Anatomical structures at risk using different approaches for sacrospinous ligament fixation

For 50 years now, sacrospinous ligament fixation (SSLF) has been used to treat pelvic organ prolapse consequent on altered integrity of the pelvic myofascial structures. It is usually performed vaginally, but it has recently been performed laparoscopically through either an anterior or a posterior approach, with the broad ligament as a landmark to differentiate the two. In the present study, these two laparoscopic approaches were assessed using Thiel-embalmed cadavers. The anterior and posterior approaches were compared in terms of the closest distance to anatomical structures at risk, including pelvic viscera, the obturator nerve, and vascular structures. The posterior approach was more often closer to the investigated vessels and the rectum. The obturator nerve and the ureter were close to both the anterior and posterior approaches. The urinary bladder was closer using the anterior approach. From an anatomical standpoint, therefore, the anterior laparoscopic approach for SSLF is more likely to cause injury to the urinary bladder, whereas the posterior approach is more prone to causing rectal and vessel injuries. This study illustrates, from a basic science perspective, the importance of combining fascia research, novel endoscopic or minimally invasive surgical exposures informed by anatomy, and contemporary trends in gynecology in order to improve patient outcomes. Clin. Anat. 33:522–529, 2020. © 2019 Wiley Periodicals, Inc.     

Prognostic value of MMP-2, -9 and TIMP-1,-2 immunoreactive protein at the invasive front in advanced head and neck squamous cell carcinomas

In head and neck cancer as well as in other carcinomas, tumor expansion and spread to distant sites require the secretion of destructive enzymes that degrade the extracellular matrix. A variety of proteases contribute to matrix destruction. Characteristics of the invasive tumor front may reflect tumor prognosis better than do other parts of the tumor. Therefore, it was the aim of the present study to (i) compare central and peripheral tumor zones for differences in the expression of matrix-metalloproteinases (MMP) -2 and -9 and their naturally occurring inhibitors (tissue inhibitor of matrix-metalloproteinases (TIMP) -1 and -2), (ii) examine the morphological potential of malignancy, and (iii) correlate these findings with clinicopathological parameters. The study population consisted of 106 surgical specimens of advanced head and neck squamous cell carcinomas. The invasive front was graded for malignancy, and immunohistochemical staining with MMP-2, MMP-9, TIMP-1 and TIMP-2 antibodies was performed. Both MMP-2 and MMP-9 were found to be significantly overexpressed at the tumor front. The MMP-2-positive invasive front exhibited diminished overall survival times. In multivariate analysis, MMP-2 expression retained its correlation with overall survival in addition to nodal status and total malignancy score. Expression of TIMP-2 correlated with local tumor invasion. We conclude that the expression of MMP-2 at the invasive front is a marker of poor survival and appears to be associated with early recurrence in initially lymph node-negative patients.     

Deep spatial profiling of human COVID-19 brains reveals neuroinflammation with distinct microanatomical microglia-T-cell interactions

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Einfach und praktisch: rechtliche Grundlagen und Verhalten an Einsatzorten mit Verstorbenen

Notfall + Rettungsmedizin -     

Perikardlazeration nach Verwendung einer automatischen externen Reanimationshilfe

Notfall + Rettungsmedizin - Wir berichten über einen 72-jährigen Patienten, der aufgrund eines plötzlichen Herzkreislaufstillstands mithilfe einer automatischen externen...     

Metabolomics in postmortem cerebrospinal fluid diagnostics: a state-of-the-art method to interpret central nervous system–related pathological processes

International Journal of Legal Medicine - In the last few years, quantitative analysis of metabolites in body fluids using LC/MS has become an established method in laboratory medicine and...     

Biological effects of imidazolium ionic liquids with varying chain lengths in acute Vibrio fischeri and WST-1 cell viability assays

Detailed biological studies of methyl- and some ethylimidazolium ionic liquids in luminescent bacteria as well as in the IPC-81 (leukemia cells) and C6 (glioma cells) rat cell lines are presented. Effective concentrations in these test systems are generally some orders of magnitude lower than effective concentrations [corrected] of the conventional solvents acetone, acetonitrile, methanol, and methyl t-butyl ether. No general influence of the anionic compound in the ionic liquids on toxicity could be found, although they seem to modulate toxicity in some cases. The clear influence of the alkyl chain length on toxicity was quantified by linear regression analysis. Alkyl chain length of the longer alkyl chain was varied from 3 to 10 carbon atoms. Consequences for a design of sustainable alternative solvents are briefly sketched.     

Einfach und praktisch: Feststellung des Todes

Notfall + Rettungsmedizin -