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1.
Front Neurol ; 13: 1034402, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36313497

RESUMO

Background and purpose: The relationship between the tortuosity of the parent artery and treatment outcomes is not well established. We investigate the association between parent artery tortuosity and flow diverter (FD) treatment outcomes in patients with internal carotid artery aneurysms in this study. Methods: A retrospective review study was conducted to identify all patients with internal carotid artery aneurysms who were implanted with Pipeline embolization device (PED) between 2016 and 2020. The relationship between parent artery tortuosity and aneurysm complete occlusion (CO) and in-stent stenosis (ISS) was analyzed. The mathematical parameters "Curvature", "torsion", and "DM" extracted from the parent artery were utilized to quantify the parent artery tortuosity. A vascular narrowing of greater than 25% was categorized as ISS. Logistic regression analysis was used to identify significant independent predictors. Furthermore, we compared the performance of four machine learning algorithms and Logistic Regression model in predicting ISS. Results: This research included 62 patients who with internal carotid artery aneurysms. In 49 (79%) cases, follow-up angiography (mean follow-up duration 11.7 ±7.3 months) revealed CO of the aneurysm. ISS was detected in 22 (35.5%) cases. According to univariate analysis, parent artery tortuosity and other variables were not associated with CO (p > 0.1). Maximum curvature (OR = 1.084; 95% CI, 1.008-1.165; p = 0.03) and DM (OR = 0.01; 95% CI, 0-0.488; p = 0.02) exhibited strong independent associations with ISS in multivariate analysis. The SVM model is superior to the conventional Logistic Regression model and the other models in predicting ISS. Conclusions: The tortuosity of the parent artery may affect the treatment outcome of FD stenting. We found that parent artery tortuosity was associated with ISS, but not with aneurysm complete occlusion following PED stenting for internal carotid artery aneurysms in this study. Parent arteries with higher maximum curvature and lower DM were more likely to develop ISS.

2.
J Healthc Eng ; 2022: 8509195, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35028125

RESUMO

To treat large intracranial aneurysms, pipeline embolization device (PED) stent with unsupervised learning algorithms was utilized. Unsupervised learning model algorithm was used to screen aneurysm health big data, find aneurysm blood flow and PED stent positioning characteristic parameters, and guide PED stent treatment of intracranial aneurysms. The research objects were 100 patients with intracranial large aneurysm admitted to X Hospital of X Province from June 2020 to June 2021, who were enrolled into two groups. One group used the prototype transfer generative adversarial network (PTGAN) model to measure mean blood flow and mean vascular pressure and guide the placement of PED stents (PTGAN group). The other group did not use the model to place PED (control group). The PTGAN model can learn feature information from horizontal and vertical directions, with smooth edges and prominent features, which can effectively extract the main morphological and texture features of aneurysms. Compared with the convolutional neural network (CNN) model, the accuracy of the PTGAN model increased by 8.449% (87.452%-79.003%), and the precision increased by 8.347% (91.23%-82.883%). The recall rate increased by 7.011% (87.231%-80.22%), and the F1 score increased by 8.09% (89.73%-81.64%). After the adoption of the PTGAN model, the average blood flow inside the aneurysm body was 0.22 (m/s). After the adoption of the CNN model, the average blood flow inside the aneurysm body was 0.21 (m/s), and the difference was 0.01 (m/s), which was considerable (p < 0.05). Through this research, it was found that the PTGAN model was better than the CNN model in terms of accuracy, precision, recall, and F1 score values. The PTGAN model was better than the CNN model in detecting the average blood flow rate and average blood pressure after treatment, and the blood flowed smoothly. Postoperative complications and postoperative relief were also better than those of the control group. In summary, based on the unsupervised learning algorithm, the PED stent had a good adoption effect in the treatment of intracranial aneurysms and was suitable for subsequent treatment.


