepatic functional reserve in the patients without infection was as follows: 17 were Child-Pugh A and 3 Child-Pugh B. In the patients who were still infected 6 were Child-Pugh A and 3 Child-Pugh B. The chi2 analysis of the hepatic functional reserve showed chi2 = 3.19 - p= 0.07. From the results the following conclusion can be drawn: residual infection or reinfection in the follow up period had not interfered with the distribution of the hepatic functional reserve of the patients in this series. However, there was a trend for a decrease of this parameter in patients with residual infection.

  1. 16-Slice CT Diagnostic Value in Adult Non- traumatic Abdominal Wall Hernia%成人非创伤性腹壁疝的16层螺旋CT诊断价值

    Institute of Scientific and Technical Information of China (English)

    丁长青; 孙迎迎; 史志卫; 王文生; 谢光彤

    2012-01-01

    目的:探讨成人非创伤性腹壁疝的16层螺旋CT诊断价值。方法:回顾性分析手术或临床随访证实的37例成人非创伤性腹壁疝16层螺旋CT资料。结果:腹壁切口疝13例,股沟斜疝10例,腰疝4例,半月线疝3例,壁造瘘口疝3例,白线疝2例,脐疝2例。疝囊直径小于5cm者23例,6~10cm者11例,大于10cm者3例。疝内容可为大网膜、肠管甚至邻近的器官。结论:多层CT及后处理是非创伤性腹壁疝较佳的诊断方法,可为进一步手术治疗提供可靠依据。%Objective: To investigate 16 layer spiral CT diagnosis value in adult non traumatic abdominal wall hernia. Methods: A retrospective analysis of 37 cases data of adult non traumatic abdominal wall hernia confirmed by operation or clinical follow-up with 16 slice spiral CT. Results: Abdominal wall incisional hernia in 13 cases, inguinal indirect hernia in 10 cases, lumbar hernia in 4 cases, spigelian hernia in 3 cases, abdominal wall stoma hernia in 3 cases, white line hernia in 2 cases, umbilical hernia in 2 cases. Hernia sac diameter less than 5 cm in 23 cases, 6-10 cm in 11 cases, greater than 10 cm in 3 cases. The hernial contents are the greater omentum, bowel and adjacent organs. Conclusion: It is a better diagnosis method with multi-layer CT and post-processing for non traumatic abdominal wall hernia, which could provide a reliable basis for further treatment.

  2. 微型腹腔镜下套线法治疗儿童腹股沟斜疝%Mini-laparoscopic indirect inguinal hernia repair by overlapping line in children

    Institute of Scientific and Technical Information of China (English)

    林洋; 穆林松; 隋武; 于文涛

    2014-01-01

    Objective To summarize the experiences of mini-laparoscopic indirect inguinal hernia repair by overlapping line in children.Methods A total of 1 760 cases with indirect inguinal hernia who underwent mini-laparoscopic hernia repair by overlapping line in Yantai Yu Huang Ding Hospital Affiliated to Qingdao University School of Medicine from August 2001 to March 201 3 were retrospectively analyzed. Results All operations were successfully completed.It took 5 to 8 minutes for operations in unilateral hernia cases,and 8 to 1 5 minutes in bilateral hernia cases.Patients were discharged in 1 to 2 days after operation. At postoperative follow-up ranging from 6 to 1 2 months,there were 8 cases of greater omentum herniation from umbilical incision,5 cases of incision knot reaction,9 cases of recurrence,and 1 case of communicating hydrocele testis.Conclusions Mini-laparoscopic indirect inguinal hernia repair by overlapping line is a safe and reliable treatment in children.It has the advantages of less trauma,lower rate of complications, shorter hospital stay,and it will contributed to find and deal with occult hernia at the same time,which is worthy to be popularized in clinic.%目的:总结微型腹腔镜下套线法治疗儿童腹股沟斜疝的经验。方法回顾性分析2001年8月至2013年3月,青岛大学医学院附属烟台毓璜顶医院应用微型腹腔镜下套线法治疗儿童腹股沟斜疝1760例的临床资料。结果本组手术均顺利完成,手术时间单侧5~8 min,双侧8~15 min,术后1~2 d出院。术后随访6~12个月,脐部切口大网膜突出8例,切口线结反应5例,复发9例,交通性鞘膜积液1例。结论微型腹腔镜下套线法治疗儿童腹股沟斜疝创伤小,疗效可靠,并发症少,住院时间短,可同时发现及处理对侧隐匿疝,值得临床推广。

  3. RNA-binding protein LIN28 is a marker for primary extragonadal germ cell tumors: an immunohistochemical study of 131 cases.

    Science.gov (United States)

    Cao, Dengfeng; Liu, Aijun; Wang, Fenghua; Allan, Robert W; Mei, Kaiyong; Peng, Yan; Du, Jun; Guo, Shuangping; Abel, Ty W; Lane, Zhaoli; Ma, Joe; Rodriguez, Maria; Akhi, Shirin; Dehiya, Neha; Li, Jianping

    2011-02-01

    LIN28 has been shown to have an important role in primordial germ cell development and malignant transformation of germ cells in mouse. In this study, we examined the immunohistochemical profile of LIN28 in 131 primary human extragonadal germ cell tumors (central nervous system (CNS) 76, mediastinum 17, sacrococcygeal region 30, pelvis 3, vagina 2, liver 1, omentum 1, and retroperitoneum 1), including the following tumors and/or components: 57 seminomas/germinomas, 10 embryonal carcinomas, 74 yolk sac tumors, 6 choriocarcinomas, 15 mature, and 13 immature teratomas. We compared LIN28 with SALL4 to assess its diagnostic value. To determine its specificity, we examined LIN28 in 406 extragonadal-non-germ cell tumors (103 carcinomas, 91 sarcomas, 9 melanomas, 12 mesotheliomas, 83 lymphomas, 9 plasmacytomas, 82 CNS tumors, and 17 thymic epithelial tumors). The staining was semi-quantitatively scored as 0 (no cell stained), 1+ (0-30%), 2+ (31-60%), 3+ (61-90%), and 4+ (>90%). LIN28 staining was seen in all seminomas/germinomas (3+ in 1 and 4+ in 56), embryonal carcinomas (4+ in all 10), and yolk sac tumors (3+ in 3 and 4+ in 71). Variable LIN28 staining was seen in 5 of 6 choriocarcinomas (1+ to 4+), 8 of 13 immature teratomas (1+ to 2+ in immature elements), and in 1 of 15 mature teratomas (1+). Only 11 of 406 non-germ cell tumors showed 1+ LIN28 staining. Therefore, LIN28 is a sensitive (100% sensitivity) marker for primary extragonadal seminomas/germinomas, embryonal carcinomas, and yolk sac tumors with high specificity. Compared with SALL4, LIN28 demonstrated a similar level of diagnostic sensitivity for seminomas/germinomas and embryonal carcinomas. For primary extragonadal yolk sac tumors, although SALL4 stained all tumors (1+ in 1, 2+ in 2, 3+ in 10, and 4+ in 61), LIN28 stained more tumor cells (mean 95 vs 90%, P = 0.03) and was therefore more sensitive. For primary extragonadal yolk sac tumors, combining LIN28 and SALL4 can achieve a higher diagnostic

  4. TRATAMENTO DE CISTO PARAPROSTÁTICO EM UM CÃO

    Directory of Open Access Journals (Sweden)

    Elzylene Léga

    2011-05-01

    Full Text Available O presente trabalho relata o caso clínico de um cão da raça American Pit Bull Terrier, de 7 anos deidade, pesando 27,3kg, atendido no Hospital Veterinário da FAFRAM, apresentando êmese, disúria, disfagia,disquesia e dor abdominal. Ao exame físico, observou-se escore corporal baixo, desidratação moderada, dor àpalpação abdominal e abdômen distendido. Os perfis hematológicos e bioquímicos evidenciaram redução nosparâmetros da série vermelha. À ultrassonografia, foi observada formação cranial à próstata com conteúdoanecóico repleto de celularidade, medindo 14,6 x 9,67cm, sugestivo de cisto paraprostatico. O animal foisubmetido a celiotomia para preenchimento do espaço morto cístico com o omento como membrana biológica. Àultrassonografia constatou-se recidiva do quadro sendo o animal submetido à nova cirurgia, realizando a técnicade cauterização do cisto seguida da omentalização convencional. Após 60 dias, ao exame ultrassonográfico, nãofoi revelado alterações e o animal encontra-se em bom estado.This paper reports a case of dog’s breed American Pit Bull Terrier, 7 years gold, weighing27,3kg, Veterinary Hospital at the FAFRAM, with emesis, dysuria, dysphagia. On physical examination, therewas a body score low, moderate dehydration, abdominal pain on palpation and distended abdomen. Thehematological and biochemical parameters showed reduction in the red series. At ultrasonography, was observedtraining cranial to the prostate with anechoic contents full of cells, measuring 14.6 X 9.67 cm, suggestive of acyst paraprostatic. The animal was subjected to celiotomy for filling cystic space with omentum as biologicalmembrane. Ultrasonography was found recurrence of the picture with the animal underwent further surgery,performing the technique of cauterization of the cyst followed by conventional omentalization. After 60 days, theultrasound test, was not revealed changes and the animal is in good condition.

  5. Bone mineral content reduction in youth with surgical form of Schistosomiasis mansoni: factors involved in the pathogenesis

    Directory of Open Access Journals (Sweden)

    Brandt Carlos Teixeira

    2001-01-01

    Full Text Available Thirty two children and adolescents from 14 to 20 years of age, suffering from hepatosplenic schistosomiasis mansoni and bleeding esophageal varicose veins, were evaluated for bone mineral density (BMD, before undergoing medical and surgical treatment. The surgical protocol was splenectomy, autoimplantation of spleen tissue into a pouch of the major omentum and ligature of the left gastric vein. Follow up of these patients? ranges from one to ten years with a mean of five years. The BMD was measured at the lumbar spine (L2 - L4 through the dual energy absorptionmetry X-ray (DEXA, using a LUNAR DPX-L densitometer. The degree of Symmers´ fibrosis was assessed by semiautomatic hystomorphometry. In eleven patients, the serum magnesium was measured before an intravenous overload of this ion and subsequently after eight and twenty four hours. Urine was collected 24 hours before and 24 hours after the magnesium overload. Deficiency of magnesium was considered when the uptake of this ion was greater than 40%. There was a significant trend of association between the status of bone mineral content and the Symmers´ fibrosis degree (c² = 6.606 R = 0.01017. There was also a moderate agreement between the greater fibrosis densities ( > the mean percentage and bone mineral deficits. Although the normal bone mineral content was more found among the patients with better hepatic functional reserve, the results did not reach statistical significance. There was a marked magnesium retention (>95% in one patient who had severe osteoporosis and a slight depletion (<5% in another patient, who presented no bone mineral deficit. It was concluded that the patients included in this series, showed an important BMD deficit, specially among the females which has had a significant improvement after medical and surgical treatment. Bone mineral deficit was associated with the degree of Symmers´ fibrosis. Magnesium depletion was present in two out of eleven patients. It is

  6. Characteristic manifestations of disseminated peritoneal adenomucinosis on multislice spiral CT%播散性腹膜黏液腺病多层螺旋CT诊断分析

    Institute of Scientific and Technical Information of China (English)

    徐丽莹; 周云峰; 吴光耀; 廖美焱; 田志雄; 张在鹏; 黄雄

    2012-01-01

    回顾性分析11例播散性腹膜黏液腺病患者的CT资料,11例患者中有9例显示为弥漫性凝胶状腹水,2例显示为局限性囊性肿块.9例弥漫性病例中5例伴腹腔多发囊性结节或肿块影,5例伴大网膜或肠系膜网状浸润.11例患者中6例出现肝脏或脾脏扇形压迹,5例出现肝脏或脾脏实质浸润,5例于囊性结节或肿块内出现弧线状、结节状钙化.6例女性患者中3例有卵巢黏液性囊腺瘤.所有病例均未见腹腔及腹膜后淋巴结肿大,未见网膜饼征象.提示播散性腹膜黏液腺病具备特征性CT征象.%Clinical data and manifestations on muhi-slice spiral CT (MSCT) of 11 patients with disseminated peritoneal adenomucinosis (DPAM) were retrospectively reviewed.The CT manifestations were also compared with surgical and histopathological findings.MSCT findings showed a large amount of gel-like ascites in 9 cases and local cystic masses in 2 cases.Among 9 cases with a large amount ascites,abdominal multiple cystic masses were shown in 5 case,and infiltration of the greater omentum and mesentery in 5 cases.Hepatic scalloping was found in 6 cases ; parenchymal invasion of the liver or spleen were showed in 5 cases; calcification of the cystic masses in 5 cases.Ovary mueinous cystadenoma was presented in 3 female patients.Enlarged lymph nodes and omental cake were not found in all cases.The results indicate that the characteristic MSCT manifestations of DPAM include diffuse gel-like ascites,multiple cystic masses with or without calcification,hepatic scalloping and parenchyma invasion.

  7. Thoracotomy for Traumatic Diaphragmatic Hernia.

    Science.gov (United States)

    Fangbiao, Zhang; Chunhui, Zheng; Chun, Zhao; Hongcan, Shi; Xiangyan, Zhang; Shaosong, Tu

    2016-10-01

    The aim of this retrospective study is to review our experience in the diagnosis and role of thoracotomy for traumatic diaphragmatic hernia (TDH). Between January 2008 and June 2014, 23 patients from Yangzhou Medical College (Yangzhou China) and Lishui Center Hospital (Lishui China), who underwent thoracotomy for TDH, were analyzed. The clinical features, imaging findings, operative findings, and outcome of treatment in these patients are presented. There were 23 patients (18 males and 5 females) who underwent surgical procedures due to TDH. The median age of the patients was 43.2 years (range, 15-68 years). The cause of rupture was penetrating trauma in 1 (4.3 %) patient and blunt trauma in 22 (95.7 %) patients. The TDH was left sided in 21 patients and right sided in two patients. The diagnosis was made by chest X-ray (n = 2) and chest or abdominal CT (n = 13) and at thoracotomy based on a high index of suspicion (n = 8). Associated injuries were seen in 21 patients (91.3 %). Twenty-two patients underwent thoracotomy, and one underwent thoracotomy with laparotomy. The mean operating time was 112 min (range, 60-185 min) and the mean blood loss was 116 mL (range, 20-400 mL). The most common herniated organs were the omentum (n = 15), stomach (n = 14), spleen (n = 11), colon (n = 10), small bowel (n = 2), and liver (n = 1). All diaphragmatic defects were repaired using interrupted prolene sutures. The overall mortality rate was 4.3 % (n = 1). The diagnosis of TDH is easily missed or delayed. Chest X-ray and computer tomography (CT), especially chest and abdominal CT, are useful in the diagnosis of diaphragmatic ruptures, and thoracotomy is an effective and successful treatment for TDH.

  8. 紫杉醇联合卡铂化疗致双侧正中神经损害%Bilateral median nerve injuries after chemotherapy with paclitaxel and carboplatin

    Institute of Scientific and Technical Information of China (English)

    杨水源; 吴宏; 曾泗宇; 童艳丽; 梅清华

    2015-01-01

    A 50-year-old female patient with serious borderline tumor received chemotherapy with paclitaxel and carboplatin(an IV infusion of paclitaxel 198 mg and carboplatin 395 mg on the first day of treatment,the cycle of treatment was 21 d)after undergoing total hysterectomy,bilateral ovarian,and greater omentum resection. After the IV infusion of third chemotherapy cycle,the patient developed persistent and progressive numbness and pain of fingers which could radiate to the elbow. After treatment with carbamazepine and mecobalamin,the symptoms were not relieved. Thus it was considered that the adverse reactions may be caused by chemotherapy drugs. So the chemotherapy was paused temporarily,and prednisone,rebamipide,mouse nerve growth factor for injection,and mecobalamin were given. After 14 d of treatments,the patientˊ s symptoms were alleviated apparently. At half a year of follow-up,the patient developed slight atrophy in the right thenar muscle and hypoesthesia in bilateral index finger and middle finger palm.%1例50岁卵巢浆液性交界性肿瘤患者行全子宫、双侧附件及大网膜部分切除术后接受紫杉醇联合卡铂化疗(紫杉醇198 mg、卡铂395 mg 静脉滴注,第1天;21 d 为1个周期)。第3周期化疗静脉给药后,患者出现双手手指麻痛,呈持续性、进行性加重,放射至肘关节。给予口服卡马西平和甲钴胺后未缓解。考虑患者症状与化疗药物有关,暂停辅助化疗,给予泼尼松、瑞巴派特、注射用鼠神经生长因子、甲钴胺等对症治疗。14 d 后,患者疼痛症状减轻。半年后随访,患者右侧大鱼际肌轻度萎缩,双侧食指和中指掌面感觉减退。

  9. 28 cases of clinical analysis of the uterus%子宫损伤28例临床分析

    Institute of Scientific and Technical Information of China (English)

    陶春梅; 孙才明

    2013-01-01

    Common cause uterine injury is Artificical Termination of pregnancy.Uterine after the equipment into the abdominal cavity, if not timely found to continue operation inevitably leads to visceral injury, the person that weigh concurrent hemorrhage or peritonitis.. This group of pure uterine injury, complexity of uterus damage al 14 cases, Complexity of 6 cases with ileal rupture in uterine lesions, greater omentum embedded into the uterine cavity in 5 cases, colon rupture, bladder rupture, the oviduct ovarian injury in 1 case, intestinal rupture with hemorrhage in 2 cases, with peritonitis in 1 case. The cases were cured. Prevention of uterine injury to preoperative diagnosis, preoperative preparation. Preoperative oral misoprostol for 2-3 hours 0.4 mg to 0.6 mg can avoid palace mouth expansion difficulties, intraoperative observe operating specifications. Once appear, uterine injury should immediately stop operation active processing.%子宫损伤常见原因是人工终止妊娠,子宫损伤后器械进入腹腔,若未及时发现,继续操作必致内脏损伤,重者并发内出血或腹膜炎。本组单纯子宫损伤复杂性子宫损伤各14例,复杂性子宫损伤中伴回肠破裂6例,大网膜嵌入子宫腔5例,结肠破裂、膀胱破裂、输卵管卵巢损伤各1例,肠破裂伴内出血2例,伴腹膜炎1例。本组病例全部治愈。预防子宫损伤要明确术前诊断做好术前准备,术前2-3h口服米索前列醇0.4mg-0.6mg可避免宫口扩张困难,术中遵守操作规范。一旦出现子宫损伤应立即停止操作积极处理。

  10. Complete and partial uterine perforation and embedding following insertion of intrauterine devices. II. Diagnostic methods, prevention, and management.

