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Luyun Chen Florian Lenz Céline D. Alt Christof Sohn John O. De Lancey Kerstin A. Brocker 《International urogynecology journal》2017,28(8):1131-1138
Introduction and hypothesis
To demonstrate mesh magnetic resonance imaging (MRI) visibility in living women, the feasibility of reconstructing the full mesh course in 3D, and to document its spatial relationship to pelvic anatomical structures.Methods
This is a proof of concept study of three patients from a prospective multi-center trial evaluating women with anterior vaginal mesh repair using a MRI-visible Fe3O4 polypropylene implant for pelvic floor reconstruction. High-resolution sagittal T2-weighted (T2w) sequences, transverse T1-weighted (T1w) FLASH 2D, and transverse T1w FLASH 3D sequences were performed to evaluate Fe3O4 polypropylene mesh MRI visibility and overall post-surgical pelvic anatomy 3 months after reconstructive surgery. Full mesh course in addition to important pelvic structures were reconstructed using the 3D Slicer® software program based on T1w and T2w MRI.Results
Three women with POP-Q grade III cystoceles were successfully treated with a partially absorbable MRI-visible anterior vaginal mesh with six fixation arms and showed no recurrent cystocele at the 3-month follow-up examination. The course of mesh in the pelvis was visible on MRI in all three women. The mesh body and arms could be reconstructed allowing visualization of the full course of the mesh in relationship to important pelvic structures such as the obturator or pudendal vessel nerve bundles in 3D.Conclusions
The use of MRI-visible Fe3O4 polypropylene meshes in combination with post-surgical 3D reconstruction of the mesh and adjacent structures is feasible suggesting that it might be a useful tool for evaluating mesh complications more precisely and a valuable interactive feedback tool for surgeons and mesh design engineers.3.
The purpose of the present study was to determine whether vitamin K2 and growth hormone (GH) had an additive effect on the long bones in hypophysectomized young rats. Forty-eight female Sprague–Dawley
rats (6 weeks old) were assigned to the following five groups by the stratified weight randomization method: intact controls,
hypophysectomy (HX) alone, HX + vitamin K2 (30 mg/kg, p.o., daily), HX + GH (0.625 mg/kg, s.c., 5 days a week), and HX + vitamin K2 + GH. The duration of the experiment was 4 weeks. HX resulted in a reduction of the cancellous bone volume/total tissue volume
(BV/TV) at the proximal tibial metaphysis, as well as decreasing the total tissue area and cortical area of the tibial diaphysis.
These changes resulted from a decrease of the longitudinal growth rate and the bone formation rate (BFR)/TV of cancellous
bone, as well as a decrease of the periosteal BFR/bone surface (BS) and an increase of endocortical bone turnover (indicated
by the BFR/BS) in cortical bone. Administration of vitamin K2 to HX rats did not affect the cancellous BV/TV or the cortical area. On the other hand, GH completely prevented the decrease
of total tissue area and cortical area in cortical bone, as well as the decrease of marrow area and endocortical circumference,
by increasing the periosteal BFR/BS compared with that in intact controls and reversing the increase of endocortical bone
turnover (BFR/BS). However, GH only partly improved the reduction of the cancellous BV/TV, despite an increase of the longitudinal
growth rate and BFR/TV compared with those of intact controls. When administered with GH, vitamin K2 counteracted the reduction of endocortical bone turnover (BFR/BS) and circumference caused by GH treatment, resulting in
no significant difference of marrow area from that in untreated HX rats. These results suggest that, despite the lack of an
obvious effect on bone parameters, vitamin K2 normalizes the size of the marrow cavity during development of the bone marrow in young HX rats treated with GH. 相似文献
4.
