Polarimetric imaging of subsurface tissue-numerical results

Tissue images obtained at deeper depths lack significant contrast. To enhance the contrast of these images and to increase the visibility of subsurface tissues, a method is proposed. This technique is based on the principle that photons at longer wavelengths penetrate deeper than photons at shorter wavelengths. In this technique, images in the original and orthogonal polarized states are recorded with the source illumination in linear polarized state at two different wavelengths. Image subtraction of a fraction of the copolarized image from the perpendicular polarized state is done on these images. The images obtained after the first processing are subjected to the next image subtraction where the shorter wavelength image is subtracted from the longer wavelength image. Monte Carlo simulations show that the resultant image has marked contrast up to 2.5 cm.     

Laparoscopic Management of Prosthetic Infections Following Laparoscopic Groin Hernioplasty — Experiences from a Tertiary Care Center

Hellenic Journal of Surgery - Despite increasing trends towards laparoscopic groin hernioplasty, its early prosthesis-related complications have hardly been addressed. Although conventionally...     

Anihypercholesterolemic effect of Semecarpus anacardium Linn nut milk extract in high-cholesterol-fed rats

The present study was carried to bring about the hypolipidemic effect of the drug Semecarpus anacardium Linn nut milk extract (SA) in hypercholesterolemia-induced rat model. Adult male Wistar rats were divided into four groups which included control rats, hypercholesterolemia-induced rats (high-cholesterol diet (4 %) for 30 days), hypercholesterolemic rats treated with the drug SA (200 mg/kg/b. wt oil), and the control rats treated with the drug SA (200 mg/kg/b. wt). Increased level of ROS and lipid peroxides were observed in hypercholesterolemic rats, whereas the levels of activities of antioxidant enzymes were found to be decreased in animals fed with a high-fat diet. Simultaneous administration of SA to these rats reverted back the changes to near-normal levels. Similarly, an increase in the expression of iNOS and LOX-1 were observed in high-fat-fed rats when compared to normal rats. Upon treatment with the drug SA, their expressions were brought back to near-normal levels. No adverse effects were observed in SA-alone treated group of rats, indicating its protective nature. The present study suggests that SA could play a protective role against hypercholesterolemia, thereby preventing coronary heart disease.     

Immunomodulatory effect of Kalpaamruthaa on 7,12-dimethyl benz(a)anthracene-induced mammary carcinoma studied in rats

Kapaamruthaa is a modified Siddha preparation prepared in our laboratory. It has been proven to have therapeutic effect against arthritis and liver cancer. The present study was carried out to bring about the protective effect of Kalpaamruthaa on experimental mammary carcinoma in rats with special reference to cytokines, carcinoembryonic antigen (CEA), carbohydrate antigen 15–3 (CA 15–3), immunoglobulin levels, and glycoprotein components. Breast cancer was induced in rats by administering 7,12-dimethylbenz(a)anthracene (DMBA) orally (25 mg/rat) as a single dose. After 90 days of induction, Semecarpus anacardium Linn. (200 mg/kg body weight) and Kalpaamruthaa (KA) (300 mg/kg body weight) were administered for 14 days, by gastric intubation. In mammary carcinoma-bearing rats, the levels of interleukin-6, interleukin-8, and tumor necrosis factor-α were significantly increased (p?<?0.001) in serum when compared to control rats. The levels of CEA and CA 15–3 were found to be significantly increased (p?<?0.001) in mammary carcinoma-bearing rats. The levels of IgG and IgM were significantly decreased (p?<?0.001) whereas IgA levels were significantly increased (p?<?0.001) in mammary carcinoma-bearing rats. The levels of glycoprotein components namely hexose, hexosamine, and sialic acid were significantly (p?<?0.001) increased in the spleen and thymus of the mammary carcinoma-bearing (group II) rats when compared to control rats. Treatment with KA significantly altered the levels of cytokines, CEA, CA 15–3, immunoglobulins, and glycoprotein components to near normal levels when compared to breast cancer-induced rats. The present study suggests the therapeutic effect of KA in DMBA-induced mammary carcinoma in rats.     