    Science.gov (United States)

    Zakin, D; Stern, W Z; Rosenblatt, R

    1981-08-01

    This paper discusses the various methods used to diagnose uterine perforation caused by an IUD. Radiography, or plain film, has a limited use in the diagnosis of uterine perforation since its usefulness depends on the radiopacity of the particular IUD; if the IUD appears on film, plain film does not allow one to conclude whether the device is in its proper position. Several modifications of plain film have been tried but all methods fall short of their goals. Hysterography permits the best diagnostic assessment since it allows the visualization of the entire uterine cavity so that the position of the IUD is immediately evident in cases of embedding and of perforation. Pelvic pneumography can differentiate between intraperitoneal or extraperitoneal locations of perforated IUDs; it can be enhanced by hysterosalpingography and can be done on an ambulatory basis. Ultrasonography simply determines the presence or absence of an IUD, but has the advantage of accurately demonstrating a concomitant pregnancy; the sonogram is not reliable if the IUD is surrounded by omentum or by loops of bowel; ultrasonography can be advantageously coupled with hysterography. Laparoscopy is still the method most used to diagnose uterine IUD perforation; when removal of the device is advisable laparotomy is usually carried out concomitantly; successful laparoscopy requires a skilled and experienced operator. Hysteroscopy is a new and extremely valuable technique which should not be chosen as a primary procedure because it carries a risk of complications. The best prevention of uterine perforation is a meticulous and well executed insertion technique, done only by an experienced operator and after a careful pelvic examination. Uterine size, consistency and position must be exactly known; IUD insertion is easier during or immediately after menstruation. Perforated IUDs should be removed even if considered innocuous, although this is a matter still debated by the specialists. Spontaneous IUD

  11. Intrinsic features in microRNA transcriptomes link porcine visceral rather than subcutaneous adipose tissues to metabolic risk.

    Science.gov (United States)

    Ma, Jideng; Jiang, Zhi; He, Shen; Liu, Yingkai; Chen, Lei; Long, Keren; Jin, Long; Jiang, An'an; Zhu, Li; Wang, Jinyong; Li, Mingzhou; Li, Xuewei

    2013-01-01

    MicroRNAs (miRNAs) are non-coding small RNA ∼22 nucleotides in length that can regulate the expression of a wide range of coding genes at the post-transcriptional level. Visceral adipose tissues (VATs) and subcutaneous adipose tissues (SATs), the two main fat compartments in mammals, are anatomically, physiologically, metabolically, and clinically distinct. Various studies of adipose tissues have focused mainly on DNA methylation, and mRNA and protein expression, nonetheless little research sheds directly light on the miRNA transcriptome differences between these two distinct adipose tissue types. Here, we present a comprehensive investigation of miRNA transcriptomes across six variant porcine adipose tissues by small RNA-sequencing. We identified 219 known porcine miRNAs, 97 novel miRNA*s, and 124 miRNAs that are conserved to other mammals. A set of universally abundant miRNAs (i.e., miR-148a-3p, miR-143-3p, miR-27b-3p, miR-let-7a-1-5p, and miR-let-7f-5p) across the distinct adipose tissues was found. This set of miRNAs may play important housekeeping roles that are involved in adipogenesis. Clustering analysis indicated significant variations in miRNA expression between the VATs and SATs, and highlighted the role of the greater omentum in responding to potential metabolic risk because of the observed enrichment in this tissue of the immune- and inflammation-related miRNAs, such as the members of miR-17-92 cluster and miR-181 family. Differential expression of the miRNAs between the VATs and SATs, and miRNA target prediction analysis revealed that the VATs-specific enriched miRNAs were associated mainly with immune and inflammation responses. In summary, the differences of miRNA expression between the VATs and SATs revealed some of their intrinsic differences and indicated that the VATs might be closely associated with increased risk of metabolic disorders.

  12. Novel use of an air-filled breast prosthesis to allow radiotherapy to recurrent colonic cancer.

    LENUS (Irish Health Repository)

    O'Duffy, F

    2012-02-01

    AiM: The authors present the novel and successful use of an air-filled breast prosthesis for extra pelvic exclusion of small bowel to facilitate adjuvant radiotherapy following resection of recurrent adenocarcinoma of the ascending bowel. The therapeutic use of radiotherapy in colon cancer can cause acute or chronic radiation enteropathy. Mobile small bowel can be sequestered in \\'dead space\\' or by adhesions exposing it to adjuvant radiotherapy. A variety of pelvic partitioning methods have been described to exclude bowel from radiation fields using both native and prosthetic materials. METHOD: In this case a 68 year old presented with ascending colon adenocarcinoma invading the peritoneum and underwent en bloc peritoneal resection. Thirty-seven months later surveillance CT identified a local recurrence. Subsequent resection resulted in a large iliacus muscle defect which would sequester small bowel loops thus exposing the patient to radiation enteropathy. The lateral position of the defect precluded the use of traditional pelvic partitioning methods which would be unlikely to remain in place long enough to allow radiotherapy. A lightweight air-filled breast prosthesis (Allergan 133 FV 750 cms) secured in place with an omentoplasty was used to fill the defect. RESULTS: Following well tolerated radiotherapy the prosthesis was deflated under ultrasound guidance and removed via a 7-cm transverse incision above the right iliac crest. The patient is disease free 18 months later with no evidence of treatment related morbidity. CONCLUSION: The use of a malleable air-filled prosthesis for pelvic partitioning allows specific tailoring of the prosthesis size and shape for individual patient defects. It is also lightweight enough to be secured in place using an omentoplasty to prevent movement related prosthesis migration. In the absence of adequate omentum a mesh sling may be considered to allow fixation. In this case the anatomy of the prosthesis position allowed for its

  13. Implantation of peritoneal catheters by laparotomy: nephrologists obtained similar results to general surgeons

    Directory of Open Access Journals (Sweden)

    Restrepo CA

    2014-10-01

    Full Text Available Cesar A Restrepo, Carlos Alberto Buitrago, Cielo Holguin Division of Nephrology, Department of Health Sciences, Caldas University, Caldas, ColombiaPurpose: To analyze the complications and costs of minilaparotomies performed by a nephrologist (group A compared with conventional laparotomies performed by a surgeon (group B for peritoneal catheter implantation.Setting: Two university hospitals (Santa Sofia and Caldas in Manizales, Caldas, Colombia.Methods: The study included stage 5 chronic kidney disease patients, with indication of renal replacement therapy, who were candidates for peritoneal dialysis and gave informed consent for a peritoneal catheter implant. Minilaparotomies were performed by a nephrologist in a minor surgery room under local anesthesia. Conventional laparotomies were performed by a surgeon in an operating room under general anesthesia.Results: Two nephrologists inserted 157 peritoneal catheters, and seven general surgeons inserted 185 peritoneal catheters. The groups had similar characteristics: the mean age was 55 years, 49.5% were men, and the primary diagnoses were diabetic nephropathy, hypertensive nephropathy, and unknown etiology. The implant was successful for 98.09% of group A and 99.46% of group B. There was no procedure-related mortality. The most frequent complications in the first 30 days postsurgery in group A versus group B, respectively, were: peritonitis (6.37% versus 3.78%, exit-site infection (3.82% versus 2.16%, tunnel infection (0% versus 0.54%, catheter entrapment by omentum (1.27% versus 3.24%, peritoneal effluent spillover (1.91% versus 2.16%, draining failure (4.46% versus 6.49%, hematoma (0% versus 1.08%, catheter migration with kinking (3.18% versus 2.70%, hemoperitoneum (1.27% versus 0%, and hollow viscera accidental puncture (1.91% versus 0.54%. There were no statistically significant differences in the number of complications between groups. In 2013, the cost of a surgeon-implanted peritoneal

  14. Adenocarcinoma mucoproductor de colon con infiltración de estómago y metástasis ováricas (tumor de Krukenberg Colon mucoproducing adenocarcinoma with stomach infiltration and ovarian metastases (Krukenberg's tumor

    Directory of Open Access Journals (Sweden)

    Orestes Noel Mederos Curbelo

    2011-12-01

    Full Text Available Se presenta una paciente femenina de 29 años, operada de urgencia por presentar un gran tumor que incluía cuerpo gástrico y colon trasverso, con una perforación gástrica. Se realizó una gastrectomía subtotal con colectomía trasversa en bloque que incluyó el epiplón mayor. El diagnóstico histológico fue adenocarcinoma túbulo papilar mucoproductor de origen colónico, que infiltra hasta la serosa y pared gástrica. Se realizó tratamiento adyuvante con poliquimioterapia. Diez meses después presenta un tumor en hipogastrio, que al tacto vaginal, correspondía a los órganos genitales, sospecha clínica que confirman el ultrasonido abdominal y la tomografía axial computarizada. El hallazgo transoperatorio fueron tumores voluminosos de ambos ovarios, y otro tumor que afectaba la unión rectosigmoide. Se realizó una histerectomía radical con ooforectomía bilateral y sigmoidectomía, se reseca la porción proximal del recto, y se cierra tipo Hartman. El diagnóstico histológico final fue metástasis en serosa uterina e intestinal, y en ambos ovarios de adenocarcinoma mucoproductor, túbulo papilar de intestino previamente diagnosticado (tumor de Krukenberg. Se complementó el tratamiento con poliquimioterapia adyuvante.This is the case of a woman aged 29 operated on of emergency due to a tumor involving gastric body and transverse colon with gastric perforation. A subtotal gastrectomy with block transverse colectomy including the greater omentum was carried out. The histological diagnosis was a mucoproducing papillary tubular adenocarcinoma of colonic origin infiltrating to serosa and gastric wall. An adjuvant treatment was applied with poly-chemotherapy. Ten months later appears a hypogastric tumor which at vaginal manual examination corresponding to genital organs, clinical suspicion confirmed by abdominal ultrasound and computerized axial tomography. The transoperative findings were bulky tumors of both ovaries and another tumor

  15. Blood flow response in small intestinal loops at different depths during negative pressure wound therapy of the open abdomen.

    Science.gov (United States)

    Lindstedt, Sandra; Hlebowicz, Joanna

    2013-08-01

    High closure rates of the open abdomen have been reported following negative pressure wound therapy (NPWT). However, the method has occasionally been associated with increased development of intestinal fistulae. We have previously shown that the application of NPWT to the open abdomen causes a decrease in microvascular blood flow in the small intestinal loop and the omentum adjacent to the visceral protective layer of the dressing. In this study we investigate whether the negative pressure affects only small intestinal loops lying directly below the dressing or if it also affects small intestinal loops that are not in direct contact with the dressing. Six pigs underwent midline incision and application of NPWT to the open abdomen. The microvascular blood flow was measured in four intestinal loops at different depths from the visceral protective layer, at two different locations: beneath the dressing and at the anterior abdominal wall, before and after the application of NPWT of -50, -70, -100, -120, -150 and -170 mmHg, using laser Doppler velocimetry. Negative pressures between -50 and -170 mmHg caused a significant decrease in the microvascular blood flow in the intestinal loops in direct contact with the visceral protective layer. A slight, but significant, decrease in blood flow was also seen in the intestinal loops lying beneath these loops. The decrease in microvascular blood flow increased with the amount of negative pressure applied. No difference in blood flow was seen in the intestinal loops lying deeper in the abdominal cavity. A decrease in blood flow was seen in the upper two intestinal loops located apically and anteriorly, but not in the lower two, indicating that this is a local effect and that pressure decreases with distance from the source. A long-term decrease in blood flow in the intestinal wall may induce ischaemia and secondary necrosis in the intestinal wall, which could promote the development of intestinal fistulae. We believe that NPWT of

  16. Male form of persistent Mullerian duct syndrome type I (hernia uteri inguinalis presenting as an obstructed inguinal hernia: a case report

    Directory of Open Access Journals (Sweden)

    Gujar Nishikant N

    2011-12-01

    Full Text Available Abstract Introduction Persistent Mullerian duct syndrome is a rare form of male pseudo-hermaphroditism characterized by the presence of Mullerian duct structures in an otherwise phenotypically, as well as genotypically, normal man; only a few cases have been reported in the worldwide literature. We report the case of a 30-year-old man with unilateral cryptorchidism on the right side and a left-sided obstructed inguinal hernia containing a uterus and fallopian tube (that is, hernia uteri inguinalis; type I male form of persistent Mullerian duct syndrome coincidentally detected during an operation for an obstructed left inguinal hernia. Case presentation A 30-year-old South Indian man was admitted to our facility with a left-sided obstructed inguinal hernia of one day's duration. He had a 12-year history of inguinal swelling and an absence of the right testis since birth. Our patient had well developed masculine features. Local physical examination revealed a left-sided obstructed inguinal hernia with an absence of the right testis in the scrotum. Exploration of the inguinal canal revealed an indirect inguinal hernia containing omentum, the left corner of the uterus and a left fallopian tube. Extension of the incision revealed a well formed uterus, cervix and upper part of the vagina attached to the prostate by a thick fibrosed band. Total excision of the uterus, bilateral fallopian tubes and right testis was performed. A biopsy was taken from the left testis. The operation was completed by left inguinal herniorraphy. Histopathological examination of the hernial contents was consistent with that of a uterus and fallopian tubes without ovaries. Both testes were atrophied, with complete arrest of spermatogenesis. Post-operative karyotype analyses were negative for 46,XY and Barr bodies on buccal smear. A semen examination revealed azoospermia with a low serum testosterone level. Conclusions In cases of unilateral or bilateral cryptorchidism

  17. Intrinsic features in microRNA transcriptomes link porcine visceral rather than subcutaneous adipose tissues to metabolic risk.

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    Jideng Ma

    Full Text Available MicroRNAs (miRNAs are non-coding small RNA ∼22 nucleotides in length that can regulate the expression of a wide range of coding genes at the post-transcriptional level. Visceral adipose tissues (VATs and subcutaneous adipose tissues (SATs, the two main fat compartments in mammals, are anatomically, physiologically, metabolically, and clinically distinct. Various studies of adipose tissues have focused mainly on DNA methylation, and mRNA and protein expression, nonetheless little research sheds directly light on the miRNA transcriptome differences between these two distinct adipose tissue types. Here, we present a comprehensive investigation of miRNA transcriptomes across six variant porcine adipose tissues by small RNA-sequencing. We identified 219 known porcine miRNAs, 97 novel miRNA*s, and 124 miRNAs that are conserved to other mammals. A set of universally abundant miRNAs (i.e., miR-148a-3p, miR-143-3p, miR-27b-3p, miR-let-7a-1-5p, and miR-let-7f-5p across the distinct adipose tissues was found. This set of miRNAs may play important housekeeping roles that are involved in adipogenesis. Clustering analysis indicated significant variations in miRNA expression between the VATs and SATs, and highlighted the role of the greater omentum in responding to potential metabolic risk because of the observed enrichment in this tissue of the immune- and inflammation-related miRNAs, such as the members of miR-17-92 cluster and miR-181 family. Differential expression of the miRNAs between the VATs and SATs, and miRNA target prediction analysis revealed that the VATs-specific enriched miRNAs were associated mainly with immune and inflammation responses. In summary, the differences of miRNA expression between the VATs and SATs revealed some of their intrinsic differences and indicated that the VATs might be closely associated with increased risk of metabolic disorders.

  18. Regeneration and Maintenance of Intestinal Smooth Muscle Phenotypes

    Science.gov (United States)

    Walthers, Christopher M.