The Integrin {alpha}<Subscript>v</Subscript>{beta}<Subscript>3</Subscript> and CD44 Regulate the Actions of Osteopontin on Osteoclast Motility 总被引:5,自引:0,他引:5
In the studies reported here we demonstrate that osteopontin is secreted from the basolateral surfaces of osteoclasts where it binds to the avb3-integrin, suggesting that it may be an autocrine factor. Osteopontin stimulation of osteoclasts produced changes in cell shape by causing disruption of peripheral podosome structures and formation of actin filaments at the leading edge of the migrating osteoclasts. The latter was part of the assumption of a motile phenotype prior to cells reforming peripheral ring type podosome containing clear zones. It is well established in our laboratory as well as in others that osteopontin stimulated osteoclast motility and bone resorption. The effect of osteopontin was mimicked by RGD containing peptides and blocked by a avb3 antibody, demonstrating that signals generated by integrin ligation contributed to the actions of osteopontin. In addition, the migratory effects of osteopontin on osteoclasts were also mediated through CD44 receptors since blocking antibodies to CD44 blocked stimulation of motility. Our data strongly suggest that osteopontin is an osteoclast autocrine motility factor binding to avb3 and CD44 during stimulation of osteoclast migration. 相似文献
5.
Hsiang-Lin Tsai Chien-Yu Lu Jan-Sing Hsieh Deng-Chyang Wu Chang-Ming Jan Chee-Yin Chai Koung Shing Chu Hon-Man Chan Jaw-Yuan Wang 《Journal of gastrointestinal surgery》2007,11(5):660-665
In patients with radically resected colorectal carcinoma, lymph node involvement is particularly important for a good prognosis
and adjuvant therapy. The number of such lymph node recoveries is still controversial, with recommendations ranging from 6
to 17 nodes. The aim of this study is to determine if a specified minimum number of lymph nodes examined per surgical specimen
can have any effect on the prognosis of patients who have undergone curative resection for T2–4N0M0 colorectal carcinoma. Between September 1999 and January 2005, a total of 366 patients who underwent radical resection for
T2–4N0M0 colorectal carcinoma were retrospectively analyzed in a single institution. All specimen segments were fixed, with node identification
performed by sight and palpation. We excluded 186 patients who received postoperative adjuvant chemotherapy via oral or intravenous
transmission to prevent possible chemotherapeutic effects on patients’ prognosis; therefore, a total of 180 patients with
T2–4N0M0 colorectal carcinoma were enrolled into this study. After the pathological examination, a mean of 12 lymph nodes (range 0–66)
was harvested per tumor specimen. No postoperative relapse was found in this group, where the number of examined lymph nodes
was 18 or more. Univariate analysis identified the size of the tumor, depth of invasion, grade of tumor, and number of examined
lymph nodes, which were significantly correlated with postoperative relapse (all P < 0.05). Meanwhile, both the depth of tumor invasion and the number of harvested lymph nodes were independent predictors
for postoperative relapse (P < 0.05). The 5-year overall survival rate of T2–4N0M0 colorectal carcinoma patients who had 18 or more lymph nodes examined was significantly higher than those who had less than
18 nodes examined (P = 0.015). Nodal harvest in patients undergoing radical resection for colorectal carcinoma was highly significant in the current
investigation. Our results suggest that harvesting and examining a minimum of 18 lymph nodes per surgical specimen might be
taken into consideration for more reliable staging of lymph node-negative colorectal carcinoma. 相似文献
6.
In this study, we compared the effects of vitamin K2 menatetrenone on bone mechanical properties in rats fed a low-magnesium (Mg) diet. In addition, the mechanism of bone quality
was examined using Fourier transform infrared imaging (FTIRI). Thirty 4-week-old male Wistar rats were divided into three
groups: intact, low-Mg-control, and low-Mg-MK-4 groups. Rats in the low-Mg groups were given a diet containing 6 mg/100 g
Mg (intact, 90 mg/100 g). After an 8-week-treatment, the cortical bone mineral content (CtBMC), outer perimeter, and endo
perimeter of the femoral diaphysis in the low-Mg-control group were significantly higher, while the maximum load (ML) and
elastic modulus (EM) were 81% and 50% of those in the intact group, respectively (respectively, P < 0.05). In the low-Mg-MK-4 group, ML and EM were significantly higher than in the low-Mg-control group (P < 0.05), with no differences in CtBMC. The mineral/matrix ratios for the periosteal and central regions in the low-Mg-control
group were 162% and 120% of those in the intact group (both, P < 0.05), respectively. MK-4 significantly inhibited these increases (P < 0.05). We found that the mineral/matrix ratios for the periosteal region of the femoral diaphysis were negatively correlated
with EM, suggesting that an increase in the mineral/matrix ratio may be involved in the reduction of EM and that MK-4 may
improve EM by improving the mineral/matrix ratio. 相似文献
7.