Assuntos
Embolização Terapêutica , Aneurisma Intracraniano , Algoritmos , Hemodinâmica , Humanos , Aneurisma Intracraniano/cirurgia , Stents , Resultado do Tratamento , Aprendizado de Máquina não Supervisionado
3.
Front Med (Lausanne) ; 9: 1094347, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36714132

RESUMO

Echovirus 18 has been recognized as an important causative pathogen of aseptic meningitis in young children worldwide, and echovirus 18-induced meningitis is rarely found in adults with immunocompetence. In this case study, we report the clinical and virological characteristics of aseptic meningitis caused by recombinant echovirus 18 in an adult with immunocompetence. A 31-year-old woman with immunocompetence was admitted to our hospital with fever, dizziness, severe headache, nausea, and vomiting for the past 1 day and was diagnosed with viral meningitis based on the clinical manifestations and laboratory results from cerebrospinal fluid (CSF). The patient received antiviral treatment with ribavirin and interferon as soon as the enterovirus infection was identified using qRT-PCR and was cured after 4 days. From the oropharyngeal swab and CSF samples, two echovirus 18 strains were isolated with a single nucleotide difference located at the 5' UTR. Phylogenetic analyses based on the VP1 gene showed that the two strains belonged to the subgenotype C2 and were clustered with sequences obtained from China after 2015, while the results from the 3D polymerase region showed that the two strains were closely related to the E30 strains. Bootscanning results using the 5' UTR to 2A region and the 2B to 3' UTR region showed that potential intertypic recombination had occurred in the 2B gene. Recombination analyses further confirmed that the two strains (echovirus 18) presented genome recombination with echovirus 30 in the nucleotide regions of the 2B gene. To the best of our knowledge, this is the first report of echovirus 18-induced meningitis in an adult with immunocompetence from mainland China, highlighting the need for close surveillance of echovirus 18 both in children and adults in the future.

4.
J Craniofac Surg ; 32(7): 2435-2440, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34705388

RESUMO

OBJECTIVE: This study intends to discuss the individualized selection of surgical scheme of hydrocephalus complicated with skull defect. METHODS: A total of 141 patients with hydrocephalus complicated with skull defect in our hospital from January 2012 to December 2018 were the main subjects of this study. Among these 141 patients, 78 patients underwent shunt and skull repair surgery in our hospital. In the present study, according to the classification of bone window tension, and combined with factors that affect the operation, different surgical schemes were selected, namely, repair surgery in the first phase and shunt surgery in the second phase, or simultaneous surgery, or shunt surgery in the first phase and repair surgery in the second phase. RESULTS: The results of the present study show that an individualized surgical scheme can allow for the operation of hydrocephalus complicated with skull defect, without increasing the risk of complications, such as shunt infection, epidural hematoma, etc. CONCLUSIONS: The surgical scheme for hydrocephalus complicated with skull defect differs in clinic.


Assuntos
Implantes Dentários , Hidrocefalia , Humanos , Hidrocefalia/complicações , Hidrocefalia/cirurgia , Estudos Retrospectivos , Crânio/cirurgia , Derivação Ventriculoperitoneal
5.
Wideochir Inne Tech Maloinwazyjne ; 16(1): 219-226, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33786137