    Tissue engineering is an emerging field of biomedical engineering that involves growing artificial organs to replace those lost to disease or injury. Within tissue engineering, there is a demand for artificial smooth muscle to repair tissues of the digestive tract, bladder, and vascular systems. Attempts to develop engineered smooth muscle tissues capable of contracting with sufficient strength to be clinically relevant have so far proven unsatisfactory. The goal of this research was to develop and sustain mature, contractile smooth muscle. Survival of implanted SMCs is critical to sustain the benefits of engineered smooth muscle. Survival of implanted smooth muscle cells was studied with layered, electrospun polycaprolactone implants with lasercut holes ranging from 0--25% porosity. It was found that greater angiogenesis was associated with increased survival of implanted cells, with a large increase at a threshold between 20% and 25% porosity. Heparan sulfate coatings improved the speed of blood vessel infiltration after 14 days of implantation. With these considerations, thicker engineered tissues may be possible. An improved smooth muscle tissue culture technique was utilized. Contracting smooth muscle was produced in culture by maintaining the native smooth muscle tissue organization, specifically by sustaining intact smooth muscle strips rather than dissociating tissue in to isolated smooth muscle cells. Isolated cells showed a decrease in maturity and contained fewer enteric neural and glial cells. Muscle strips also exhibited periodic contraction and regular fluctuation of intracellular calclium. The muscle strip maturity persisted after implantation in omentum for 14 days on polycaprolactone scaffolds. A low-cost, disposable bioreactor was developed to further improve maturity of cultured smooth muscle cells in an environment of controlled cyclical stress.The bioreactor consistently applied repeated mechanical strain with controllable inputs for strain

  19. Variations in Metastasis Site by Primary Location in Colon Cancer.

    Science.gov (United States)

    Amri, Ramzi; Bordeianou, Liliana G; Sylla, Patricia; Berger, David L

    2015-08-01

    The purpose of this paper is to determine whether sites of distant recurrence are associated with specific locations of primary disease in colon cancer. A cohort including all patients (n = 947) undergoing a segmental colonic resection for colon cancer at our center (2004-2011) comparing site-specific metastatic presentation and recurrence rates, as well as their respective multivariable American Joint Committee on Cancer (AJCC) stage-adjusted hazard ratios (mHR). Right-sided colectomies (n = 557) had a lower overall metastasis rate (24.8% vs. 31.8%; P = 0.017; mHR = 1.24 [95% CI: 0.96-1.60]; P = 0.011) due to significantly lower pulmonary metastasis in follow-up (2.7% vs. 9%; P mHR = 0.32 [95% CI: 0.17-0.58]; P = 0.001) and lower overall liver metastasis rate (15.6 vs. 22.1%; P = 0.012; mHR = 0.74 [95% CI: 0.55-0.99];P = 0.050). Left colectomies (n = 127) had higher rates of liver metastasis during follow-up (9.4% vs. 4.8%; P = 0.029; mHR = 1.64 [95% CI: 0.86-3.15]; P = 0.134). Sigmoid resections (n = 238) had higher baseline rates of liver metastasis (17.1% vs. 11.3%; P = 0.015) and higher cumulative rates of lung (12.2% vs. 5.4%; P mHR = 2.26 [95% CI: 1.41-3.63]; P = 0.001) and brain metastases (2.3% vs. 0.6%; P = 0.033; mHR = 4.03 [95% CI: 1.14-14.3]; P = 0.031). Other sites of metastasis, including the (retro) peritoneum, omentum, ovary, and bone, did not yield significant differences. Important variations in site-specific rates of metastatic disease exist within major resection regions of colon cancer. These variations may be important to consider when evaluating options for adjuvant treatment and surveillance after resection of the primary disease.

  20. Clinical experience of laparoscopic inguinal hernia repair in children%腹腔镜下微创治疗儿童腹股沟疝的临床体会

    Institute of Scientific and Technical Information of China (English)

    陈康; 王光远; 郎庆华; 冉启琼; 毛宏铭; 孟祥宁; 刘应梅

    2014-01-01

    目的:探讨腹腔镜下微创治疗儿童腹股沟疝的可行性。方法回顾性分析2012年4月至2013年9月,六盘水市人民医院在全身麻醉腹腔镜下行儿童疝囊高位结扎治疗儿童腹股沟疝198例的临床资料。结果198例患者手术均顺利,手术时间10~20 min,平均15 min。术后均未用抗生素,术后6h内即可适量活动及进流质饮食。所有患者均达一期愈合,住院时间3~4d。术后随访6个月,均无复发、血肿、水肿等并发症;术后发生切口大网膜疝1例。结论儿童腹股沟疝行腹腔镜下疝囊高位结扎术,减少术后复发,并发症少,值得临床推广应用。%Objective To evaluate the feasibility of laparoscopic inguinal hernia repair as a minimally invasive treatment in children.Methods A total of 1 98 cases of inguinal hernia in children receiving laparoscopic high ligation of sac under general anesthesia in Liupanshui People′s Hospital from April 201 2 to September 201 3,were enrolled and their clinical data were retrospectively analyzed.Results All operations were successfully completed.The operating time ranged from 1 0 to 20 minutes (mean 1 5 minutes).No postoperative antibiotics was applied.Appropriate activity and liquid diet could been given in 6 hours after operation.All patients were healing by first intention,and the hospital length of stay was 3 to 4 days.After a follow-up of 6 months,no recurrence,hematoma,edema and other complications was observed;while greater omentum incisional hernia occurred in 1 patient after operation.Conclusion Laparoscopic high ligation hernia sac technique in children reduce postoperative recurrence of hernia,and has few complications,is worthy to be popularized in clinic.

  1. Vascular endothelium-leukocyte interaction; sticking shear force in venules.

    Science.gov (United States)

    Schmid-Schoenbein, G W; Fung, Y C; Zweifach, B W

    1975-01-01

    To determine the shear force acting on a white blood cell sticking to the endothelium of a blood vessel, the flow field about a single white blood cell in a venule was determined by hign-speed motion picture photomicrography. The force acting on the white blood cell was then calculated according to the principles of fluid mechanics. In this paper, the calculation was made using an experimentally determined dimensionless shear force coefficient obtained from a kinematically and dynamically similar model. The large physical model of the hemodynamic system could be easily instrumented, and the shear force acting on the model cell and the flow field around it were measured. The data were then used to calculate a shear force coefficient. On the basis of dynamic similarity, this shear force coefficient was applied to the white blood cell in the venule. The shear force coefficient was strongly influenced by the hematocrit, so in vivo hematocrits were measured from electron micrographs. It was found that in the venules of the rabbit omentum a white blood cell sticking to the endothelial wall was subjected to a shear force in the range of 4 times 10--5 dynes to 234 times 10--5 dynes; the exact value depended on the size and motion of the white blood cell, the size of the blood vessel, the velocity of the blood flow, and the local hematocrit, which varied between 20% and 40% in venules of about 40 mum in diameter. The contact area between the white blood cell and the endothelial cell was estimated, and the shear stress was found to range between 50 dynes/cm-2 and 1060 dynes/cm-2. The normal stress of interaction between the white blood cell and the endothelium had a maximum value that was of the same order of magnitude as the shear stress. The accumulated relative error of the experimental procedure was about 49%. The instantaneous shear force was a random function of time because of random fluctuations of the hematocrit.

  2. Discussion of the CT differential diagnosis between the tumor and tubercu-lous ascites%肿瘤性与结核性腹腔积液CT鉴别征象探讨

    Institute of Scientific and Technical Information of China (English)

    谭书德; 池祥波; 李恩春; 刘敏; 李瑾

    2016-01-01

    Objective:To identify neoplastic and tuberculous peritoneal effusion from CT signs.Methods:The CT performances of 60 patients with peritoneal effusion proved by pathology who were hospitalized from January 201 1 to December 2013 were retrospec-tively analyzed.Results:(1 )Little to medium amount of peritoneal effusion accounted for 91 .3% of all tuberculous cases(21 /23 );Medium to large amount of peritoneal effusion accounted for 91 .9% of all neoplastic cases(33 /37)There was a significant difference between the groups.(2)In terms of CT value,78.3% of all cases were greater than 20 Hu (18 /23);In terms of CT value,81 .1 % of all cases were less than 20 Hu(30 /37);There was a significant difference between the groups.(3)Thickened peritoneum accounted for 74.0% of all tuberculous peritoneal effusion cases(17 /23);The irregular or tubercular thickening of peritoneum with no or little en-hancement accounted for 78.4% of all neoplastic peritoneal effusion cases (29 /37 );There was a significant difference between the groups.(4)The mass-like or smudged change of omentum and mesentery accounted for 74.0% of all tuberculous peritoneal effusion ca-ses(17 /23);The omentum change with pancake thickening and serious adhesion accounted for 73.0% of all neoplastic peritoneal effu-sion cases(27 /37);There was a significant difference between the groups.(5)The percentages of lymph nodes with ring-like enhance-ment and calcification in the mesenter to tuberculous peritoneal effusion cases were 47.8%(1 1 /23)and 56.5%(13 /23)respectively. In the same way,their percentages to neoplastic peritoneal effusion were 8.1 %(3 /37)and 5.4%(2 /37)respectively;there was a sig-nificant difference between the groups.(6)The floatation or aggregation of intestina accounted for 69.6% of all tuberculous peritoneal effusion cases(16 /23);The radial distribution of intestina accounted for 45.9% of all neoplastic peritoneal effusion cases(17 /37 ). There was a significant difference between the groups

  3. Pancreatic Extra-Gastrointestinal Stromal Tumor: An Unusual Presentation of a Rare Diagnosis

    Science.gov (United States)

    Joshi, Jitesh; Rustagi, Tarun

    2010-01-01

    Background: Gastrointestinal stromal tumors (GISTs) rarely develop outside the digestive tract and such tumors are designated extra-GISTs (EGISTs). The majority of EGISTs are located in the mesentery, omentum, and retroperitoneum, and the primary localization in the pancreas has been reported in only about six cases. We describe a patient with a large metastatic pancreatic EGIST that had metastasized to the liver at time of presentation. Case: An 84-year-old male presented with worsening confusion and agitation for the past few days. He also reported progressively increasing abdominal distension for the past 3 years, more so in the past few months. He denied any abdominal pain, nausea, or vomiting. He mentioned one episode of melena 2 months ago. There was a history of unintentional weight loss of 30 pounds over the past few months. Review of systems was otherwise negative. Past medical history was significant for diabetes mellitus and lactose intolerance. Pertinent examination findings included a cachectic appearance, altered mentation without any focal neurologic deficit, and marked abdominal distension with dullness on percussion. Investigations were significant for elevated ammonia level (168 ug/dL), AST/ALT/Alk. phosphatase (424/153/102 U/L), and total bilirubin of 1.7 mg/dL. CEA and CA19-9 were within normal limits. Computed tomography (CT) scan of the abdomen showed an extremely large central heterogeneous mass of 34 × 24 × 27 cm replacing the entire pancreatic tissue and multiple hepatic metastases. Subsequently, a CT-guided liver biopsy demonstrated a spindle cell neoplasm with CD117 (c-kit), CD34, and vimentin-positive cells, consistent with liver metastasis from an EGIST. On day 3, he had massive hematemesis, for which he was transferred to the intensive care unit. His condition rapidly deteriorated with hemodynamic instability and further worsening of mental status. After a thorough discussion about treatment options and prognosis, his family

  4. Repair of bile duct defect with degradable stent and autologous tissue in a porcine model

    Institute of Scientific and Technical Information of China (English)

    Yue-Long Liang; Yi-Chen Yu; Kun Liu; Wei-Jia Wang; Jiang-Bo Ying; Yi-Fan Wang; Xiu-Jun Cai

    2012-01-01

    AIM:To introduce and evaluate a new method to repair bile duct defect with a degradable stent and autologous tissues.METHODS:Eight Ba-Ma mini-pigs were used in this study.Experimental models with common bile duct (CBD) defect (0.5-1.0 cm segment of CBD resected) were established and then CBD was reconstructed by duct to duct anastomosis with a novel degradable stent made of poly [sebacic acid-co-(1,3-propanediol)-co-(1,2-propanediol)].In addition,a vascularized greater omentum was placed around the stent and both ends of CBD.Cholangiography via gall bladder was performed for each pig at postoperative months 1 and 3 to rule out stent translocation and bile duct stricture.Complete blood count was examined pre-and post-operatively to estimate the inflammatory reaction.Liver enzymes and serum bilirubin were examined pre-and post-operatively to evaluate the liver function.Five pigs were sacrificed at month 3 to evaluate the healing of anastomosis.The other three pigs were raised for one year for long-term observation.RESULTS:All the animals underwent surgery successfully.There was no intraoperative mortality and no bile leakage during the observation period.The white blood cell counts were only slightly increased on day 14 and month 3 postoperatively compared with that before operation,the difference was not statistically significant (P =0.652).The plasma level of alanine aminotransferase on day 14 and month 3 postoperatively was also not significantly elevated compared with that before operation (P =0.810).Nevertheless,the plasma level of γ-glutamyl transferase was increased after operation in both groups (P =0.004),especially 2 wk after operation.The level of serum total bilirubin after operation was not significantly elevated compared with that before operation (P =0.227),so did the serum direct bilirubin (P =0.759).By cholangiography via gall bladder,we found that the stent maintained its integrity of shape and was still in situ at month 1,and it disappeared

  5. Misdiagnosis Analysis of Female Pelvic Tuberculosis(A Report of 60 Cases)%盆腔结核60例误诊原因分析

    Institute of Scientific and Technical Information of China (English)

    颜为红; 陈葵喜; 马超

    2011-01-01

    medium to mass seroperitoneum in 24 patients, abnormal solid or spina bifida cystica in adnexa region or cavitas pelvis in 56 patients,nodose abnormal thickening in greater omentum, peritoneum, and mesentery in 14 patients, and lymphadenovarix behind peritoneum in 8 patients. 22 cases were misdiagnosed as malignancy with extensive intrapelvic metastasis. All the patients were diagnosed as pelvic tuberculosis by pathology after surgery. Conclusion Pelvic tuberculosis has slow pathogenesis and atypical clinical manifestations. Paracentesis under type-B ultrasonic and laparoscopy can avoid misdiagnosis of tuberculosis.

  6. Value of High-frequency Color Doppler Ultrasound in Diagnosis of Inguinal Hernia in Senile Men%高频彩色多普勒超声在诊断老年性腹股沟疝中的价值

    Institute of Scientific and Technical Information of China (English)

    王福明; 衷爱华; 郭金强

    2011-01-01

    目的 探讨高频彩色多普勒超声(高频彩超)在诊断老年性腹股沟疝中的价值.方法 回顾性分析80例老年性腹股沟疝的高频彩超检查的影像资料,观察疝囊内容物及血流显示,并结合临床按照疝囊颈部内径对腹股沟疝进行分型描述.结果 以腹壁下动脉作为标志,确定腹壁下动脉与疝囊颈的关系,鉴别腹股沟的斜疝、直疝.腹股沟疝的声像表现:在腹股沟区探及由疝囊和内容物组成的混合性包块回声,疝囊口与腹腔相通,当内容物为肠管可表现为肠管壁、肠腔气体及肠腔内容物回声;当内容物为大网膜时可表现为簇状杂乱回声团或筛网状回声光团.疝囊内容物彩色多普勒血流显示:易复性疝显示红、蓝条状或点状较多血流信号;难复性和嵌顿疝血流显示减少,呈散在棒状或星点状血流信号;绞窄性疝显示无血流或少许星点状血流信号.结论 高频彩超可作为老年性腹股沟疝诊断的首选检查方法.%Objective To investigate the value of high-frequency color Doppler ultrasound in the diagnosis of inguinal hernia in senile men. Methods Image data of high-frequency color Doppler ultrasound examination were analyzed retrospectively in 80 elderly patients with inguinal hernia,and hernial contents and blood flow were observed. The hernia was classified according to the diameter of internal hernial ring and the clinical symptoms. Results Considering the inferior epigastric artery as a reference,the relation between inferior epigastric artery and hernia sac neck was revealed,and direct and indirect inguinal hernias were identified. On ultrasound images,inguinal hernia was represented by echoes of hernial sac and contents in the inguinal region. Since hernial sac opening was connected to abdominal cavity,when the contents were intestine,the intestine walls,gas and the other contents produced ultrasound echoes. When the contents were the great omentum

  7. 腹膜假性黏液瘤多层螺旋CT表现及鉴别诊断%Multislice spiral CT manifestations and differential diagnosis of pseudomyxoma peritonei

    Institute of Scientific and Technical Information of China (English)