Vitamin D2 and D3 are generally considered equipotent in humans. A few studies have reported that serum 25OHD levels are higher in vitamin D3- compared with vitamin D2-supplemented subjects. As both vitamin D2 and D3 supplements are commonly used by elderly in United States, in the present study we determined the effect of self-reported vitamin D2 and vitamin D3 supplement use on serum total 25OHD levels according to season in elderly women aged 65–77 years. Serum total 25OHD levels were determined in winter and summer in unsupplemented women (N = 307) and in women who reported taking vitamin D2 (N = 56) and vitamin D3 (N = 55) supplements by competitive protein binding assay. In vitamin D2-supplemented women, the contribution of vitamin D2 and D3 to the mean serum total 25OHD level was assessed by HPLC. In summer, there were no significant differences in the mean total serum 25OHD levels (ng/ml) among the vitamin D2 (32 ± 2.1), vitamin D3 (36.7 ± 1.95), and unsupplemented (32.2 ± 0.95) groups. In winter, the mean serum total 25OHD levels were higher in women on vitamin D2 (33.6 ± 2.34, P < 0.05) and vitamin D3 (29.7 ± 1.76, NS) supplements compared with unsupplemented women (27.3 ± 0.72). In vitamin D2-supplemented women, about 25% of the mean serum total 25OHD was 25OHD2, in both summer and winter. Twelve percent of unsupplemented women and 3.6% of vitamin D-supplemented women had a mean serum total 25OHD level below 15 ng/ml in winter. In elderly subjects, both vitamin D2 and Vitamin D3 supplements may contribute equally to circulating 25OHD levels, with the role of vitamin D supplement use being more predominant during winter.
This work was presented in part as an abstract at Second Joint Meeting of the American Society for Bone and Mineral Research and The International Bone and Mineral Society, San Francisco, CA, 1–6 December 1998. 相似文献
8.
Milene da Silva Melo Leandro Procópio Alves Adriana Barrinha Fernandes Henrique Cunha Carvalho Carlos José de Lima Egberto Munin Mônica Fernandes Gomes Miguel Angel Castillo Salgado Renato Amaro Zângaro 《Lasers in medical science》2018,33(7):1537-1547
Many studies have been conducted on the treatment of burns because they are important in morbidity and mortality. These studies are mainly focused on improving care and quality of life of patients. The aim of this study was evaluate the LED phototherapy effects in rats skin full-thickness burns induced by CO2 laser. The animals were divided in NT group that did not received any treatment and LED group that received LED irradiation at 685 nm, 220 mW, and 4.5 J/cm2 during 40 s by burned area. Biopsies were obtained after 7, 14, and 21 days of treatment and submitted to histological and immunohistochemical analysis. The LED phototherapy shows anti-inflammatory effects, improves angiogenesis, and stimulates the migration and proliferation of fibroblasts. The T CD8+ lymphocytes were more common in burned areas compared to T CD4+ lymphocytes since statistically significant differences were observed in the LED group compared to the NT group after 7 days of treatment. These results showed that LED phototherapy performs positive influence in full-thickness burns repair from the healing process modulated by cellular immune response. The obtained results allowed inferring that burns exhibit a characteristic cell immune response and this cannot be extrapolated to other wounds such as incision and wounds induced by punch, among others. 相似文献
9.