RESUMO

INTRODUCTION: Subdural effusion is a common complication that occurs after decompressive craniectomy. According to the endoscopy results, the formation mechanism of subdural effusion after decompressive craniectomy was discussed. AIM: The morphological structure of subdural effusion in skull defects was observed with endoscopy, and endoscopic-assisted surgery was performed for subdural effusion. MATERIAL AND METHODS: From January 2018 to March 2020, 19 cases of skull repair and treatment of subdural effusion were performed. The external wall of the capsule was kept intact during the operation, subdural effusion and surgical procedure of the subdural effusion under an endoscope could be observed, and the results of endoscopic observation were described and recorded. A hemostasis gauze was placed between the two layers of the subdural effusion cavity. Another 13 cases of skull defects with subdural effusion treated without endoscopy during the same time period were enrolled in the study as the control group. The postoperative disappearance of effusion and the incidence of postoperative complications were compared between the two groups. RESULTS: Analysis with an endoscope revealed that all cases of subdural effusion in skull defects presented capsules. The main structures included the outer wall, boundary, inner wall, and fistula. The outer wall was made up of new tissue that had formed after removing the bone flap under the skin flap by artificial peeling under the condition of keeping the whole cavity. The inner wall consisted of thickened arachnoid, dura, and artificial dura. It presented with neovascularization networks, which showed a tendency to form new membrane structures through mutual adhesion and fusion. The inner and outer wall of the skull had fused to form the boundary of the cavity. Cerebrospinal fluid fistulas were detected in 31.6% of the internal walls. Subdural effusion was effectively treated in both the experimental group and the control group. Compared with the control group, complications in the experimental group were significantly reduced. CONCLUSIONS: The effusion cavity can be divided into three types based on its structural characteristics: fistula type, membrane type, and closed type. In this study, the formation mechanism of skull defects combined with subdural effusion was explored. This represents a new method for treating subdural effusion in which hemostasis gauze is placed between the two layers of the effusion cavity and cerebrospinal fluid fistula under an endoscope, which can effectively reduce the incidence of postoperative complications.

6.
Nanoscale ; 12(34): 17715-17724, 2020 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-32555857

RESUMO

As a new class of two-dimensional transition-metal carbides and carbonitrides, MXenes have been widely used in energy storage, sensing, catalysis, electromagnetic interference shielding and other fields. It is a challenge to simultaneously realize a sensor with extremely high sensitivity, wide detection limits, low power consumption and good mechanical stability. In this work, taking advantage of the high conductivity of MXenes and the porous structure of polyvinyl butyral, a highly sensitive piezoresistive sensor was fabricated. The fabricated MXene/PVB-based sensor exhibits high sensitivity and reliability with a factor of ∼11.9 kPa-1, ∼1.15 kPa-1 and ∼0.20 kPa-1 in the ranges of 31.2 Pa-312 Pa, 312 Pa-62.4 kPa and 62.4 kPa-1248.4 kPa, respectively. The sensor has a wide detection range (∼31.2 Pa to ∼2.205 MPa), low detection limit (6.8 Pa), low detection voltage (0.1 mV), low power consumption (∼3.6 × 10-10 W), fast response time (∼110 ms) and good mechanical stability (over 10 000 maximum-pressure cycles). Moreover, it is demonstrated that the sensor can detect subtle bending and release activities of humans, including arterial pulses and voice signals, which makes it potentially suitable to be used as a wide detection range, highly sensitive and low power consumption piezoresistive sensor. This work provides a new avenue to expand the application of MXene-based flexible pressure sensors with a wide sensing range and ultra-low power consumption.

8.
Medicine (Baltimore) ; 98(32): e16725, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31393380

RESUMO

BACKGROUND: To verify the accuracy of serum dickkopf-1 protein (DKK-1) in the diagnosis of hepatocellular carcinoma (HCC) by an updated meta-analysis. METHODS: We searched potential eligible studies in PubMed and Embase before July 8, 2018. Sensitivity (SN), specificity (SP), positive likelihood ratio (PLR), negative likelihood ratio (NLR), summary receiver operating characteristics curve (sROC), and diagnostic odds ratio (DOR) were pooled with their 95% confidence intervals CIs) using a bivariate random-effects model. RESULTS: A total of 8 articles contained 10 studies on diagnosis of HCC with DKK-1 alone,7 articles contained 9 studies on diagnosis of HCC with a-fetoprotein (AFP) alone and 5 articles contained 7 studies on diagnosis of HCC with DKK-1 + AFP were identified. The pooled SN, SP, PLR, NLR, and DOR of DKK-1 alone, AFP alone and DKK-1 + AFP were 0.72 (95% CI: 0.70-0.75), 0.62 (95% CI:0.59-0.64) and 0.80 (95% CI:0.78-0.83), 0.86 (95% CI: 0.84-0.87), 0.82 (95% CI:0.80-0.84) and 0.87 (95% CI: 0.85-0.88), 4.91 (95% CI: 2.73-8.83), 3.60 (95% CI:2.01-6.44) and 6.18 (95% CI: 4.68-8.16), 0.32 (95% CI: 0.22-0.47), 0.49 (95% CI:0.40-0.60) and 0.20 (95% CI: 0.15-0.26), and 17.21 (95% CI: 9.10-32.57), 7.45 (95% CI:3.69-15.01) and 31.39 (95% CI: 23.59-43.20), respectively. The area under the sROC was 0.88, 0.70, and 0.92 for the 3 diagnostic methods. CONCLUSIONS: Serum DKK-1 + AFP showed a high accuracy for diagnosis of HCC, and serum DKK-1 alone had moderate accuracy as compared to a previous meta-analysis, while AFP alone owned an unsatisfied diagnostic behavior for HCC. Due to the limitations of the current analysis, further well-designed studies are needed to confirm the diagnostic value of DKK-1 and DKK-1 + AFP in HCC diagnosis.