    蒲红; 刘登平; 王娜; 彭泽华; 白林; 陈加源; 蒋瑾

    2013-01-01

    Objective To investigate the CT manifestations of pseudomyxoma peritonei and raise the diagnosis and differential diagnosis of this disease. Methods 12 cases of pseudomyxoma peritonei confirmed by surgery and pathology were collected. Enhanced scans were performed in twelve patients by multi-slice spiral CT before operation. The CT manifestations were reviewed and analyzed. Results In 12 cases, the lesion of ovarian and appendix were main primary lesion in 11 cases,the lesion of colon in 1 case. CT manifestations including: (1 )①ascites were found in 8 cases which density was slightly higher than water, and uniformity, with line compartmentation; ②abdominal cavity, pelvic organs peripheral scallopings were seen in 8 cases, which outline was clear,and the organs were not encroached straightly;③the cystiform masses in the celiac and pelvic were demonstrated in 4 cases, which density was uniformity and slightly higher than water, with the edge enhancement after enhanced , and the wall thickness was uniform or heterogeneous; ④ infiltrative changes in the mesentery and omentum and peritoneum were seen in 6 cases which manifestated diffuse irregular thickening with a reticulation or node or pie lesson, adjacent bowel compression and displacement; ⑤spot or node calcifications in the local of lesion were appeared in 3 cases;⑥the lesions of cystiform and mass in ovarian and appendix were found in 4 cases. Conclusion On CT examination, this lesion have some features, which is very valuable to the diagnosis and differential diagnosis of pseudomyxoma peritonei.%目的 探讨腹膜假性黏液瘤的多层螺旋CT表现及鉴别诊断,提高对本病的认识.方法 收集本院经手术及病理证实的腹膜假性黏液瘤病例12例,全部病例术前均行腹部多层螺旋CT扫描,回顾分析其CT影像表现.结果 12例中,11例原发病变为阑尾及卵巢病变,1例为结肠病变.CT表现包括:(1)腹水,密度较高,其内密度不

  8. Peritonitis granulomatosa por el almidón en guantes quirúrgicos Granulomatous peritonitis due to the starch used in surgical gloves

    Directory of Open Access Journals (Sweden)

    Ignacio Juaneda

    2008-06-01

    Full Text Available La peritonitis granulomatosa por almidón de guantes quirúrgicos es una entidad de difícil diagnóstico y escasa incidencia. Los pacientes presentan dolor abdominal, fiebre e íleo funcional prolongado tres a cuatro semanas después de una laparotomía con empleo de guantes lubricados con almidón de maíz. En la exploración quirúrgica se evidencia peritoneo y epiplón con múltiples nódulos pequeños blanquecinos y líquido libre inflamatorio. La anatomía patológica muestra tejido inflamatorio con células gigantes multinucleadas englobando material birrefringente, compatibles con cristales de polvo de guantes. Mediante luz polarizada se evidencia el típico patrón en cruz de malta del almidón de maíz. Presentamos el caso de una mujer de 54 años con dolor abdominal, fiebre e íleo funcional inusualmente prolongado. Se realizó histerectomía convencional tres meses antes. Al ingreso se realizó videolaparoscopía exploradora, en la cual se perforó accidentalmente el yeyuno distal lo cual requirió laparotomía para enterorrafia. Un mes después fue relaparotomizada debido a la persistencia de íleo, evidenciándose peritonitis granulomatosa por almidón que confirmó la anatomía patológica. Recibió hidrocortisona endovenosa durante dos semanas y prednisona vía oral durante 4 semanas con disminución gradual hasta su suspensión. La paciente permanece asintomática a siete meses del postoperatorio. El tratamiento con corticoesteroides es una opción eficaz. La prevención es clave y radica en el uso de guantes quirúrgicos libres de almidón.Granulomatous peritonitis due to surgical glove starch is an entity of difficult diagnosis and low incidence. Patients present with abdominal pain, fever and prolonged functional ileus three to four weeks postoperatory of a laparotomy where corn starch as glove's lubricant had been used. In surgical re-exploration both the peritoneum and omentum are widely affected with multiple small white

  9. Ultrasound diagnostics ofbowel diseases in adults

    Directory of Open Access Journals (Sweden)

    Andrzej Smereczyński

    2015-06-01

    Full Text Available Ultrasonography is the first step in the diagnosis of acute and chronic diseases of the abdominal cavity by imaging methods. In an increasing number of cases ultrasound examination is used to diagnose lesions located in the intestines, which beside the mesenteries and the omentum are an important part of the abdomen. The aim of this overview paper is to present the current possibilities of ultrasonography in the assessment of pathologies of the gastrointestinal tract. Currently it is possible to present the anatomy of the intestinal wall, vascular network and the surrounding tissue with a great precision, even through transabdominal access. It is facilitated by digital sonograms, especially using harmonic imaging, spatial and XRES imaging as well as variable transducer pressure. Even better results can be obtained using endoscopic ultrasound, which can be equipped with a Doppler blood flow imaging facility and elastography. In addition, endoscopic ultrasound can be used to guide the collection of material for cytology or pathomorphology examination and the performance of various medical procedures. Over the recent years the diagnostic value of ultrasound increased following the introduction of intestinal hydrosonography and ultrasound contrast media, which also work very well in fistulography. Therefore, it is not surprising that ultrasonography used by an experienced practitioner makes it possible to diagnose the vast majority of intestinal pathologies and their complications as well as the results of the treatment applied. This is especially applicable to infectious, inflammatory, ischaemic and various neoplastic diseases. In the case of neoplastic lesions the stage of local advancement of the process can be determined, especially using endosonography. In a transabdominal examination this method achieves high efficacy in the diagnosis of acute appendicitis and in diverticulitis of

  10. 小儿炎性成肌纤维细胞瘤的CT表现%CT features of inflammatory myofibroblastic tumor in children

    Institute of Scientific and Technical Information of China (English)

    段晓岷; 程华; 周春菊; 韩忠龙; 曾津津; 孙国强

    2011-01-01

    Objective To investigate the CT features of inflammatory myofibroblastic tumor in children. Methods Eighteen patients with inflammatory myofibroblastic tumor proven by surgery and pathology were examined with plain and contrast medium enhancement CT scan. Results Of 18 cases,16 had isolated lesions located at lung (n =4), mesentery (n =3), kidney (n =2) and trachea (n = 1 ),left main bronchus ( n = 1 ), right thoracic cavity ( n = 1 ), peritoneum cavity ( n = 1 ), pancreas ( n = 1 ),left thigh ( n = 1 ), prostate ( n = 1 ), superclvicle soft t tissue ( n = 1 ) , bladder ( n = 1 ). The other 2 cases were with multiple lesions on omentum and mesentery, and in intraperitoneal and side of split of right hepatic lobe, respectively. The CT findings of 18 cases included 16 solid mass with calcifications in 3 of them, and 2 solid-cystic mass. After contrast enhancement, moderate or marked homogeneous or heterogeneous enhancement were shown in all the solid parts of tumor on dynamic CT. Mass can compress surround great vessel and tube-like structure. On pathological examination, the tumor was mainly composed of spindleshaped fibrous cells and inflammatory cells, and the immunohistochemically staining for SMA was observed positively. Conclusion CT can provide specific information for diagnosis of inflammatory myofibroblastic tumor, yet definite diagnosis relies on pathology.%目的 探讨小儿炎性成肌纤维细胞瘤(IMT)的CT表现.方法 搜集经手术病理证实的18例IMT,所有病例均行CT平扫及增强扫描.结果 18例中单发16例,分别位于肺组织4例,大网膜2例,肾脏2例,气管、左主支气管、右侧胸膜、胰腺、左大腿肌层、前列腺、右锁骨上窝、膀胱各1例;多发2例,位于大网膜和空肠系膜1例,位于腹腔内及肝右叶肝裂旁1例.CT表现为实性肿块16例,其中3例合并钙化,囊实性肿块2例.增强扫描显示实性瘤体呈外周中度强化,中心部分轻度强化8例,轮辐状强化2

  11. 多层螺旋 CT 小肠造影在诊断肠结核与克罗恩病中的价值研究%Diagnostic value of multi-slice CT enterography in Crohn’s disease and intestinal tuberculosis

    Institute of Scientific and Technical Information of China (English)

    徐莹; 余晨; 陈业媛; 肖香佐; 龚洪翰

    2015-01-01

    Objective To investigate the application value of multi-slice CT enterography (MSCTE)in diagnosing intestinal tuberculosis (ITB)and Crohn’s disease (CD).Methods MSCTE findings were retrospectively analyzed in 25 patients with ITB and in other 25 patients with CD diagnosed through endoscopy,pathologic examination and clinical follow-up.Statistical analysis was performed to find out the difference in CT findings between the ITB and CD.Results 25 patients with CD included the involved ileum in 23,involved duode-num and jejunum in 8,multiple segmental lesions in 20,asymmetrically thickened intestinal wall in 20,hierarchical reinforcement in 1 9,mesenteric vascular hyperplasia in 20,fibrofatty hyperplasia in 18,peritoneal abscess or fistula in 8,anal fistula in 1,and pseu-do-diverticulum formation in the intestinal wall on the opposite side of the mesentery in 2.Meanwhile,the other 25 patients with ITB included the involved terminal ileum in 25,symmetrically thickened intestinal wall in 23,annular enhancement of lymph nodes in 11,thickened peritoneum and omentum together with distinct enhancement,or intestinal adhesion,or ascites appeared in 15.The CD was more likely to represent multiple segmental lesions,asymmetrically thickened intestinal wall,hierarchical reinforcement,mesenteric vascular hyperplasia,fibrofatty hyperplasia,and peritoneal abscess or fistula formation (P <0.05).Meanwhile,the ITB was more likely to represent the lesion only in ileum,symmetrically thickened intestinal wall,and annular enhancement of lymph nodes (P <0.05).Conclusion MSCTE shows promising clinical application in diagnosis and differential diagnosis of CD and ITB.%目的:探讨多层螺旋 CT 小肠造影(MSCTE)在肠结核(ITB)、克罗恩病(CD)诊断中的应用价值。方法回顾性分析经内镜、病理或临床随访证实的 ITB、CD 各25例的 MSCTE 影像表现,并对两者间的差异进行统计学分析。结果25例 CD 中,病变累及回肠23

  12. Restauração do diafragma de felino com enxerto autólogo de pericárdio Reconstruction of feline diaphragm with autologous pericardium graft

    Directory of Open Access Journals (Sweden)

    Saulo Tadeu Lemos Pinto Filho

    2003-10-01

    macroscopic observation and sample collection for histological evaluation. RESULTS: Partial substitution of the pericardium was observed 30 days postoperatively, and total substituition 60 days after surgery allowing the complete reestablishment of the diaphragm. Macroscopically, presence of adherence with the lung and parietal pleura and the graft was verified in the thoracic cavity, and with the liver and omentum in the abdominal cavity, however, with no clinical consequences of the involved structures. CONCLUSION: The autograft in felines can be used to repair diaphragmatic defects, once it supports the gradient of pressure of the diaphragm and it is substituted by connective tissue, without presenting clinical and histological signs of rejection.

  13. Cirurgias conservadoras do baço para tratamento da doença de Gaucher Partial splenectomy in the treatment of Gaucher's disease

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    Andy Petroianu

    2004-03-01

    , have been treated by partial splenectomy. However, the splenic remnant, vascularized by the hilar vessels, may enlarge leading to recurrent splenomegaly and all its adverse effects. More than eighteen years of experience treating portal hypertension, splenic trauma, myeloid splenomegaly, splenomegalic somatic and sexual hypodevelopment, chronic lymphocytic lymphoma and cystadenoma of pancreatic tail by subtotal splenectomy, maintaining the upper pole supplied only by the splenogastric vessels showed that the splenic remnant does not increase its size. Based on evidence that the hilar vessels may contribute to the increase of the splenic remnant, we performed in five cases with Gaucher's disease subtotal splenectomy, maintaining the upper pole supplied only by the splenogastric vessels. The splenic remnant did not modify in size during a postoperative follow-up of more than twelve years, and the hematological parameters remained normal. Another patient whose splenogastric vessels were insufficient to maintain the upper splenic pole, was submitted to total splenectomy and autologous splenic tissue transplantation on the greater omentum. The autotransplant survived and presented with function. All six patients had uneventful postoperative follow-up in relation to the splenic conservative procedure. In conclusion, in presence of giant splenomegaly with severe hematologic and clinical symptoms the spleen must be resected in a conservative fashion such as subtotal splenectomy or total splenectomy followed by autotransplants of splenic tissue.

  14. [Third National Ovarian Consensus. 2011. Grupo de Investigación en Cáncer de Ovario y Tumores Ginecológicos de México "GICOM"].

    Science.gov (United States)

    Gallardo-Rincón, Dolores; Cantú-de-León, David; Alanís-López, Patricia; Alvarez-Avitia, Miguel Angel; Bañuelos-Flores, Joel; Herbert-Núñez, Guillermo Sidney; Oñate-Ocaña, Luis Fernando; Pérez-Montiel, María Delia; Rodríguez-Trejo, Amelia; Ruvalcaba-Limón, Eva; Serrano-Olvera, Alberto; Ortega-Rojo, Andrea; Cortés-Esteban, Patricia; Erazo-Valle, Aura; Gerson-Cwilich, Raquel; De-la-Garza-Salazar, Jaime; Green-Renner, Dan; León-Rodríguez, Eucario; Morales-Vásquez, Flavia; Poveda-Velasco, Andrés; Aguilar-Ponce, José Luis; Alva-López, Luis Felipe; Alvarado-Aguilar, Salvador; Alvarado-Cabrero, Isabel; Aquino-Mendoza, Cinthia Alejandra; Aranda-Flores, Carlos Eduardo; Bandera-Delgado, Artfy; Barragán-Curiel, Eduardo; Barrón-Rodríguez, Patricia; Brom-Valladares, Rocío; Cabrera-Galeana, Paula Anel; Calderillo-Ruiz, Germán; Camacho-Gutiérrez, Salvador; Capdeville-García, Daniel; Cárdenas-Sánchez, Jesús; Carlón-Zárate, Elisa; Carrillo-Garibaldi, Oscar; Castorena-Roji, Gerardo; Cervantes-Sánchez, Guadalupe; Coronel-Martínez, Jaime Alberto; Chanona-Vilchis, José Gregorio; Díaz-Hernández, Verónica; Escudero-de-los Ríos, Pedro; Garibay-Cerdenares, Olga; Gómez-García, Eva; Herrera-Montalvo, Luis Alonso; Hinojosa-García, Luz María; Isla-Ortiz, David; Jiménez-López, Josefina; Lavín-Lozano, Arturo Javier; Limón-Rodriguez, Jesús Alberto; López-Basave, Horacio Noé; López-García, Sergio César; Maffuz-Aziz, Antonio; Martínez-Cedillo, Jorge; Martínez-López, Dulce María; Medina-Castro, Juan Manuel; Melo-Martínez, Carlos; Méndez-Herrera, Carmen; Montalvo-Esquivel, Gonzalo; Morales-Palomares, Miguel Angel; Morán-Mendoza, Andrés; Morgan-Villela, Gilberto; Mota-García, Aída; Muñoz-González, David Eduardo; Ochoa-Carrillo, Francisco J; Pérez-Amador, Maricruz; Recinos-Money, Edgar; Rivera-Rivera, Samuel; Robles Flores, Juan U; Rojas-Castillo, Edith; Rojas-Marín, Carlos; Salas-Gonzáles, Efraín; Sámano-Nateras, Liliana; Santibañez-Andrade, Miguel; Santillán-Gómez, Antonio; Silva-García, Araceli; Silva, Juan Alejandro; Solorza-Luna, Gilberto; Tabarez-Ortiz, Adán Raúl; Talamás-Rohana, Patricia; Tirado-Gómez, Laura Leticia; Torres-Lobatón, Alfonso; Quijano-Castro, Félix

    2011-01-01

    be performed in certain cases, the procedure should include a detailed inspection of the contralateral ovary and also negative for malignancy omentum and ovary biopsy. Until now, laparoscopy for diagnostic-staging surgery is not well known as a recommended method. The recommended chemotherapy is based on platin and taxanes for 6 cycles, except in Stage IA, IB and grade 1, which have a good prognosis. In advanced stages, primary cytoreduction is recommended as initial treatment. Minimal invasion surgery is not a recommended procedure for the treatment of advanced ovarian cancer. Radiotherapy can be used to palliate symptoms. Follow up of the patients every 2-4 months for 2 years, every 3-6 months for 3 years and anually after the 5th year is recommended. Evaluation of quality of life of the patient must be done periodically. In the present, there is not a standardized screening method. Diagnosis in early stages means a better survival. Standardized treatment includes primary surgery with the objective to perform an optimal cytoreduction followed by chemotherapy Treatment must be individualized according to each patient. Radiotherapy can be indicated to palliate symptoms.

  15. Efeito da secção hepática parcial e omentoplastia na regeneração hepática de cão Effect of partial hepatic section and omentoplasty on liver regeneration in the dog

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    Andy Petroianu

    1999-06-01

    sodium pentobarbital anesthesia ( 10mg/kg, the animals were submitted to a 2.5 cm deep and 8 cm long incision of the left liver lobe. The dogs were divided into three groups: 1- without repair (control; II- only hepatic suture; III- hepatic suture and omentoplasty. The two repairs were performed with 4-0 chromic catgut thread. All animals of group I died during the early postoperative period. The dogs of the groups II and III supported the 28 day-follow-up without problem. At the relaparotomy of the groups II and III multiple adhesions to an aparently normal liver were found. In the Group III, the omentum introduced in the hepatic wound was expulsed and remained attached to the liver capsule. At microscopy, it was observed discontinuity of vessels and biliary ducts at the leveI of liver scar; the intensity of inflammatory phenomenon was more important in the Group III. Little sections of omental tissue were found inside the parenchima. In conclusion the omentoplasty helped the liver suture, but did not prevent the interruption of vessels and bile ducts.