Koutaro Oh-ie Takashi Miyazaki Iwao Koyama Shigeru Hokari Tsugikazu Komoda 《Journal of bone and mineral metabolism》2002,20(1):21-27
We reported previously that Ca and Pi levels are elevated and alkaline phosphatase (ALP) activity and 1α,25(OH)2D3 levels are reduced in chlorpromazine (CPZ)-challenged rats. In the present study, we determined the serum levels of interleukin
(IL)-6 and acid phosphatase (ACP) in CPZ-challenged rats, in addition to levels of ALP protein. ALP mRNA and coccyx morphology
were examined in CPZ-challenged rats as well as the effect of CPZ on 1α(OH)D3 production in vivo. Although Ca, Pi, IL-6, and ACP activity levels in CPZ-challenged rats were markedly increased on day
30, the elevated serum levels were restored to within normal ranges by the in vivo addition of 1α(OH)D3 to CPZ administration. The gain in body weight in CPZ-treated rats was significantly improved by the addition of 1α(OH)D3. Reduced levels of 1α,25(OH)2D3 in CPZ-treated rats were restored to normal levels by the administration of 1α(OH)D3. Moreover, the decreased ALP activity and ALP mRNA levels in the rat coccyx marrow in CPZ-treated rats were also restored
by the administration of 1α(OH)D3 with CPZ. However, the molecular sizes of rat ALP molecules and ALP mRNA were the same for each group. Furthermore, bone
morphometry showed that trabecular bone in the rat coccyx was decreased in CPZ-treated rats. However, the reduced volume of
trabecular bone in CPZ-treated rats was restored by the addition of 1α(OH)D3 to CPZ administration. Taken together, altered bone metabolism in CPZ-treated rats can be improved by the addition of 1α(OH)D3.
Received: January 11, 2001 / Accepted: July 18, 2001 相似文献
10.
Purpose We assessed the accuracy of a point-of-care blood gas analyzer in providing data from saline samples obtained by gastrointestinal tonometry (Tonometrics Catheter; Tonometrics Division, Instrumentarium, Helsinki, Finland) for the calculation of intramucosal pH (pHi) and the PCO2 gap (intramucosal PCO2 – PaCO2).Methods We compared the point-of-care analyzer (Opti; AVL Medical Instruments, Schaffhausen, Switzerland; Opt) with a conventional analyzer (Compact 2 AVL Medical Instruments, Schaffhausen; Elect) in a clinical study (Elect being taking as the standard). In an in vitro study, PCO2 data of tonometer saline (PrCO2) from Opt and Elect were compared with PCO2 data from a continuous air tonometer (Tonocap Tonometrics Division, Instrumentarium) for a bottle containing a mixed PCO2 gas. Data were evaluated by the Bland-Altman method.Results In the clinical study, the bias (B) and precision (P) were: B = 0.223 and P = 0.056 for pHi, B = –14.0 and P = 2.43 (mmHg) for PrCO2, and B = –16.7 and P = 2.6 (mmHg) for the PCO2 gap (n = 27). In the in vitro study, the bias between the two values (PrCO2 and bottle PCO2) was –1.98mmHg and precision was 1.23mmHg for Elect, but for Opt, these values were –22.09mmHg and 3.15mmHg, respectively (n = 18).Conclusion Opt is not suitable for measuring pHi and the PCO2 gap because it does not provide an accurate PCO2 for tonometry saline.Part of this study was presented at the 20th International Symposium on Intensive Care and Emergency Medicine (Brussels, March, 2000). 相似文献
11.
The present investigation evaluated the effect of 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) on alveolar bone formation during tooth movement in rats. Orthodontic elastics were inserted between the maxillary first and second molars on bilateral sides in male rats. 1,25(OH)2D3 was injected locally, at the concentration of 10–10M, once every 3 days in the submucosal palatal area of the root bifurcation of the molar on the right side. Histomorphometric analysis revealed that tooth movement without application of 1,25(OH)2D3 decreased the mineral appositional rate (MAR) on the compression area at 7 days. Repeated injections of 1,25(OH)2D3 in the orthodontically treated animals distinctly stimulated alveolar bone formation on the mesial side at 14 days. There was a significant increase in MAR associated with elevated osteoblast surface (Ob.S/BS) value on the tension surface. These findings suggest that local application of 1,25(OH)2D3 enhances the reestablishment of supporting tissue, especially alveolar bone of teeth, after orthodontic treatment. 相似文献
12.