Assuntos
Carcinoma Hepatocelular/sangue , Peptídeos e Proteínas de Sinalização Intercelular/sangue , Neoplasias Hepáticas/sangue , Carcinoma Hepatocelular/diagnóstico , Humanos , Neoplasias Hepáticas/diagnóstico , Valor Preditivo dos Testes , alfa-Fetoproteínas/análise
9.
Exp Ther Med ; 15(4): 3815-3819, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29581739

RESUMO

The aim of the present study was to investigate the advantages and disadvantages of the diving endoscopic technique in pituitary adenoma surgery, and the application value in determining the extent of tumor resection. A total of 37 patients with pituitary adenoma initially underwent tumor resection under an endoscope-assisted microscope via standard trans-nasal-sphenoidal approach, and tumor cavity structure was observed by applying the diving endoscopic technique. Surgery was subsequently performed again under a microscope or endoscope. The diving endoscopic technique allowed surgeons to directly observe the structure inside a tumor cavity in high-definition. In the present study, 24 patients had pituitary macroadenomas or microadenomas that did not invade the cavernous sinus, and were considered to have undergone successful total resection. Among these patients, no tumor residues were observed through the diving endoscopic technique. Some white lichenoid or fibrous cord-like tissues in the tumor cavity were considered to be remnants of tumors. However, pathology confirmed that these were not tumor tissues. For tumors that invaded the cavernous sinus in 13 patients, observation could only be conducted under the angulation endoscope of the diving endoscope; i.e., the operation could not be conducted under an endoscope. The present study suggests that the diving endoscopic technique may be used to directly observe the resection extent of tumors within the tumor cavity, especially the structure of the tumor cavity inside the sella turcica. The present study also directly validates the reliability of pituitary adenoma resection under endoscope-assisted microscope. In addition, the diving endoscopic technique also allows the surgeon to observe the underwater environment within the sella turcica.

10.
Nanoscale ; 10(4): 2148-2153, 2018 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-29327012

RESUMO

Two-dimensional atomically flat sheets with a high mechanical flexibility are very attractive as ultrathin membranes but are also inherently challenging for microscopic investigations. We report on a method using Scanning Tunneling Microscopy (STM) under ultra-high vacuum conditions for non-indenting low-force spectroscopy on micrometer-sized freestanding graphene membranes. The method is based on applying quasi-static voltage ramps with active feedback at low tunneling currents and ultimately relies on the attractive electrostatic force between the tip and the membrane. As a result a bulge-test scenario can be established. The convenience and simplicity of the method relies on the fact that the loading force and the membrane deflection detection are both provided simultaneously by the STM. This permits the continuous measurement of the stress-strain relation. Electrostatic forces applied are typically below 1 nN and the membrane deflection is detected at sub-nanometer resolution. Experiments on single-layer graphene membranes with a strain of 0.1% reveal a two-dimensional elastic modulus E2D = 220 N m-1.