  16. Reação peritoneal tardia ao calculo biliar humano, de colesterol, deixado na cavidade abdominal de ratos Late peritoneal reaction to human cholesterol gallstone left into abdominal cavity of rats

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    Luiz Carlos Bertges

    1999-08-01

    and E and were involved in a transparent tissue or blocked by omentum and intestinal loops. The rat used as a pilot in group E had a sub- intestinal occlusion and the gallstone was not found after 5 months. We supposed that it migrated to into the bowel. Histopathology did not showed any alteration in groups A and B but showed fibrosis. inflamatory cells, hemossiderin, calcifications and a foreign body like reaction in groups C, D and E (except the pilot rat. It was concluded that gallstones were not absorbed and a foreign body like reaction appeared. The gallstones were involved with fibrosis and inflamatory cells.

  17. Doença de Crohn isolada do apêndice cecal como causa de enterorragia Crohn’s disease isolated of the appendix as a source of enterorrhagia

    Directory of Open Access Journals (Sweden)

    Sizenando Ernesto de Lima Jr.

    2004-03-01

    physical examination there are signs of peritoneal irritation and an abdominal mass is palpable in the right iliac fossa. AIMS: To report a case of Crohn’s disease confined to the appendix and presenting with enterorrhagia. The source of the bleeding was localized by colonoscopy. PATIENT: A 16-year old caucasian male without past history of gastrointestinal symptoms, presented with two episodes of enterorrhagia within a period of one year. In the second episode colonoscopy identified the appendicular ostium as the source of bleeding. RESULTS: At operation the cecum and terminal ileum were normal in thickness and texture, and an inflammatory appendix adherent to the omentum was removed. Microscopically there were non-caseating granulomas, intense infiltration of the wall with plasma cells, lymphocytes and macrophages. The patient has not suffered recurrence, and a colonoscopy realized 2 years after the operation did not show signs of Crohn’s disease. CONCLUSION: This case, like others in the literature, appendectomy is curative, but a 5-year follow-up is mandatory. When a young patient presents with enterorrhagia, this diagnosis has to be considered.

  18. Low-GDP peritoneal dialysis fluid ('balance') has less impact in vitro and ex vivo on epithelial-to-mesenchymal transition (EMT) of mesothelial cells than a standard fluid.

    Science.gov (United States)

    Bajo, María Auxiliadora; Pérez-Lozano, María Luisa; Albar-Vizcaino, Patricia; del Peso, Gloria; Castro, María-José; Gonzalez-Mateo, Guadalupe; Fernández-Perpén, Antonio; Aguilera, Abelardo; Sánchez-Villanueva, Rafael; Sánchez-Tomero, J Antonio; López-Cabrera, Manuel; Peter, Mirjam E; Passlick-Deetjen, Jutta; Selgas, Rafael

    2011-01-01

    Peritoneal membrane deterioration during peritoneal dialysis (PD) is associated with epithelial-to-mesenchymal transition (EMT) of mesothelial cells (MC), which is believed to be mainly due to glucose degradation products (GDPs) present in PD solutions. Here we investigate the impact of GDPs in PD solutions on the EMT of MC in vitro and ex vivo. For in vitro studies, omentum-derived MC were incubated with standard PD fluid or low-GDP solution diluted 1:1 with culture medium. For ex vivo studies, 33 patients, who were distributed at random to either the 'standard' or the 'low GDP' groups, were followed over 24 months. Effluents were collected every 6 months to determine EMT markers in effluent MC. Exposure of MC to standard fluid in vitro resulted in morphological change into a non-epitheloid shape, down-regulation of E-cadherin, indicative of EMT, and in a strong induction of vascular endothelial growth factor (VEGF) expression. In contrast, in vitro exposure of MC to low-GDP solution did not lead to these phenotype changes. This could be confirmed ex vivo, as the prevalence of non-epitheloid phenotype of MC in the standard group was significantly higher with increasing PD duration and MC isolated from this group showed significantly higher levels of EMT-associated molecules including fibronectin, collagen I, VEGF, IL-8 and TGF-β levels when compared with the low-GDP group. Over time, the expression of E-cadherin also decreased in the standard but increased in the low-GDP group. In addition, the levels of EMT-associated molecules (fibronectin, VEGF and IL-8) increased in the standard but decreased in the low-GDP group. A similar trend was also observed for collagen I and for TGF-β (for the first year), but did not reach global statistical significance. Accordingly, effluent MC with non-epitheloid morphology showed significantly lower levels of E-cadherin and greater levels of fibronectin, collagen I, VEGF and IL 8 when compared with MC with epitheloid phenotype

  19. Value of 18 F-FDG PET/CT imaging in the differential diagnosis of tuberculosis and cancerous diffuse peritoneal lesions%结核性与肿瘤性腹膜弥漫性病变的18 F-FDG PET/CT 鉴别诊断价值

    Institute of Scientific and Technical Information of China (English)

    尹亮; 林志春; 岳建兰; 陈薇; 黄世明

    2016-01-01

    OBJECTIVE There was certain difficulty in differential diagnosing of tuberculous and cancerous diffuse peritoneal lesions in clinical.We discussed the value of 18 F-FDG PET/CT imaging in the differential diagnosing of them through analyzing the 18 F-FDG PET/CT features.METHODS The 18 F-FDG PET/CT features of 12 tuberculosis perito-nitis,22 PM,16 PSPCP and 4 DPM were retrospectively reviewed,which had been confirmed by clinic or histopathology. Four indicators were observed:(1)18 F-FDG PET/CT features of parietal peritoneum,greater omentum and mesentery,in-cluding peritoneal metabolism and thickening;(2)features of ascites;(3)changes of lymph nodes and metastatic lesions;(4)accompanying signs of others.The statistical analysis was used to differentiate the 18 F-FDG uptake of peritoneal le-sions,the density of ascites and the degree of 18 F-FDG uptake between tuberculosis peritonitis and cancerous peritonitis, and the statistical description of situation of lymph nodes and metastases were done.RESULTS The parietal peritoneum was given priority to with smooth peritoneal thickening and irregular nodular thickening of TBP and cancerous diffuse peritoneal lesions,respectively,there were statistical differences between them (χ2 =7.509,P =0.006).The greater o-mentum was given priority to with stains-like change and nodules and pie-shape changes of TBP and cancerous diffuse per-itoneal lesions,respectively,there were statistical differences between them (χ2 =8.447,P =0.015).The typical features of mesentery of TBP and cancerous diffuse peritoneal lesions were stains like change and irregular nodular thickening,re-spectively,but the difference was not statistically significant (χ2 =1.199,P =0.274).FDG uptake was increased in all peritoneal lesions,and the tuberculosis group was lower than that of the cancerous group (10.7±4.2 and 14.7±5.7,re-spectively),the differences were significant (t=-2.252,P =0.029).The density of malignant ascites was obviously low-er than that

  20. 脐疝嵌顿伴肝硬化腹水15例的治疗体会%Incarcerated umbilical hernia complicated with cirrhotic ascites in 15 cases

    Institute of Scientific and Technical Information of China (English)

    费阳; 李基业

    2009-01-01

    Objective To summarize the experience in the management of incarcerated umbilical hernia in cirrhotic patients with aseites. Methods The operative methods, perioperative management and fellow-up data of 15 patients diagnosed incarcerated umbilical hernia in the setting of cirrhosis and ascites were studied retrospectively. All the patients underwent emergency operation to remove necrotic umbilical skin and hernial content, including incarcerated greater omentum (6 cases) and strangulated segment of small bowel (5 cases). After debriding the operating field thoroughly, the umbilical hernia was repaired with polypropylene mesh, among those Sublay repair was used in 11 cases with the longest diameter of hernial ring more than 3 cm and Onlay repair in 4 cases with the longest diameter of hernial ring less than 3 cm. During the perioperative period, albumin and fresh frozen plasma transfusion, as well as diuresis and ascites paracentesis, was adopted to treat eirrhosis and ascites. Results All the patients underwent operation successfully. The operative time was 90~185 min, averaging at 122 min. Seroma formation in 2 cases and incision infection in one were cured with conservative therapy. One patient died of multiple organ dysfunction after the operation. During the fellow-up of 1~5 years, 1 patient died of liver function failure and there was no hernia recurrence. Conclusion With appropriate perioperative management and correct operative method, polypropylene mesh could be adopted in the emergency repair operation of incarerated umbilical hernia in the setting of cirrhosis and ascites.%目的 总结对肝硬化腹水患者之嵌顿性脐疝的治疗经验.方法 回顾性分析2002年6月至2007年6月收治的嵌顿性脐疝伴肝硬化腹水15例患者的手术方法、围手术期处理及随访资料.15例患者均行急诊手术,11例因脐部皮肤坏死而行局部皮肤切除,探查疝内容物后发现11例疝内容物坏死,

  1. 单孔腹腔镜治疗小儿腹股沟嵌顿斜疝的探讨%Single-port Laparoscopic Surgery for Incarcerated Indirect Inguinal Hernia in Children

    Institute of Scientific and Technical Information of China (English)

    张军; 葛军涛; 魏延栋; 刘树立; 李龙

    2014-01-01

    Objective To explore the value of single-port laparoscopic surgery in the treatment of incarcerated indirect inguinal hernia in children . Methods From March to September 2013, a total of 48 cases of incarcerated indirect inguinal hernia were treated by single-hole laparoscopic surgery .Preoperative diagnosis of hernia was right sided in 32 cases and left sided in 16 cases. Via an umbilical incision , one trocar was inserted to establish the pneumoperitoneum .A Z-shaped laparoscope was introduced from the umbilicus, accompanying with a no-damage clamp to explore the lesion and extend of incarceration .If the incarcerated organs were not necrosed , the high ligation of hernial sac was performed .Intraoperatively , contralateral side was explored for finding concealed hernia . Results The single-hole laparoscopic surgery was successfully completed in all the cases .Intraoperative exploration found 10 cases of concealed contralateral hernia .Incarcerated hernia contents included bowel in 36 cases, ovaries in 8 cases, and omentum in 4 cases. All the incarcerations were successfully restored by manual reduction assistance .After observation for 5 minutes, the incarcerated organ had good blood flow in all the 48 cases.The operation time was 10-18 minutes (mean, 15 minutes) for unilateral hernia (in 38 cases) and 16-30 minutes (mean, 24 minutes) for bilateral hernia(in 10 cases).All the children began to diet after awake from anesthesia.No postoperative pain was observed .The patients were discharged from hospital at 10-15 postoperative hours (mean, 12 hours).The follow-up time was 3 -13 months.There were no postoperative wound infection , scrotal edema, or hematoma.No recurrence or other complications occurred . Conclusions Single-port laparoscopy for incarcerated inguinal hernia in children has advantages of preservation of anatomy of the inguinal canal , easy to perform high ligation of hernial sac , and simultaneous reduction under direct visual control .It is a safe

  2. 单切口腹腔镜治疗儿童腹股沟嵌顿斜疝121例%Single-incision laparoscopic technique for incarcerated inguinal hernia in children

    Institute of Scientific and Technical Information of China (English)

    张军; 魏延栋; 杨轩; 刘树立; 张金山; 李龙

    2014-01-01

    hernia contents and the degree of incarceration.Hernia was reduced with the help of external manual pressure.A laparoscopic high ligation of hernia sac would be performed when no incarcerated viscera injury was found.If existed,a contralateral occult hernia would be repaired simultaneously.Results All the operations were successfully completed. The contralateral occult hernia were detected in 34 cases. Incarcerated hernia contents included 90 cases of bowel,20 cases of ovarian,1 1 cases of omentum.After the successful assisted manipulative reduction,with 5 minutes of observation,the organ blood supply were good in all cases.Unilateral hernia (87 cases)took 9 to 1 5 minutes,mean 1 2 minutes;while 1 5 to 28 minutes in bilateral hernia (34 cases),mean 24 minutes.Children started on an oral diet after anesthesia awake,with a tolerable pain.All had discharge in mean of 1 2 hours after the operation.There was no postoperative wound infection,scrotal edema and hematoma.The follow-up was 1 to 1 5 months,no recurrence and other complications.Conclusion Single-incision laparoscopy for incarcerated inguinal hernia in children does not destroy the anatomical structure of inguinal canal,which can receive high ligation of hernia sac,explore with a direct-view in both hernia contents and contralateral groin area.Technically,it is safe,effective,and minimally invasive,is a worth promoting new technology.

  3. Congenital Morgagni's hernia in infants and children%婴儿和儿童胸骨后疝

    Institute of Scientific and Technical Information of China (English)

    金惠明; 吴晔明; 王俊

    2016-01-01

    .The hemial contents included transverse colon,small intestine,stomach,left hepatic lobe and omentum.All cases were operated via a transabdominal approach.Four early cases underwent open surgery while another 4 underwent laparoscopic-assisted operation.And 1 patient underwent simultaneous repair of right inguinal hernia.Among 4 patients with hernial sac,1 underwent excision.One patient with omphalocele and intestinal malrotation died postoperatively while the remainder recovered well postoperatively without recurrence during follow-ups.Conclusions As a rare type of congenital diaphragmatic hernia,CMH has diverse clinical manifestations with a high incidence of associated common anomalies,including congenital heart disease.A transabdominal approach is recommended for repairing.And laparoscopic-assisted operation should be a first choice.Comparing with an open approach,this less invasive procedure promotes faster postoperative recovery,allows earlier commencement of feeds,contributes to a shorter hospital stay and yields better cosmetic outcomes.

  4. Preliminary study on tolerance induction by combined xenotransplantation of rat thymus and metanephros anlagen%大鼠胚胎胸腺和后肾原基联合异种移植与诱导免疫耐受的初步研究

    Institute of Scientific and Technical Information of China (English)

    徐春岳; 徐剑; 姚水洪

    2012-01-01

    目的 将大鼠胚胎胸腺与后肾原基联合移植至无胸腺裸小鼠,探讨联合移植能否重建受体细胞免疫功能并诱导受者对异种供者器官的特异性免疫耐受的关系.方法 从受孕第15天(E15)的Lewis大鼠胚胎中提取胸腺、后肾原基,分别植入BALB/c裸小鼠腹腔右肾包膜下及大网膜内.移植后第10周,行胸腺、后肾移植物的形态学检查及移植后肾的功能检测;并进行外周血T淋巴细胞流式细胞学检测、单向混合淋巴细胞反应(MLR)及皮肤移植试验.结果 移植后第10周,移植胸腺及后肾形态发育良好.移植后肾显示一定的排泄功能,联合移植受体双肾切除后的生存时间明显延长(P<0.05).联合移植受体的外周血T淋巴细胞重建良好;其淋巴细胞对胸腺供体来源的Lewis大鼠脾细胞的刺激呈特异性低反应(P<0.01);且胸腺供体来源的大鼠移植皮片平均存活时间明显大于C57BL/6小鼠、BN大鼠移植皮片存活时间(P<0.01).结论 E15 Lewis大鼠胚胎胸腺、后肾原基联合移植至细胞免疫缺陷的裸小鼠,移植物可生长分化形成器官并发挥功能,受体裸小鼠能重建免疫功能,并有可能诱导对同源供体器官的特异性异种移植免疫耐受.%Objective To investigate whether the cellular immune function of athymia nude mice can be reestablished and whether the recipients' specific immune tolerance can be induced by the combined xenotransplantation of embryonic thymus and metanephros anlagen from rats to athymia nude mice.Methods Male and female rats were mated overnight.The presence of vaginal plaques was marked as the embryonic day 0(E0).The whole embryos from Lewis rats on embryonic day 15(E15) were taken for the present experiment.The Lewis E15 metanephros and thymus anlagen were taken out from the embryos and immediately preserved in normal saline at 4℃,and then were implanted into the omentum and renal capsule of nude mice.10 weeks post

  5. Colopexia incisional por celiotomia ou transparietal auxiliada por laparoscopia em cães Open or laparoscopic assisted transparietal colopexy in dogs

    Directory of Open Access Journals (Sweden)

    Maurício Veloso Brun

    2004-06-01

    melhores resultados.Two groups of dogs, GA (n=8 and GL (n=16 were used to compare the conventional and the transparietal laparsocopic assisted technique for colopexy and to compare with the conventional surgery. In the GA group, the colopexy was proceded by incisional technique trough celiotomy. In the GL group, the colopexy was performed using the transparietal laparoscopic assisted technique. The GL dogs were separated in four subgroups (S1, S2, S3 and S4 with four dogs each. In each subgroup a different stent was used, capton of infusion tube (S1; plastic disks made with NaCl solutions bottles (S2; disks made with rubber (S3 and silicone disks (S4. The time for complete surgery was statically higher in the GL group than GA. Seven GA dogs maintained the colopexy and all of these presented adherences of the omentum in the suture zone. In three GL animals, all of the S4 subgroup the colopexies were not maintained. In all dogs of this subgroup dermatitis and/or cellulites were observed. Best results were obtained in the S3 subgroup dogs. The main histological observations in the 14d-after surgery biopsies in GL animals were related to a higher connective tissue deposition at the colon adherence, and infiltration of this type of tissue into the associated musculature. In the 28d biopsies, no difference was found between groups. In both groups, the collagen fibers presented mature aspect. Concluding, the transparietal laparoscopic assisted technique is viable, however it’s associated with tissue lesions in the regions in contact with the material used to support the suture. The rubber disk presented better results.