Perforation of Jejunal Diverticula in Steroids and Nonsteroidal Anti-Inflammatory Drug Abusers: A Case Series

INTRODUCTION: Jejunal diverticula are rare lesions, and when complications arise, they pose diagnostic difficulties. Perforation is a common complication resulting in an acute abdomen, although preoperative diagnosis is usually not possible. The "gold standard" for management for patients with complications is surgery. We present a series of patients with perforated jejunal diverticula who were on prolonged treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) and steroids for Chikungunya fever. METHODS: There were a total of six patients, all of them presenting with perforative peritonitis, with or without shock. Plain abdominal radiogram and ultrasonogram confirmed this, although the exact site of the perforation was not diagnosed preoperatively. All patients underwent exploratory laparotomy and perforated jejunal diverticulum was found. Resection and anastomosis was performed in all cases. RESULTS: The mean operating time was 113.5 minutes, and the blood loss was not significant. Postoperative course was uneventful except wound infection in two patients. There was no mortality. CONCLUSIONS: Prolonged NSAID and steroid use are known to cause ulceration/perforation of the upper digestive tract and colonic diverticula. This seems to be the most likely cause for the perforation of jejunal diverticula in our series of patients. This view is supported by the absence of inflammation and infiltration of neutrophils on histopathological examination of the diverticula.     

Laparoscopic restorative total proctocolectomy with ileal pouch anal anastomosis for familial adenomatous polyposis

BACKGROUND: Familial adenomatous polyposis is a hereditary disease characterized by the presence of thousands of colonic adenomas, which, if untreated, invariably undergo malignant transformation. Because this disease manifests at a young age, the laparoscopic approach to perform surgery would be desirable due to its cosmetic benefits. We describe our experience with this procedure and review the literature on the topic. METHODS: This is a case series of 15 patients who underwent restorative proctocolectomy with ileo-anal pouch anastomosis for familial adenomatous polyposis between 2000 and 2007. The salient operative steps are described. RESULTS: There were 9 males and 6 females, 32 to 52 years of age, with an average age of 44.8 years. The median body mass index was 21.5 (range, 17 to 28). Rectal cancer was already present in 4 patients at the time of diagnosis. The median operating time was 225 minutes. Mean blood loss was 60 mL, with none of the patients requiring perioperative blood transfusion. None of the surgeries required conversion to the open approach. Bowel function resumed on the second postoperative day in 12 patients and on the third postoperative day in 3 patients. The median hospital stay was 8 days. Postoperatively, there was no mortality and no serious morbidity. CONCLUSION: Laparoscopic restorative proctocolectomy with ileal pouch anal anastomosis is a feasible surgery for familial adenomatous polyposis, and considering its cosmetic benefit, is a desirable option for this group of predominantly young patients.     

Laparoscopic right hemicolectomy for mucocele due to a low-grade appendiceal mucinous neoplasm.

Tumors of the appendix are rare entities causing mucoceles. The majority of them are discovered incidentally during investigation for other conditions. Laparoscopic surgery for appendiceal tumors is still controversial, as inadvertent rupture of the lesion due to improper handling will cause pseudomyxoma peritonei. The patient was incidentally discovered to have an appendiceal tumor and referred to us for laparoscopy. Because the tumor involved the entire appendix, a laparoscopic right hemicolectomy was performed without directly handling the tumor. Postoperative recovery was uneventful. Pathological diagnosis was low-grade appendiceal mucinous neoplasm. The safety of laparoscopic appendectomy for the management of incidentally discovered appendiceal tumors has not yet been established. Several reports in the literature support both laparoscopic and open surgery. The main concerns to be addressed are the adequacy of resection and intraperitoneal rupture of the tumor. Our patient successfully underwent laparoscopic surgery without any complications. A formal right hemicolectomy was performed because the tumor involved the entire appendix. We now think laparoscopic surgery for appendiceal tumors is safe, feasible, and even may be beneficial.     

Laparoscopic repair of diastasis recti using the ‘Venetian blinds’ technique of plication with prosthetic reinforcement: a retrospective study

Background  Diastasis is a separation of the two recti due to various reasons, and can be measured as the ‘inter-recti distance’ (IRD). Surgery for diastasis is controversial, while laparoscopic repair has rarely been reported. We describe our method of laparoscopic plication—the ‘Venetian blinds’ technique combined with mesh reinforcement for patients with diastasis of the recti. Materials and methods  A total of 18 patients out of 35 that presented to us were operated. The common indications were cosmesis and discomfort while performing normal activities. Laparoscopic plication with the ‘Venetian blinds’ technique of the diastasis with prosthetic reinforcement was performed for all cases. Results  The mean body mass index (BMI) was 28.6 kg/m² (range 25–32.2) and obese patients had a larger IRD. The mean operating time was 113 min (range 72–154). Minor complications were present in five (27.77%) patients. The recurrence rate after 6–48 months follow up was 0% in this series. Discussion  Even though surgery for diastasis is controversial, we advocate repair for cosmesis and restoring function of the recti muscles. Our ‘Venetian blinds’ technique provides a solid repair and reduces the risk of seroma. The use of a prosthesis for the repair is mandatory to prevent recurrence. The adequacy of repair was assessed by measuring the IRD preoperatively and postoperatively with computed tomography (CT) scan. Laparoscopy provides all of the benefits of minimal access surgery.