11.
Anat Sci Int ; 91(2): 175-9, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25859757

RESUMO

The myodural bridge was first described by Hack in 1995 and was thought to be related to chronic cervicogenic headaches. For a long time, few studies revealed the patterns of the myodural bridge considering the rectus capitis posterior minor muscle. In this study, P45 plastination technology and anatomical dissection were performed on head specimens, and four different terminal region types of the rectus capitis posterior minor muscle were observed, including the posterior atlanto-occipital interspace, posterior arch of the atlas and posterior atlanto-axial interspace. We propose that the myodural complex structures in the posterior atlanto-occipital and posterior atlanto-axial interspace have cooperative effects on cerebrospinal fluid and work together. This force might be an important source for the circulation of cerebrospinal fluid.


Assuntos
Cabeça , Músculo Esquelético/anatomia & histologia , Pescoço , Líquido Cefalorraquidiano/fisiologia , Dissecação/métodos , Humanos , Músculo Esquelético/fisiologia , Inclusão em Plástico/métodos
12.
Int J Clin Exp Med ; 8(9): 14863-70, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26628968

RESUMO

OBJECTIVE: To determine whether Povidone-iodine was toxic to brain tissues by rinsing the cerebral cortex of New Zealand rabbits with Povidone-iodine Solution of different concentrations. METHODS: 12 New Zealand rabbits were randomly divided into 4 groups (Group A, B, C and D, 3 rabbits each group). In each group, the left cerebral cortex of rabbits was rinsed with physiological saline after the craniotomy; in Group A and B, the right cerebral cortex of rabbits was also locally rinsed with Povidone-iodine Solution (0.01%), in Group C and D, the right cerebral cortex of rabbits was also locally rinsed with Povidone-iodine Solution (0.05%). In Group A and C, the rabbits were sacrificed at D3 after the operation, and the brain was taken out; and in Group B and D, the rabbits were sacrificed at D7 after the operation, and the brain was taken out. Under the optical and electron microscope, the change in micro-structure of brain tissues was observed in each group. RESULTS: In each group, there was no epilepsy or paralysis during and after the operation. At the treatment side of physiological saline, there was no significant cell damage in the local brain tissues. At the treatment side of Povidone-iodine Solution, there was no cell apoptosis or degeneration in the local brain tissues. CONCLUSION: The Povidone-iodine Solution (0.05% and 0.01%) was toxic to brain tissues, with a more obvious damage of brain tissues for the former concentration. The histological sign was more serious at D7 than that at D3.