  6. 儿童门静脉海绵样变性的多层螺旋CT研究%Spiral CT Diagnosis of Cavernous Transformation of the Portal Vein in Children

    Institute of Scientific and Technical Information of China (English)

    刘玥; 彭芸; 段晓珉; 曾津津; 孙国强

    2011-01-01

    Objective To investigate the value of 64-slice multi-detector computed tomography(MDCT) in the diagnosis of cavernous transformation of portal vein(CTPV) in children. Materials and Methods 22 patients were screened out by uhrasonography (US) at first,then received contrast enhanced CT scan(arterial and venous phase). Imaging data of CTPV were processed with CT reconstruction. All CT images were evaluated by two radiologists and a consensus was reached regarding liver parenchyma, portal vein and collateral circulation. Results In all 22 cases,the trunk and branches of portal vein of 14 eases(64% ) were broaden and circuitous with narrow intrahepatic portal vein. The congenital absence of portal vein were observed in 4 cases( 18% ) including 1 trunk and 3 left branch. Four cases( 18% )showed portal vein thrombosis including 1 tumor embolus and 3 thrombus. 22 cases of CTPV showed collateral veins, which were biliary collateral veins of the portal vein (n = 22,100% ), gallbladder vein (n = 16,73 % ), gastric collateral veins (n= 21,95 % ), pancreatieoduodehal region collateral veins(n =5,23% ) and parumbilical collateral veins (n = 1,5% ). The other forms of portal-systemic shunt collateral veins included spleen-gastric collateral veins,ascending lumbar vein-spleen vein and spleen-kidney vein( n = 18,82% ). Abnormal hepatic perfusion was detected in 3 cases. 11 cases(50% ) appeared disproportion of liver lobes,20 cases showed splenomegaly and 4 hepatomegaly. The other characteristic features included congenital anomaly of bile ducts (n = 1 ), thicken walls of gastrointestinal tract, mesentery and lesser omentum swelling( n = 5 ) and ascites/pleural fluid (n = 8). Conclusion MDCT is an effective method to diagnose CTPV and may be great helpful for clinical treatment.%目的 探讨64排螺旋CT在诊断儿童门静脉海绵样变性(cavernous transformation of the portal vein,CTPV)中的临床价值.资料与方法 22例CTPV患者

  7. 超声显像对创伤性脾破裂自体移植脾生长与存活的监测%Ultrasonic visualization of splenic autotransplant survival and growth following traumatic splenic rupture

    Institute of Scientific and Technical Information of China (English)

    李征毅; 李泉水; 张家庭; 张敏捷; 冯健; 刘伟宗

    2008-01-01

    study. METHODS: Non-injured autologous splenic tissue was prepared into thin sections with an area of(2-4)cm×(1-3)cm and a thickness of≤0.5 cm. And transplanted into the greater omentum with abundant vessels in patients undergoing splenectomy.A1118 patients received ultrasonography at 3,6,and 12 months after splenic transplantation, and were subjected to spleen imaging with99Tcm-heat damaged red blood cells. MAIN OUTCOME MEASURES: Nuclein examination of splenic autotransplant survival and growth. RESULTS: Splenic autotransplants survived and gradually grew in 14 of 18 patients. Splenic autotransplants exhibited low level echo similar to normal spleen, regular contour, clear boundary, and visible internal blood flow signal. Splenic autotransplants were not found growing in 4 patients with accessory spleen. CONCLUSION: Ultrasonography can precisely monitor splenic autotransplant survival and growth.

  8. Computed tomography features of small intestinal obstruction caused by primary abdominal cocoon%原发性腹茧症致小肠梗阻的CT检查特征

    Institute of Scientific and Technical Information of China (English)

    李斌; 冯联忠; 陈徐艰; 张斌忠; 陆忠烈; 沈文艳; 董来荣

    2016-01-01

    vessel distribution.(3) Sagittal reconstruction images of abdominal CT showed that a huge mass consisted of fibrous capsules as cocoon and agglomerate and expanding-distortion intestinal tube was petal-like and fixed on posterior abdominal wall.(4) Coronal reconstruction images of abdominal CT showed that agglomerate and expanding-distortion intestinal tube was annularly surrounded by uneven thickness fibrous capsules with abnormal vessel distribution in the mesentery.Results of abdominal CT at 10 hours after admission:(1) coronal plain scan of abdominal CT showed that small intestinal obstruction was obviously exacerbated and expanding intestinal tubes were increased and aggravated.(2) Plain scan of abdominal CT showed that a typical sign of small intestinal obstruction was exacerbated and there were multiple air-fluid levels in the agglomerate and expanding-distortion intestinal tube with fluid and gas accumulation.Patient underwent successful enterodialysis + resection of fibrous capsules.During operation,a huge mass in the intestine from suspensory ligament of duodenum to ileocecum was fixed on posterior abdominal wall and surrounded by dense,smooth and white fibrous capsules,partial colon was also surrounded by fibrous capsules and greater omentum was missing.Patient received the postoperative supporting treatments of fasting,anti-infection and inhibition of acid.Number of white blood cells,absolute value and percentage of neutrophils,levels of high-sensitivity C-reactive protein and procalcitonin were 17.10 × 109/L,15.70 × 109/L,91.5%,127.49 mg/L and 1.370 μg/L by blood routine retest at postoperative day 1,respectively.Patient had normal liver,renal and coagulation functions.Fluid diet intake at postoperative week 1 was gradually replaced by normal diet intake.Patient had normal liver and renal functions by blood routine retest at postoperative day 10 and a good recovery without intestinal fistula,abdominal and pulmonary infections and other complications

  9. Short-term outcomes of laparoscopic D2 lymphadenectomy with complete mesogastrium excision for advanced gastric cancer.

    Science.gov (United States)

    Xie, Daxing; Yu, Chaoran; Liu, Liang; Osaiweran, Hasan; Gao, Chun; Hu, Junbo; Gong, Jianping

    2016-11-01

    serosa and bluntly mobilize through the plane with gauze. Turn to the common hepatic artery (CHA), remove the adherent adipose tissue. Expose the root of left gastric vein, clip and cut. Dissect the thick sheath of left gastric artery, expose at the root, trip clip and cut. All mobilized lateral adipose tissues and dorsal parts are defined as left gastric mesentery (LGM) [10]. Toward right, dissect follow the CHA and hepatic portal vein (HPV). Next, move toward the left side of LGM and dissect along the splenic artery until reaching the posterior gastric wall. Move to the anterior area of stomach and divide the lesser omentum. Clean up the adipose tissue and nerves along the lesser curvature up to the gastroesophageal junction. Expose and cut the right gastric vessels (RGVs) where the mobilized adipose tissues are defined as right gastric mesentery (RGM) [10]. Reconstruction of the alimentary tract was done by extracorporeal anastomosis. Standard recovery protocols were followed in postoperative treatments. Fifty-four patients between September 2014 and March 2015 have been recruited with informed consent and underwent laparoscopic D2 + CME by a single surgeon. The mean number of retrieved regional lymph nodes was 35.04 ± 10.70 (range 14-55). The mean volume of blood loss was 12.44 ± 22.89 ml (range 5-100). The mean laparoscopic surgery time was 127.82 ± 17.63 min (range 110-165). The mean hospitalization time was 11.09 ± 4.28 days (range 8-28). No operative complication was observed during the hospitalization. The anatomical boundary of mesogastrium is well described and dissected within D2 + CME surgical process. It proves to be safely feasible and repeatable with less blood lost, qualified lymph nodes retrieval results and other improved short-term surgical outcomes in advanced gastric cancer. Meanwhile, potential disseminated cancer cells fall into the mesogastrium can be eradicated by D2 + CME.

  10. Establishment and evaluation of an opening-method model of endometriosis in rats%开放法大鼠子宫内膜异位症模型的建立与评价

    Institute of Scientific and Technical Information of China (English)

    哈春芳; 肖成明; 张晟宁; 刘培淑

    2011-01-01

    目的 通过与移植法建立的模型对比,探讨开放法子宫内膜异位症模型建立的可行性、判定指标及建模成功率.方法 开腹取同一只大鼠的子宫,左侧宫腔采用开放法将子宫内膜与骶韧带或大网膜贴近建模,右侧采用移植法将1.0 cm的子宫内膜移植于侧腹膜上建模,1个月后二次开腹判定建模的情况,免疫组化测定骨桥蛋白(OPN)及基质金属蛋白酶-9(MMP-9)的表达.结果 开放法建立的模型成模率为81.08%,低于移植法的83.78%,两组比较差异无统计学意义(P>0.05);①成模后肉眼观:移植法以透亮囊肿为主,占64.86%,其次为紫蓝色结节(10.81%),开放法主要以紫蓝色结节为主,占35.13%,其次为透亮囊肿(24.32%);术后盆腹腔粘连开放法器官粘连率为64.86%,明显高于移植法的18.90%(P<0.01);肠梗阻及感染等并发症发生率两组无明显差异(P>0.05);②镜下特点:72.73%的透亮囊肿和68.42%的火焰状改变镜下可见到典型或变异的腺体或腺上皮细胞层,并在异位的腺体及腺上皮细胞上有很强的OPN和MMP-9的表达.结论 开放法和移植法均有较高的成模率,但临床观察开放法成模的肉眼观更类似于人类的子宫内膜异位症改变,且具有成模面积大、简单、易行、并发症少等特点.%Objective To research the reliability, evaluation index and achievement ratio of an opening-method model of endometriosis in rats compared with the transplanting-method.Methods Female virginal rats were operated on with the opening-method ( the left side of the uterus) and transplanting-method ( the right side of uterus).In the left side of the uterus, the endometrium was stuck to the uterosacral ligament or omentum majus, while the endometrium of the right side was implanted onto the right abdominal wall.The second operation was carried out 4 weeks after implantation to evaluate establishment of the models.Samples from the rats were detected with the

  11. Extraction and identification of human adipose-derived stem cells%人脂肪干细胞的提取和鉴定

    Institute of Scientific and Technical Information of China (English)

    吴尉; 梁芳; 宋小琴; 胡平安; 刘敏

    2015-01-01

    BACKGROUND:Adipose-derived stem cel s are totipotent stem cel s in the adipose tissue, and have the function of self-renewal and multi-directional differentiation. Human adipose-derived stem cel s are ideal seed cel s with stable genetic milieu and few rejections. OBJECTIVE:To extract human adipose-derived stem cel s from human omental adipose tissue and to identify the cel s by adipogenic and osteogenic induction. METHODS:Omental adipose tissues were col ected from surgical patients to isolate and culture adipose-derived stem cel s using type I col agenase digestion, filtration and centrifugation. Cel growth was observed and proliferative curve of human adipose-derived stem cel s were drawn by cel counting method to calculate the doubling time at logarithmic growth phase. After adipogenic and osteogenic induction, induced cel s were identified using oil red O and alizarin red staining, respectively. RESULTS AND CONCLUSION:Human adipose-derived stem cel s were successful y isolated from the omentum tissues of surgical patients. Adherent cel s were fusiform-shaped and like fibroblasts. The growth curve of passage 3 cel s was in S shape, and the doubling time was 45.90 hours. After adipogenic and osteogenic induction for 2 and 3 hours, respectively, oil red O staining showed unequal-sized orange fat droplets, and alizarin red staining showed typical calcified nodules that were in orange. These findings indicate that adipose-derived stem cel s have the adipogenic and osteogenic capacity.%背景:脂肪干细胞是存在于脂肪中的全能干细胞,具备自我更新能力与多向分化潜能,遗传背景相当稳定,体内植入后免疫排斥少,是一种比较理想的种子细胞。目的:提取人大网膜脂肪干细胞,并进行成脂和成骨分化能力鉴定。  方法:收集手术患者大网膜的脂肪组织,经Ⅰ型胶原酶消化、过滤、离心后进行原代培养,观察细胞生长状态;用细胞计

  12. Laparoscopic Surgery for Splenic Benign Lesions:a Report of 19 Cases%腹腔镜手术治疗脾良性病变19例

    Institute of Scientific and Technical Information of China (English)

    王卫东; 林杰; 陈小伍; 吴志强; 梁智强; 马靖; 冯剑平; 刘清波; 何威; 陈坚平

    2015-01-01

    was successfully performed in all the patients .Among 12 cases of laparoscopic splenectomy, primary splenic pedicle procedure was used in 5 cases with an operation time of 60-115 min ( mean, 85 min) and an intraoperative blood loss of 30 -300 ml ( mean, 170 ml ) , and secondary splenic pedicle procedure was used in 7 cases with an operation time of 85-195 min (mean, 105 min) and an intraoperative blood loss of 30-500 ml (mean, 240 ml).In the 4 cases of fenestration, the operative time was 55-70 min (mean, 60 min) and the intraoperative blood loss was 20-50 ml (mean, 30 ml).In 3 cases of partial splenectomy , the operation time was 90 min, 110 min, and 110 min, respectively , and the intraoperative blood loss was 40 ml, 60 ml, and 100 ml, respectively .One patient underwent laparoscopic re-exploration due to postoperative large volume red drainage in short time .During the exploration , accidental laceration of the greater omentum leading to bleeding was encountered , and the bleeding was stopped under laparoscopy successfully .The mean postoperative hospital stay was 6.0 d ( range, 4 -11 d).No operative complications were observed .The patients were followed up for 3-87 months with a mean of 35 months, during which 12 cases of laparoscopic splenectomy had no long-term complications , 6 cases of splenic cyst fenestration or partial splenectomy showed no recurrence , and the case of splenic lymphangioma had no residual or recurrence . Conclusion Laparoscopic splenectomy and partial splenectomy are safe , minimally invasive , and feasible for patients with splenic benign lesions .

  13. 恶性腹膜间皮瘤26例临床特点及预后影响因素分析%Clinical characteristics and prognostic factors of patients with malignant peritoneal mesothelioma: An analysis of 26 cases

    Institute of Scientific and Technical Information of China (English)

    曾艳; 童瑞; 王翔耀; 梁浩

    2015-01-01

    Objective To analyze the clinical characteristics and potential prognostic factors of patients with malignant peritoneal mesothelioma (MPM).Methods Clinical data about 26 MPM patients who admitted to Chinese PLA General Hospital from 2005 to 2013 were retrospectively analyzed.Results The mean age of 26 patients was 57 years old. Of the 26 cases, 3 male patients had a history of asbestos exposure. The main clinical symptoms of the patients were abdominal distension, abdominal pain, ascites and peritoneal cavity mass. Peritoneum or omentum thickening and space- occupying mass were the main signs on CT scans. There were 20 epithelioid patterns and 6 sarcomatoid/mixed patterns in MPM. There were 12 patients in StageⅠ-Ⅱand 14 patients in StageⅢ-Ⅳ. Surgery plus hyperthermic intraperitoneal chemotherapy (HIPEC) were performed in 8 patients, surgery plus chemotherapy in 14 patients, and single surgery in 4 patients. The median survival time was 20 months, with a 6-, 12-, 18-, and 24-month survival rate of 96.15%, 80.27%, 52.90% and 26.46%, respectively. Significant prognostic factors were age (P<0.001), histologic subtype (P<0.001), TMN staging (P=0.016) and treatment strategy (P=0.019), while gender and general classification were uncorrelated with prognosis by univariate analysis, only histologic subtype (P=0.002) and TMN staging (P=0.021) showed statistical significance by multivariate analysis.Conclusion Patients with epithelioid patterns and TMN stagingin stageⅠ-Ⅱhave positive prognosis, so early diagnosis and comprehensive treatment can improve the survival rate in PMP patients.%目的 探讨恶性腹膜间皮瘤的临床特点及影响该病预后的相关因素.方法 收集解放军总医院2005 - 2013年收治的26例恶性腹膜间皮瘤患者的临床资料,回顾性分析预后影响因素.结果 26例患者平均年龄57岁,3例男性患者有石棉接触史,主要临床表现为腹胀、腹痛、腹水及腹部肿块.CT示腹膜或大网膜增

  14. 回盲部憩室炎的超声诊断%Diagnosis of Ileocecal Diverticulitis with Ultrasonography

    Institute of Scientific and Technical Information of China (English)