Akbulut G Polat C Aktepe F Yilmaz S Kahraman A Serteser M Gökçe C Gökçe O 《Surgical endoscopy》2004,18(9):1384-1388
Background Despite its advantages, laparoscopic donor nephrectomy is associated with prolonged operation time, which could potentially increase oxidative stress in the graft. We performed the first experimental, randomized, controlled study with blind assessment of outcome to address this possibility.Methods Wistar–Albino rats were randomized into three groups. The animals in the control group were subjected to a sham operation under anesthesia; the animals in the other two groups were subjected to CO2 pneumoperitoneum (Pp) for 120 and 240 min, respectively. The kidneys were removed at the end of each experiment. The concentrations of protein carbonyl and sulfhydryl (SH) groups and the activities of superoxide dismutase (SOD) were measured in renal tissue samples as markers of oxidative stress. Renal tissue samples were also evaluated histopathologically using light microscopy.Results Exposure to 120 min of Pp significantly increased the finding of oxidative stress in renal tissue samples, with an increase in protein carbonyl content and a decrease in protein sulfhydryls and tissue (SOD) activities. When exposure to Pp was prolonged from 120 min to 240 min, Pp associated oxidative stress was found to be increased. These changes occurred in the absence of light microscopical evidence of overt tissue damage.Conclusions In an experimental model resembling laparoscopic donor nephrectomy, we found that exposure of pneumoperitoneum prolonged from 120 min to 240 min acts as an additive factor with respect to causing increased oxidative stress in renal tissue. Because these effects imply subtle tissue injury that may contribute to the chronic demise of renal grafts obtained laparoscopically, avoiding the use of Pp if possible and keeping operation time less than 120 min during laparoscopic donor nephrectomy appear to be advisable.Poster presented at the 39th Congress of the European Renal Association and European Dialysis and Transplant Association, Copenhagen, Denmark, July 2002 相似文献
13.
Okui M Kohno M Izumi Y Asakura K Nomori H 《General thoracic and cardiovascular surgery》2011,59(9):632-635
A technique for combined resection of S2
b (horizontal subsegment of the posterior segment) and S3
a (lateral subsegment of the anterior segment) of the right upper lobe of the lung is presented. Although both the S2
b and S3
a should be resected from the interlobar fissure, an approach for the artery and bronchus of S3
a (A3
a and B3
a, respectively) is easier from the ventral side of the hilum rather than from the interlobar fissure, because B3 runs in back of V2 at the interlobar fissure. To resolve this contradiction, we devised a procedure as follows: (1) A2
b and B2
b are cut at the interlobar fissure; (2) A3
a and B3
a are cut from the ventral side of hilum; (3) the peripheral stumps of A3
a and B3
a are transferred to the interlobar fissure; and (4) subsegments of S3
a and S2
b are resected with the peripheral stumps of A2
b, B2
b, A3
a, and B3
a from the side of the interlobar fissure. We believe this procedure makes the combined resection of S2
b and S3
a easy. 相似文献
14.