13.
Zhonghua Gan Zang Bing Za Zhi ; 23(1): 17-22, 2015 Jan.
Artigo em Chinês | MEDLINE | ID: mdl-25751381

RESUMO

OBJECTIVE: To investigate the effect of different nucleoside analogues on the long-term survival rate of patients with acute-on-chronic liver failure (ACLF) associated with hepatitis B virus (HBV) infection. METHODS: One hundred and eighty patients with HBV-related ACLF were enrolled in this prospective cohort study and divided into a basic treatment group (n=30) and an antiviral treatment group, the latter of which was further subdivided into the lamivudine treatment group (n=66), telbivudine treatment group (n=38) and entecavir treatment group (n=46) according to voluntary choice by the patient.All study participants were followed-up for 24 months. The Kaplan-Meier method was applied for survival analysis. RESULTS: The patients in the four antiviral treatment groups had statistically similar baseline clinical characteristics and 1-month survival rates (Breslow =4.475, P=0.215).However, the basic treatment group had a significantly lower survival rate than the antiviral treatment groups that received lamivudine, telbivudine, or entecavir (all P less than 0.05) at the treatment periods of 2, 3, 6, 12 and 18-months; however, these three treatment groups showed no significant differences in survival rates. At the time point of 24 months of treatment, the basic treatment group retained its lower rate of survival than the three antiviral treated groups (lamivudine:Breslow =5.604, P=0.018; telbivudine:Breslow =5.621, P=0.018; entecavir:Breslow =14.701, P less than 0.001); while the survival rates were similar for the lamivudine treatment group and the telbivudine treatment group at this time point, their survival rates were significantly lower than that of the entecavir treatment group (Breslow =4.010, P=0.045; Breslow =4.307, P=0.038).Stratification analysis showed that when the baseline was 30 less than PTA less than or equal to 40 or MELD less than or equal to 29 or HBV DNA more than or equal to 5 log10 IU/mL, the cumulative survival rates of the basic treatment group and antiviral treatment group were statistically similar even though the patients had completed 1 month of treatment After being treated for 2, 3, 6, 12, 18 and 24 months, the cumulative survival rates of the basic treatment group were consistently below those of the overall antiviral treatment group (P less than 0.05). The cumulative survival rate of the basic treatment group followed-up for 1 to 24 months, with PTA values between 20 and 30, was lower than that of the overall antiviral treatment group (P less than 0.05); two groups of patients with PTA less than or equal to 20 or MELD more than or equal to 30 were followed-up for 1 months to 24 months, and their cumulative survival rates showed no significant difference (P more than 0.05). Among the patients whose baseline was HBV DNA less than 5 log10 IU/mL, the comparison of survival rates between the basic treatment group and the overall antiviral treatment group showed no significant differences after treatment for 1, 2, 3, 6, 12 or 18 months, and the survival rate was lower than that of the overall antiviral treatment group (Breslow =4.055, P=0.044) after 24 months. CONCLUSION: Nucleoside analogues can improve the long-term survival rate of HBV-related ACLF patients.Entecavir is preferred for the long-term treatment of these patients.Patients in the early and middle stages of this disease and HBV DNA-positive patients should adopt antiviral treatment as early as possible.


Assuntos
Insuficiência Hepática Crônica Agudizada , Vírus da Hepatite B , Hepatite B Crônica , Antivirais , Estudos de Coortes , Guanina/análogos & derivados , Humanos , Lamivudina , Estudos Prospectivos , Análise de Sobrevida , Taxa de Sobrevida , Telbivudina , Timidina/análogos & derivados , Fatores de Tempo
14.
PLoS One ; 9(8): e103451, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25084162

RESUMO

Few studies have been conducted specifically on the dense connective tissue located in the posterior medial part of the cervical epidural space. This study was undertaken to examine the presence of this connection between the cervical dura mater and the posterior wall of spinal canal at the level of C1-C2. 30 head-neck specimens of Chinese adults were used. Gross dissection was performed on the suboccipital regions of the 20 specimens. Having been treated with the P45 plastination method, 10 specimens were sliced (9 sagittal and 1 horizontal sections). As a result, a dense fibrous band was identified in the nuchal ligament of 29 specimens (except for one horizontal section case). This fascial structure arose from the tissue of the posterior border of the nuchal ligament and then projected anteriorly and superiorly to enter the atlantoaxial interspace. It was termed as to be named ligament (TBNL). In all 30 specimens the existence of a fibrous connection was found between the posterior aspect of the cervical dura mater and the posterior wall of the spinal canal at the level of the atlas to the axis. This fibrous connection was identified as vertebrodural ligament (VDL). The VDL was mainly subdivided into three parts, and five variations of VDL were identified. These two structures, TBNL and VDL, firmly link the posterior aspect of cervical dura mater to the rear of the atlas-axis and the nuchal region. According to these findings, the authors speculated that the movements of the head and neck are likely to affect the shape of the cervical dural sleeve via the TBNL and VDL. It is hypothesized that the muscles directly associated with the cervical dural sleeve, in the suboccipital region, may work as a pump providing an important force required to move the CSF in the spinal canal.