    许慧君; 赵静

    2013-01-01

    Background: Acute ileocecal diverticulitis is easily to be misdiagnosed as acute appendicitis because the clinical manifestation of the two diseases are similar. Progress has been made on application of ultrasonography for diagnosis of gastrointestinal diseases, however, reports focused on the diagnosis of ileocecal diverticulitis with ultrasonography are still scanty. Aims: To study the value of ultrasonography in diagnosing ileocecal diverticulitis. Methods: A total of 17 cases of acute ileocecal diverticulitis were enrolled retrospectively from Feb. 2010 to Dec. 2011 at Tianjin Xiqing Hospital. All cases were diagnosed initially with emergency ultrasonography and confirmed by surgical pathology or other imaging technologies. Their sonographic appearance and treatment outcome were reviewed. Results: Of the 17 cases of ileocecal diverticulitis, 7 located at cecum or ascending colon and 10 located at terminal ileum, with the size ranged from 0.62 cm X 0. 80 cm to 2. 30 cm ×1. 32 cm. At the area of abdominal tenderness, round or oval masses formed by protruding local bowel were detected by ultrasonography in all 17 cases. The masses displayed hypoechoic pattern and might be complicated with echo of gas, liquid or fecalith in some cases. Around the mass were varying extent of thickened fatty tissue and meso-omentum. Ten cases received emergency operation and 7 received conservative anti-inflammatory treatment. All cases were cured with no major complications. Conclusions: Ultrasonography is of great importance for the diagnosis and differential diagnosis of ileocecal diverticulitis. It is also helpful for selection of optimal therapeutic regimen.%背景:急性回盲部憩室炎的临床表现与急性阑尾炎相似,易误诊为急性阑尾炎.近年来,超声检查在胃肠疾病诊断中的应用研究不断深入,但关于回盲部憩室炎超声诊断的报道尚少.目的:探讨超声检查对回盲部憩室炎的诊断价值.方法:纳入17例于2010年2

  15. Surgical Approach of Laparoscopic D2 Radical Gastrectomy for Distal Gastric Cancer%腹腔镜远端胃癌D2根治术手术路径的临床应用研究

    Institute of Scientific and Technical Information of China (English)

    徐建; 王守光; 滕世岗; 季志刚; 刘忠诚

    2011-01-01

    目的 探讨腹腔镜远端胃癌D2根治术手术路径的临床效果. 方法 2007年10月~2010年5月,对56例远端胃癌实施腹腔镜远端胃癌D2根治手术.手术路径:大网膜切除和横结肠系膜前叶剥离;解剖腹腔动脉、肝总动脉、脾动脉及清扫相应淋巴结;处理胃右动脉和5组淋巴结;清扫12a组淋巴结等顺序进行,淋巴清扫以4d→4 sb→14v→6→7/9→11 p→8a→5→12a→1→3的路径进行. 结果 手术时间130 ~375 min,(203.4±48.4) min.清扫淋巴结13 ~21枚,(16.2±1.2)枚.术后胃肠功能恢复时间48 ~120 h,(80.6±17.7)h.标本远近切缘无癌残留.无围手术期死亡病例.术后72 h吻合口出血1例,96 h输出端梗阻1例.56例术后随访2~31个月,(14.1±6.9)月,死亡8例:肿瘤广泛转移6例,心脑血管疾病2例;带瘤生存5例,无瘤生存43例,无瘤生存时间最长已31个月. 结论 腹腔镜远端胃癌D2根治术按照合理的路径进行手术,能够保证手术在正确的间隙和解剖层面进行,有利于在遵循肿瘤根治的原则下完成手术.%Objective To investigate the clinical effects of the surgical pathway of laparoscopic D2 radical gastrectomy for distal gastric cancer. Methods Totally 56 patients underwent laparoscopic D2 radical resection for distal gastric cancer from October 2007 to May 2010. The operation included 5 main steps in a certain order; first, resecting the omentum and divesting anterior lobe of the transverse mesocolon; second, anatomizing the celiac, common hepatic, splenic arteries and dissecting corresponding lymph nodes; third, managing the right gastric artery and five lymph node groups; fourth, dissecting the lymph node of 12a group;finally, the lymph nodes were dissected following the order of 4d→4sb→14v→6→7/9→llp→8a→5→12a→1→3. Results The operation time was 130 - 375 minutes [ mean, (203. 4 ±48. 4) minutes], number of harvested lymph nodes was 13 - 21 ( mean,16. 2 ± 1. 2) , and the

  16. 上腹部多器官移植14例临床分析%Clinical analysis of combined ‘en bloc’ liver and pancreas transplantation in patient with upper abdominal multiple organ disease: a report of 14 cases

    Institute of Scientific and Technical Information of China (English)

    何晓顺; 鞠卫强; 林建伟; 王东平; 巫林伟; 邰强; 郭志勇; 韩明; 朱晓峰

    2013-01-01

    目的 探讨上腹部多器官移植治疗上腹部多器官病变的适应证及临床疗效.方法 回顾性分析14例上腹部多器官移植受者的临床资料.其中5例为上腹部器官恶性肿瘤伴邻近器官转移患者,予以肝脏、胰腺及上消化道全切除术后行上腹部多器官移植(A组);9例为终末期肝病合并糖尿病患者,保留其胰腺和全消化道,行单纯肝脏切除后接受上腹部多器官移植(B组).结果 所有受者均于术后1~7 d停用胰岛素,血糖水平较术前下降,丙氨酸转氨酶、天冬氨酸转氨酶及胆红素总量等在术后1周趋于正常水平;C肽在术后1~2周达到正常范围.A组5例受者最长存活326 d,最终3例死于多器官功能衰竭,2例死于肿瘤复发;B组9例受者中,除1例于术后1个月时死于移植物抗宿主病以及1例于术后12个月时死于急性单核细胞白血病外,其他受者均存活.B组存活受者中,2例发生肺部感染并发症,1例出现胰漏后继发肠瘘,均治愈,随访期间移植肝和胰腺的功能正常,未出现乙型肝炎和肿瘤的复发.结论 终末期肝病伴有胰腺功能障碍患者更适合接受上腹部多器官移植,预后较好,采用保留受者胰腺的上腹部多器官移植在技术上具有可行性.%Objective To investigate the clinical efficacy of liver-duodeno-pancreatic organ cluster transplantation in patients with upper abdominal malignancy and in patients with end-stage liver disease and type 2 diabetes.Method The clinical data of 14 cases of liver-duodeno-pancreatic organ cluster transplantation were retrospectively analyzed.Five patients (group A) who suffered from unresectable advanced upper abdominal malignancy,experienced the liver,stomach,spleen,pancreas,duodenum,omentum and variable amounts of the colon resection,and then underwent standard multivisceral transplantation (including liver,stomach,pancreatodoudenal and small bowel).Besides,7 cases (group B) of liver

  17. 上腹部器官簇移植治疗多器官病变的临床分析%Clinical analysis on multivisceral transplantation

    Institute of Scientific and Technical Information of China (English)

    王东平; 邰强; 唐决; 何晓顺; 朱晓峰; 鞠卫强; 巫林伟; 马毅; 王国栋; 胡安斌

    2010-01-01

    Objective To assess the indication, surgical and post-operative complications of the multivisceral transplantation. Methods The post-transplant complications of 8 patients who underwent multivisceral transplantation between May 2004 and May 2010 were analyzed. There were 7 male and 1 female, aged from 28 to 65 years. Five patients who suffered from non-resectable advanced upper abdominal malignancy experienced the liver, stomach, spleen, pancreas, duodenum,omentum and variable amounts of the colon resection, and then underwent standard multivisceral transplantation (included liver, stomach,pancreatodoudenal and small bowel). After underwent hepatectomy while retaining the native pancreas and entire gastrointestinal, three recipients with end-stage liver cirrhosis and type 2 insulin-dependent diabetes mellitus(IDDM) was performed combined en bloc liver/pancreatodoudenal transplantation. Results Since the third day post-operation, all recipients no longer needed exogenous insulin and had normal blood glucose concentrations. Two weeks after transplantation, their liver function almost became normal. For the 5 recipients who suffered abdominal malignancy, the longest survival period was 326 days. Cause of death are recurrent tumor( n = 2 ), multiple organ failure ( n = 3 ). All the 5 patients experienced infection. For 3 patients suffered cirrhosis and IDDM, the longest survival was over 18 month. Excepting the case 8 died of graft versus host disease, all were still living without apparently post-transplant complication. Conclusions Multivisceral transplantation is an alternative in the treatment of the patients with benign massive abdominal pathologies.Careful patient selection and technical modification are crucial to improve the outcome of these patients.%目的 探讨和总结上腹部器官簇移植治疗多器官病变的手术适应证、手术方式及术后并发症.方法 回顾性研究2004年5月至2010年5月8例接受器官簇移植的患

  18. Estudo comparativo entre os fios de algodão, poliglactina e poliglecaprone nas anastomoses intestinais de cães Comparative study of cotton, polyglactin and polyglecaprone sutures in intestinal anastomoses in dogs

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    Walter Octaviano Bernis-Filho

    2013-03-01

    abandoned. Until now was not found an ideal suture to the intestinal tract or other tissues in general, making the choice a difficult task. AIM: To evaluate, macroscopically and microscopically, the healing process of intestinal anastomoses in dogs using polyglecaprone 25, polyglactin 910 and cotton sutures. METHODS: Twenty adult male dogs were operated on and underwent to three small bowel anastomosis using the technique with submucosal sutures. Were used three threads and the anastomoses were evaluated at different postoperative periods - group I - three days; group II - seven days; group III - 14 days and group IV - 21days. Macroscopic analysis was to assess the presence or absence of peritonitis, aspect of the anastomosis and adhesions. Histological studies of the anastomoses, using hematoxylin and eosin and Masson's trichrome analyzed the exudative inflammation, granulomatous inflammation, the mucosal epithelial coating and collagen fibers. RESULTS: The macroscopic analysis showed good coaptation of the edges with a moderate degree of adhesion between the intestines and omentum three to 21 days after surgery. The microscopic evaluation revealed exudative inflammation with neutrophils and fibrin, which ranged from mild to moderate until the 14th day; granulomatous inflammation with macrophages, multinucleated giant cells and epithelioid cells were more evident at 14th day for the cotton, presence of granulation tissue (fibroblasts and collagen fibers, a moderate way, from the 7th for the three threads. CONCLUSION: All three threads showed similar behavior and thus they can be indicated for anastomoses of the small intestine.

  19. Aspectos clínico-patológicos e laboratoriais do envenenamento crotálico experimental em bovinos Clinical and pathological aspects of experimental Crotalus poisoning in cattle

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    Flávio A.S. Graça

    2008-06-01

    -americanas em bovinos não cursa com mioglobinúria e que o quadro marcado de paralisia flácida mimetiza o observado no botulismo. Adicionalmente foram feitas observações sobre o diagnóstico do envenenamento crotálico e sua diferenciação com enfermidades que cursam com paralisia e necrose muscular em bovinos do Brasil.Crotalus poisoning was experimentally reproduced by subcutaneous inoculation of Crotalus durissus terrificus (South American rattlesnake venom into 10 clinically healthy mixed bred 12 to 36-month-old cattle, weighing 125 to 449 kg. Two animals were used as controls. The animal that received a dose of 0.03mg/kg body weight died 7h40min after inoculation. A 0.015mg/kg dose provoked death in 4 out of 7 young oxen. Two animals given 0.0075mg/kg became slightly sick and recovered. Onset of symptoms occurred from 1h30min to 13h45min after inoculation. The clinical course varied from 5h25min to 45h for animals that died, and from 33h15min to 17 days for animals that recovered. The main nervous signs observed were diminished response to external stimuli, hypotonic reflexes, dragging of the hooves, apathy, difficulties in moving around obstacles, ocular globe paralysis, lateral and sternal decubitus, and tongue paralysis. Adipsia and sometimes petechiae in the conjunctival and vaginal mucosa were observed. A slight to moderate increase in bleeding time was noted in 6 animals, and a moderate increase in partial thromboplastin time was found in 7 others. Moderate leukocytosis with neutrophilia, relative lymphopenia, eosinopenia, and monocytosis was found. There was a significant increase in creatine kinase serum levels of a ten-fold order. No significant alterations were revealed by urinalysis. Necropsy revealed minimal edema at the inoculation site, few petechiae and equimoses in the epicardium, omentum, biliary vesicle and bladder mucosa of some animals. Histopathological examination revealed necrosis (hyalinization of groups or isolated myocytes in different

  20. 16层CT轴位结合矢状位重建在胃肠穿孔腹腔积气积液分布诊断中的价值%16-Slice CT Findings of the Distribution of Intraperitoneal Free Gas and Fluid in Gastrointesti-nal Perforation

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    姚亮平; 莫国友; 邓锦忠

    2013-01-01

    [Objective] To explore the diagnostic value of axial and sagittal reconstruction of 16-slice CT for in-traperitoneal free gas and fluid distribution caused by gastrointestinal perforation .[Methods]The data of 16-slice CT scanning of 48 patients with gastrointestinal perforation confirmed by surgery were collected and analyzed retrospec-tively .[Results] Small amount of gas accumulation in inferior phren of upper abdomen was found in 28 patients (58% ) .Axial CT findings showed small air bubble-like ,linear or luniform gas shadow under xiphoid and in right su-prahepatic space and cellulites around gastric antrum .Sagittal reconstruction revealed linear or luniform gas shadow in anterior peritoneal cavity .Extensive gas and fluid accumulation under xiphoid of abdominal cavity was found in 20 pa-tients(42% ) .Axial CT findings showed fluid-gas plane around liver in 15 patients ,fluid-gas plane around liver and spleen in 5 patients ,gas and fluid accumulation in small omental sac in 3 patients ,fluid and small gas bubble around intestinal wall in 5 patients ,lumen expanding and wall thickening of right hemicolon in 6 patients and fat dense of o-mentum majus in 3 patients .Sagittal reconstruction revealed luniform gas shadow in anterior peritoneal cavity in 7 pa-tients and fluid-gas plane formation in 13 patients .According to the effusion at perforation and the change of wall out-line ,the perforation position was assessed in 36 patients after operation correctly ,and the accurate rate was 75% .[Conclusion] Axial and sagittal reconstruction of 16-slice CT can reveal the distribution of small amount of free gas in peritoneal cavity ,and has good value in the diagnosis of gastrointestinal perforation and the evaluation of the severity of the disease .%[目的]探讨16层C T轴位结合矢状位重建对胃肠穿孔所致腹腔内游离气体、积液分布的诊断价值。[方法]收集48例手术证实胃肠穿孔病例的16层C T扫描影像资料作回顾性分析

  1. Clinical Treatment and Prognosis of External Gastrointestinal Stromal Tumor%胃肠道外间质瘤的治疗与预后

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    杨弘鑫; 陈秀峰; 张波; 陈海宁; 陈志新; 陈佳平

    2012-01-01

    Objective To investigate the clinical manifestations, treatment and prognosis of patients with external gastrointestinal stromal tumor (EGIST). Methods Clinical data of 35 patients with EGIST treated between January 2004 and June 2010 were retrospectively analyzed. There were 26 males and 9 females in our study with their age ranging from 33 to 78 years old, averaging at 56 years. The course of the disease ranged from 5 days to 8 months, averaging 2 months. The main clinical manifestations included abdominal discomfort, pain and abdominal mass. CT or Enhancement CT was the main diagnostic method, which showed that 16 cases of the disease had their focuses on the mesentery, 15 on the omentum, and 4 on the retroperitonium. All 35 patients accepted surgical operations. Results After operation, the diagnosis was confirmed through pathological examination and immunohistochemistry. The tumors were mainly composed of spindle cells. The number of very low risk cases, low risk cases, moderate risk cases and high risk cases were respectively 0, 3, 0 and 32. Immunohistochemistry showed the positive rates of tyrosine kinase receptors (CD 117), DOG-1, bone marrow stem cell Antigen (CD34), acid calcium-binding protein (S-100), smooth muscle actin (SMA), and Desmin were 91.4% (32/35), 100% (3/3), 71.4% (25/35), 8.6% (3/35), 22.9% (8/35), and 0% (0/35) retrospectively. The follow-up time ranged from 19 to 96 months averaging 46 months for 15 patients. During the follow-up period, 8 patients improved their conditions, and 7 were stable. Conclusions EGIST is often in high-risk with giant mass when identified and the prognosis is not so good. Surgical operation is the main treatment method, and imatinib used as an adjuvant treatment can have a satisfying effect.%目的 探讨胃肠道外间质瘤(EGIST)的临床表现、外科治疗及预后.方法 回顾性分析2004年1月-2010年6月收治的35例EGIST患者的临床资料.男26例,女9例;年龄33~78岁,平均56岁.病程5 d

  2. Método laparoscópico no diagnóstico e extensão da carcinomatose peritoneal Laparoscopy in diagnosis and extension of peritoneal carcinomatosis

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    Ulysses Ribeiro-Júnior

    2010-09-01

    peritoneum, liver, epiíplon, pelvic cavity and other organs of the abdominal cavity, and permit to deal with ascites. AIM: To describe laparoscopic technique and method to accomplish the peritoneal carcinomatosis status and indications for peritoniectomies. METHODS: After the introduction of the trocar under direct vision in the region of the umbilicus it is possible to empty ascites to the fullest, and collect material for cytological examination, avoiding contamination with blood. If there is no ascites, peritoneal lavage can be performed. Releases adhesions and adhesions can be also done prior to the operation of the cavity and also several biopsies of parietal peritoneum, diaphragm, omentum and pelvic cavity for confirmation. To determine whether the patient is a candidate for peritoniectomy and / or intra-abdominal hyperthermic chemotherapy, it can permit the realization of index of peritoneal carcinomatosis. For this to occur is essential to use the operating table with the ability to move the positions of Trendelemburg, proclivity and sides. CONCLUSION: The laparoscopic method is good to evaluate ascites, hepatic and peritoneal metastases, and may achieve efficiency, sensitivity and specificity of 100% for these attributes. It should be performed when there is clinical suspicion of intraperitoneal dissemination, but no diagnostic imaging confirmation.