Kamal K Mahawar Alastair Reid Yitka Graham Lindes Callejas-Diaz Chetan Parmar William RJ Carr Neil Jennings Rishi Singhal Peter K Small 《Obesity surgery》2018,28(7):1916-1923
Background
Many respectable guidelines recommend lifelong vitamin B12 injections for Roux-en-Y gastric bypass (RYGB) patients in the absence of lack of consensus on the efficacy of oral route of prophylaxis and the appropriate doses needed for this purpose. The purpose of this review was to examine the published English language scientific literature in accordance with PRISMA principles to find out if orally given vitamin B12 is adequate for prophylactic purposes in RYGB patients and the appropriate dosages needed for this purpose if it is.Methods
We examined the PubMed database for all English language articles examining various doses of oral vitamin B12 supplementation after proximal RYGB in adult patients. The search revealed 19 such articles.Results
The data suggest that oral vitamin B12 supplementation doses of ≤?15 μg daily are insufficient to prevent deficiency in RYGB patients. Higher supplementation doses show better results and it appears that a dose of 600.0 μg vitamin B12 daily is superior to 350.0 μg daily suggesting an incremental dose-response curve. It further appears that supplementation doses of 1000.0 μg vitamin B12 daily lead to an increase in B12 levels and are sufficient for the prevention of its deficiency in most RYGB patients.Conclusion
The review finds that oral supplementation doses of ≤?15 μg vitamin B12 daily are inadequate for prophylaxis of vitamin B12 deficiency in adult RYGB patients but doses of 1000 μg vitamin B12 daily might be adequate. Future studies need to examine this and even higher oral doses for vitamin B12 supplementation for patients undergoing RYGB.15.
C. J. Andresen M. Moalli C. H. Turner E. Berryman R. Pero C. M. Bagi 《Calcified tissue international》2008,83(6):393-403
Intermittent combination of an anabolic agent to promote bone formation and an antiresorptive agent that would prevent further
bone loss is a theoretically attractive approach for restoring bone mass. We tested the potential of intermittently dosed
calcitriol and calcitonin (CT) to restore bone properties in ovariectomized (Ovx) rats. Rats had Ovx or sham surgery at 8 weeks
old and 4 weeks later were assigned to experimental groups: (1) sham vehicle, (2) Ovx vehicle, (3) Ovx + parathyroid hormone
(PTH, 40 μg/kg), and (4) Ovx + calcitriol (2 μg/kg) + CT (2 μg/kg). Group 3 received PTH every week throughout the study,
and group 4 received calcitriol at weeks 1, 3, 5, and 7 and CT at weeks 2, 4, 6, and 8. Dosing was carried out for 8 weeks
with serum, and micro-computed tomographic analysis was done at 0, 4, and 8 weeks. Femurs and tibias were used for radiological
analyses and for mechanical testing. Dosing with PTH improved bone mass and structure of cancellous bone at metaphyses of
tibias and femurs as well as properties of cortical bone including geometry and strength. Intermittent dosing with calcitriol
and CT was less potent in correcting loss of cancellous bone relative to treatment with PTH and had no effect on cortical
bone parameters. However, intermittent dosing with calcitriol and CT was robust enough to improve cancellous bone mass and
structure through bone formation without causing deleterious side effects. Our data provide additional evidence that therapies
can be devised to ameliorate the skeletal defects associated with established osteoporosis. 相似文献
16.
H. J. M. Smelt S. Pouwels M. Said K. A. Berghuis A. K. Boer J. F. Smulders 《Obesity surgery》2016,26(12):2873-2879
Background
The incidence of vitamin B12 deficiency after bariatric surgery can range from 26 to 70 %. There is no consensus on optimal vitamin B12 supplementation in postbariatric patients. The objective of this study was to compare three different regimes.Methods
In this retrospective matched cohort study, we included 63 patients with methylmalonic acid (MMA) levels ≥300 nmol/L. Group A (n?=?21) received 6 intramuscular (im) vitamin B12 injections including a loading dose, group B (n?=?21) received 3 im vitamin B12 injections without loading dose and group C (n?=?21) received no im vitamin B12 injections.Results
The total post-bariatric patient population consisted of 14 males (22.2 %) and 49 women (77.8 %) with a mean current body mass index of 30.6?±?8.0 kg/m2. There was no significant difference in vitamin B12 and MMA levels between 3 groups at baseline. There was a significant difference in follow-up vitamin B12 levels of group A compared to group B (p?=?0.02) and group A compared to group C (p?=?0.03). In the follow-up results, there is also a significant decrease in MMA levels of group A compared to group B (p?=?0.02), group A compared to group C (p?<?0.001), and group B compared to group C (p?<?0.01).Conclusions
In this study, a shorter injection regime is probably not sufficient to treat a vitamin B12 deficiency. An injection regime with 6 injections recovered all vitamin B12 deficiencies biochemically. MMA levels cannot recover spontaneously over time without additional im injection regime.17.