  3. New composite patches and biologic patches for repair of contaminated abdominal wall defect in dogs: A comparative study%污染环境下新型复合补片和生物补片修补犬腹壁缺损的比较研究

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    郑亚杰; 田文; 丁国飞; 姚京; 马冰

    2012-01-01

    Objective To compare the characteristics of two compound patches made of collagen and polypropylene(PP) and the feasibility of their application in repair of contaminated wounds. Methods Twenty-four adult male dogs, weighing 16-20kg, were included in this study. A dog model with 3 contaminated defects at the upper, left and right abdominal wall was established. The 3 abdominal wall defects were repaired by implanting 3 kinds of patches into them. The patches were divided into PP and collagen compound patch group(group A), porcine cross-linked biologic patch group(group B), and cattle cross-linked biologic patch group(group C). A dog abdominal hernia model was established. A segment of small intestine was removed, into which 10ml 0.9% sodium chloride solution was injected and then aspirated to contaminate the abdominal cavity, abdominal wall and patches. The abdominal wall defects were closed with 5cm × 5cm patches. The dogs were killed on day 90 after operation to observe the adhesion of organs in abdominal cavity. The patches and their adjacent tissue were cut into sections for histological study. Results No death occurred while patch and omentum adhesion was observed in different groups 90 days after operation. Histological study showed that the scores of proliferating fibroblasts, inflammatory reaction and formation of new blood vessels were higher in group A than in groups B and C. Conclusion The effect of PP and collagen compound patch and biological patch is similar in preventing adhesion under contaminated environment. However, it leads to severer proliferation of fibroblasts, inflammatory reaction and formation of new blood vessels than biologic patch.%目的 比较胶原蛋白与聚丙烯(polypropylene,PP) 制作的复合补片和两种生物补片的特点及其应用于污染伤口一期修补的可行性.方法 成年雄性普通犬24 只,体质量16-20kg,在同一只动物上、左、右腹部建立三个污染缺损模型,将3 种补

  4. Isolation and Culture of Human Microvascular endothelium for comparison of the morphological and molecular characteristics of Microvascular endothelial cells under normal gravity against simulated micro gravity

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    Tholcopiyan L

    2010-01-01

    Full Text Available BACKGROUND: Vascular endothelial cells play a major role in wound healing and also in growth of the tumors. Angiogenesis can be a target for treating diseases that are due to either poor vascularisation or decreased blood supply as in stroke, ulcers, heart disease, etc or abnormal and increased vasculature like in tumours. Application of specific compounds that may inhibit or induce the creation of new blood vessels in the body may help in the treatment of such diseases (1. Ex vivo generation of blood vessels may offer an excellent alternative to the synthetic valves that are being currently used in cardiology. Micro gravity also referred to, as weightlessness is not essentially zero gravity but rather minimal gravity. According to cell type, micro gravity causes variety of changes in proliferation and differentiation of cells while also affecting the migration of cells and cellular functions (2, 3. Siamwala et al from AUKBC have already studied the effects of microgravity on the microvascular endothelial cells from bovine lung and macrovascular endothelial cells from the bovine pulmonary artery. It was observed that the proliferation and migration of macrovascular endothelial cells were increased in microgravity (4, 5. Nitric oxide production was also studied and observed that microgravity treatment did not change nitric oxide production by microvascular endothelial cells (4OBJECTIVE: Isolation and Comparison of culture characteristics of Human microvascular endothelium cultured conventionally and in novel nanomaterial scaffold and further study the morphological and molecular characteristics of microvascular endothelial cells under normal gravity against simulated micro gravityMATERIALS AND METHODS: The human Omentum samples were obtained using surgical procedures after informed consent. The microvascular endothelial cells were isolated following the protocol described by Scott et al (6.The isolated cells were seeded in two groups; Group I

  5. Effects of increased intra-abdominal pressure on the healing process after surgical stapling of the stomach of dogs Efeitos da elevação da pressão intra-abdominal e de seu tempo de ação na cicatrização de suturas mecânicas no estômago de cães

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    Nilson Chaves Jr

    2007-10-01

    Full Text Available PURPOSE: To assess the initial healing after surgical stapling of the stomach using a linear cutting stapler and creating pneumoperitoneum (12-14 mmHg for 60 minutes or 120 minutes, and compare it with the healing of a staple line not submitted to increased pressure. METHODS: A total of 30 dogs were divided into three groups of 10 animals each: Group I (control group - surgical stapling, Group II (surgical stapling and increased intra-abdominal pressure for 60 minutes and Group III (surgical stapling and increased intra-abdominal pressure for 120 minutes. All dogs were maintained under general anesthesia for two hours after surgical stapling. Seven days after surgery, the area around the staple line was macroscopically and microscopically examined. RESULTS: The macroscopic examination of the samples (n = 30 did not show dehiscence, fistula or abscess. Adhesions between the omentum and the staple line were observed in all animals of Groups II and III (n = 20, which were significantly different from Group I (p = 0.008*. The histopathological analysis showed normal healing up to day 7 in the control animals (n = 10. When these results were compared with those of Groups II and III (n = 20, non-parametric tests revealed that there was a significant difference with regard to certain parameters of the early stages of healing, such as fibroblast migration (p = 0.011*, edema (p OBJETIVO: Avaliar os efeitos do pneumoperitônio com CO2 sobre a fase inicial da cicatrização (7º dia de uma sutura gástrica mecânica em cães, com diferentes tempos de aumento da pressão intra-abdominal. MÉTODOS: Trinta cães foram divididos em três grupos e submetidos à laparotomia mediana e realização de uma sutura vertical na grande curvatura gástrica com grampeador linear cortante. Após a síntese abdominal, nos animais dos grupos II e III instalou-se pneumoperitônio com CO2, permanecendo os animais com pressão intra-abdominal entre 12 e 14 mmHg durante 60

  6. Tips and Tricks of Percutaneous Gastrostomy Under Image Guidance in Patients with Limited Access

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    Marcy, Pierre-Yves; Figl, Andrea; Thariat, Juliette [Sophia Antipolis University, Nice cedex (France); Lacout, Alexis [Centre Me' dico-Chirurgical, Aurillac (France)

    2011-10-15

    -gastrectomized patients who were contraindicated for endoscopic gastrostomy (2). Another condition precluding the traditional supracolic approach is the Chilaiditi sign, i.e. a usually asymptomatic interposition of the colon between liver and diaphragm. This condition may occur in patients with dolichocolon, chronic lung disease, cirrhosis, as well as ascites and right hemi-diaphragm palsy. Colonic opacification should always be performed prior to a gastrostomy to prevent the potential risk of gastrocolic fistula. Colonic opacification can be achieved using air inflation when starting a gastrostomy (1) or barium swallow 12 hours prior. We and others perform PFG using an uncomplicated controlled percutaneous gastropexy below the transverse mesocolon (2,4). The PFG tract is made centrally on the gastropexy using a true right-angle 18G-needle to the skin surface, a 0.0038-inch Amplatz guidewire and serial dilators following cutaneous anesthesia down to peritoneum with 40 ml of 1% Lidocaine chlorhydrate. The needle (N) traverses the greater omentum (GO), transverse mesocolon (TM), gastrocolic ligament (GCL), and lesser sac (between TM and GCL). Four anchor hooks were then inserted with limited pressure, and a 17-Fr catheter subsequently placed through a peel-away sheath inside the stomach and below the transverse colon (Fig. 1). We noted that GO is known as the so-called 'abdominal policeman' because it wraps itself around an inflamed organ thereby protecting other viscera from it. Literature data on infracolic PFG insertion are scarce (4): less than ten (uncomplicated) cases have been performed worldwide. The real contraindication of infracolic PFG includes hypopharyngeal/cervical esophageal neoplasia since the gastropexy precludes any further pull-up technique attempt. In conclusion, contraindications for endoscopic gastrostomy include UDTO and Chilaiditi sign. We suggest that the fluoroscopy-guided gastrostomy Chan's technique can be improved using effervescent sodium

  7. Feasibility of constructing artificial cartilage with rabbit mesenchymal stem cells and polyglycolic acid scaffold%兔骨髓间充质干细胞及聚羟基乙酸支架材料构建人工软骨的可行性

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    杨大鉴; 黄定强; 胥方元

    2007-01-01

    ear rabbits, of both genders, clean grade, aged from 2 to 3 months, weighing 1.5-2.0 kg, were fed in normal temperature and humidity. Poly-glycolic acid was provided by Albany Company, USA.METHODS: Rabbit MSCs were separated, obtained and amplified. In addition, poly-glycolic acid was sheared into pieces with the size of 1 cm × 1 cm × 1 cm and embedded with poly-L-lysine. Amplified MSCs were inoculated on the surface of poly-glycolic acid, and then, they were averagely grown on pre-wet scaffold of poly-glycolic acid according to 4 mL/cm3multi-points spreading style and cultured in vitro for 3 weeks. After the operations mentioned above, samples were regarded as the experimental group. Scaffolds of poly-glycolic acid without MSCs were considered as the control group.Samples in both experimental group and control group were transplanted into abdominal cavity of 4 rabbits, respectively,cultured in vivo for 6-12 weeks, taken out and observed generally. Meanwhile, the samples were fixed with 100 g/L neutrality formaldehyde, cut into sections with the thickness of 5 μm, stained with haematine-eosin (HE) and observed their histomorphological characteristics. Moreover, the samples were stained with alcian blue for observation of glycosaminoglycans formation, with toluidine blue for observation of metachromasia matrix formation, and with immunohistochemical staining for detection of type- Ⅱ collagen expression.MAIN OUTCOME MEASURES: Generally observational results of two kinds ofscaffolds at 6 and 12 weeks after transplanting into experimental rabbits, various staining results and expression of type- Ⅱ collagen.RESULTS: A total of 8 experimental rabbits were involved in the final analysis. ① Generally observational results of two kinds of scaffolds at 6 and 12 weeks after transplanting into experimental rabbits: At 6 weeks after transplanting scaffold into abdominal cavity of rabbits, samples in the experimental group were still coated with greater omentum of

  8. 结核性与恶性腹膜弥漫性病变的18F-FDG PET/CT影像特征分析%Analysis of 18F-FDG PET/CT imaging features of tuberculous and cancerous diffuse peritoneal lesions

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    陆东燕; 侯莎莎; 丁恩慈; 赵炎; 沈婕

    2014-01-01

    differentiating the lesions.Methods The 18F-FDG PET/CT features of 10 tuberculous peritonitis,13 primary serous papillary carcinoma of the peritoneum and 16 peritoneal metastases were retrospectively reviewed,which had been confirmed by clinic and / or histopathology.Four indicators were observed and graded:(1) 18F-FDG PET/CT features of parietal peritoneum,greater omentum and mesentery; (2)features of ascites; (3)enlargement of lymph nodes; (4)accompanying signs of other organs.Two sample t test was used to differentiate the 18F-FDG uptake of peritoneal lesions,the density and 18F-FDG concentration of ascites between tuberculous peritonitis and cancerous peritonitis.Results The typical 18F-FDG PET/CT features of tuberculous peritonitis was uniformity thickening of parietal peritoneum,mesenteric and omental stains like change,widely and even distribution of the peritoneal 18F-FDG,while the cancerous peritonitis was obvious uneven thickening of parietal peritoneum,mesenteric and omental nodules and pie-shape changes,uneven distribution of the peritoneal 18F-FDG.The 18F-FDG uptake was increased in all peritoneal lesions,and there are no significant difference between the tuberculous group (SUVmax=12.74±9.75) and the cancerous group (SUVmax=12.45 ±7.40) (t=0.099,P>0.05).The density of malignant ascites[CTavg=(11.34±3.55) HU] was obvious lower than tuberculous ascites[CTavg=(14.4±2.37)HU] (t=2.5,P<0.05).The 18F-FDG concentration in malignant ascites (SUVmax =2.10 ±0.65,T/NT =0.77 ±0.18) was obvious higher than tuberculous ascites (SUVmax=1.61±0.35,T/NT=0.58±0.12) (t=-2.278,-3.084,both P<0.05).Conclusion The 18F-FDG PET/CT imaging can show the morphology and metabolic changes of peritoneal lesions,and fully display the lesions in the whole body.It is important to analyze 18F-FDG PET/CT features of disuse peritoneal lesions in order to improve the accuracy of diagnosing the diffuse peritoneal lesions.

  9. Regional intra-arterial chemotherapy for treatment of advanced malignant tumors in children%小儿不可切除性恶性实体瘤区域性动脉化疗的探讨

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    李民驹; 黄勇; 吴德华; 唐达星; 徐珊; 周银宝; 章毅英

    2009-01-01

    Objective To evaluate the efficacy and long-term outcomes of regional intra-arterial chemotherapy for the treatment of advanced malignant solid tumors in children.Methods During Jul 1999 and Dec 2006,regional intra-arterial chemotherapy was performed in 15 patients (aging from 0.5 to 12 years,6 males and 9 females) with advanced malignant solid tumors in various parts of their bodies.In all the eases,13 accepted preoperative treatment and 2 accepted postoperative treatment.The tumors included rhabdomyosarcoma (2 cases in pelvis,2 in vagina and 1 in bladder),endodermal sinus tumor (3 in sacroiliac and 1 in colic omentum),malignant teratoma (1 in ovary and 1 in cerebellum),desmoplastic small round cell tumor (1 in abdomen),pancreablastoma (1 in root of mesentery),ependymoma (1 in cerebellum) and dermatofibrosareoma (1 in upper arm).Transcatheter arterial infusion chemotherapy (TAIC) of cisplatin,pirarubicin and vindesine was performed with the doses as follows:cisplatin 80 mg/m2,pirarubicin 40 mg/m2 and vindesine 3 mg/m2.Internal lilac artery was chosen as the route of administration for tumors in pelvis,bladder and vagina,internal I|iac artery and coccygeal artery for tumors in sacroiliac,superior mesenteric artery for tumors in abdomen,branch of brachial artery for tumors in upper arm and vertebral artery for tumors in cerebellum.TAIC was repeated every 4 weeks.In the intermission of TALC,intravenous systemic chemotherapy with vindesine,VP16,and ephosphamide were administered.Results In the period of chemotherapy,no cardiotoxicity,nephrotoxicity or hepatic dysfunction were observed except for grade Ⅰ-Ⅱ bone marrow suppression.One patient with ependymoma in the cerebellum got mild hemiplegia and recovered 4 weeks later.The tumors of the 13 patients accepting preoperative treatment were significantly shrunken,localized and could be completely resected.Remnant tumors of the 2 patients who underwent postoperative TAIC disappeared with no recurrence

  10. Coronary renal shunt via splenic vein for portal hypertension after splenectomy%脾切除后经脾静脉冠肾静脉分流术治疗门静脉高压症

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    田明国; 杨勇; 杜鹏; 丁洋; 辛国军; 詹晶

    2016-01-01

    SV was freed from the residual end to the right for 5-6 cm in length and end-to-side spleno-renal shunt was carried out.The anterior wall of superior mesenteric vein (SMV) was exposed beneath the pancreatic neck and dissected behind the neck upward until the upper edge of the SV and its confluence with the left gastric vein (LGV) were exposed.The SV was ligated with clip between portal vein (PV) and LGV to let blood flow from LGV drain through the whole course of SV to left renal vein (LRV).Procedure 2:the peritoneum at the inferior border of the pancreas was incised,and the junctions of the SV and SMV and junctions of the SV and LGV were exposed.The inferior mesenteric vein (IMV) was divided between ligations.Dissection of the SV was carried out to the left for 3-4 cm in length and was divided.Its distal end was tied and proximal stump anastomosed to LRV by the end-to-side anastomosis.The SV was ligated with clip between PV and LGV.The right gastric and gastroepiploic vessels were ligated at the junction of the antrum and the body,and from this point,the hepatogastric ligment and the omentum were divided upward and downward respectively to completely separate the venous flow between the hepatointestinal area and the stomach in the two procedures.Patients took oral enteric-coated aspirin and warfarin after operation.(1) Intraoperative observation indicators included surgical procedures,operation time,volume of blood loos and free portal pressure (FPP).(2) Postoperative observation indicators included recovery of patients,time to anal exsufflation,time for diet intake,time of abdominal drainage,duration of hospital stay and occurrence of complications.(3)The follow-up using telephone interview and outpatient examination was performed to detect the changes of platelet (PLT),portal vein thrombosis (PVT),patency of spleno-renal vein anastomosis,oral anticoagulants and gastroesophageal varices up to October 2015.Measurement data with skewed distribution were analyzed by M