Esthetics is an important factor for patients seeking orthodontic treatment, and not always is the orthodontist able to make
adjustments on the gingival contour, and this aspect is neglected. Many orthodontists are familiar with the name laser. However,
there is a lack of information regarding their application on the orthodontic practice. There are several options for the
use of CO2 lasers on surgical procedures of interest to orthodontists, especially on soft tissues. There is no evidence that the use
of the CO2 laser has any side effect or contraindication on surgical procedures. This paper reports a series of surgical procedures
carried out on orthodontic patients. It is concluded that the carbon dioxide laser not only allows surgeons to enhance current
surgical options for treatment but also have contributed to the evolution of a variety of new procedures that are now commonplace
in oral surgery, and its use shows several benefits for the orthodontic patient. 相似文献
18.
Stefano Cianci Giuseppe Vizzielli Anna Fagotti Fabio Pacelli Andrea Di Giorgio Alessandro Tropea Antonio Biondi Giovanni Scambia 《Updates in surgery》2018,70(4):529-533
The role of loco-regional treatment of peritoneal carcinomatosis using intraperitoneal chemotherapy is still investigated. Actually, new technologies are suitable for these procedures, especially a new hybrid system using CO2 called Peritoneal Recirculation System (PRS-1.0 Combat). A HIPEC procedure in a porcine model using the PRS system was conducted. The objective of experimentation was to assess the distribution of liquid inside the abdomen, by using methylene blue instead of chemotherapy. Moreover, we positioned six different thermal probes in different abdominal regions inside the abdomen to measure the temperature during procedure. During the procedure, all thermal probes recorded an average temperature of 41.5°. At the end of infusion, the abdomen was emptied and then opened; the tracer distribution was recorded. No technical problems were recorded during the procedure. Good distribution of tracer was recorded. More studies are needed to investigate better this new technology. 相似文献
19.
Background Local peritoneal effects of laparoscopic gases might be important in peritoneal biology during and after laparoscopic surgery.
The most commonly used gas, CO2, is known to be well tolerated, but also causes changes in acid-base balance. Helium is an alternative gas for laparoscopy.
Although safe, it is not widely used. In this study a method for monitoring peritoneal pH during laparoscopy was evaluated
and peritoneal pH during CO2 and helium pneumoperitoneum was studied as well as its systemic reflection in arterial pH.
Methods For these experiments 20 pigs were used, with ten exposed to pneumoperitoneum with CO2, and ten to helium. Peritoneal and sub-peritoneal pH were continuously measured before and during gas insufflation, during
a 30-minute period with a pneumoperitoneum and during a 30-minute recovery period. Arterial blood-gases were collected immediately
before gas insufflation, at its completion, at 30 minutes of pneumoperitoneum and after the recovery period.
Results Peritoneal pH before gas insufflation was in all animals 7.4. An immediate local drop in pH (6.6) occurred in the peritoneum
with CO2 insufflation. During pneumoperitoneum pH declined further, stabilising at 6.4, but was restored after the recovery period
(7.3). With helium, tissue pH increased slightly (7.5) during insufflation, followed by a continuous decrease during pneumoperitoneum
and recovery, reaching 7.2. Systemic pH decreased significantly with CO2 insufflation, and increased slightly during helium insufflation. Systemic pH showed co-variation with intra-peritoneal pH
at the the end of insufflation and after 30 minutes of pneumoperitoneum.
Conclusions Insufflation of CO2 into the peritoneal cavity seemed to result in an immediate decrease in peritoneal pH, a response that might influence biological
events. This peritoneal effect also seems to influence systemic acid-base balance, probably due to trans-peritoneal absorption. 相似文献