Assuntos
Líquido Cefalorraquidiano/fisiologia , Vértebras Cervicais/anatomia & histologia , Ligamentos Articulares/anatomia & histologia , Ligamentos/anatomia & histologia , Espaço Epidural , Feminino , Humanos , Masculino
15.
Chin Med J (Engl) ; 127(2): 348-52, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24438627

RESUMO

BACKGROUND: The operating microscopes have been applied to modern surgery for nearly a century. However, generations of microsurgeons have to flex their necks and fix their eyes on the eyepieces of a microscope continually that leads to physical and mental fatigue during a long operation. Stereoscopic three-dimensional (3D) media provides more ergonomic working environment, subsequently, resulting better performance in tasks and more accurate judgment. In this study, an alternative method of magnification was analyzed using a three-dimensional microsurgical video system and compared with the traditional method under microscopy to evaluate the availability and feasibility of a 3D microsurgical video system for microvascular anastomosis. METHODS: Forty Sprague-Dawley rats were randomly divided into four groups with each of 10. In 20 rats, 10 femoral artery anastomoses with a conventional microscope (arterial microscope group) were compared with that of 10 femoral artery anastomoses with a 3D microsurgical video system (arterial 3D group). For the other 20 rats, 10 femoral vein anastomoses using a conventional microscope (venous microscope group) were compared with that of 10 femoral vein anastomoses using a 3D microsurgical video system (venous 3D group). The arterial and venous microscope groups were considered to be the control groups. The arterial and venous 3D groups were the experimental groups. The examined criteria were as follows: anastomotic time, patency right after the procedure and 10 days later, number of sutures, vessel caliber, and pathological features. RESULTS: There were no differences between the operating equipment with respect to vessel caliber, anastomotic time, patency rate, number of sutures, and pathological changes in either the small arteries or veins. The average arterial anastomotic time of the arterial microscope group and arterial 3D group was 34.21 and 33.87 minutes, respectively (P > 0.05). The average venous anastomotic time of the venous microscope group and venous 3D group was 29.95 and 31.50 minutes, respectively (P > 0.05). CONCLUSIONS: A small vessel anastomosis can be performed successfully with the help of a 3D display system. Although the vascular anastomotic time did not demonstrate a significant difference between the groups, the 3D microsurgical video system offers another option to improve the working environment for surgeons. Further development of our 3D monitoring system should focus on a higher resolution and better flexibility.


Assuntos
Anastomose Cirúrgica/métodos , Artéria Femoral/cirurgia , Veia Femoral/cirurgia , Microscopia de Vídeo/métodos , Animais , Feminino , Ratos , Ratos Sprague-Dawley
16.
Clin Anat ; 25(4): 489-95, 2012 May.
Artigo em Inglês | MEDLINE | ID: mdl-21913230

RESUMO

With the development of hepatic surgery and radiology, an increasing amount of researchers have reported discrepancies between the real distribution of the hepatic portal vein branches and Couinaud's segmentation, especially for further division of the right medial division. The present study investigated 25 cadaveric liver dissections and 30 three-dimensional reconstruction images of intrahepatic vessels. The ramifications, course, distribution and quantity of the portal branches were analyzed. An oblique fissure that had few vessels was found among third-order branches of the hepatic portal vein of the right medial division. The right medial division could be redivided into the ventral subsegment and dorsal subsegment by this oblique fissure. A hepatic vein coursed in the oblique fissure between the ventral subsegment and dorsal subsegment. The hepatic vein could serve as an anatomical landmark of the inter-subsegmental plane. This new method of identifying further division of the right medial division is a novel concept providing further information on conventional segmental anatomy.


Assuntos
Fígado/irrigação sanguínea , Veia Porta/anatomia & histologia , Adulto , Humanos , Imageamento Tridimensional , Fígado/diagnóstico por imagem , Veia Porta/diagnóstico por imagem , Tomografia Computadorizada Espiral
17.
World J Gastroenterol ; 11(19): 3005-7, 2005 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-15902747

RESUMO

AIM: To determine whether mild hypothermia could protect liver against ischemia and reperfusion injury in pigs. METHODS: Twenty-four healthy pigs were randomly divided into normothermia, mild hypothermia and normal control groups. The experimental procedure consisted of temporary interruption of blood flow to total hepatic lobe for different lengths of time and subsequent reperfusion. Hepatic tissue oxygen pressure (PtiO2) and aspartate aminotransferase (AST) values were evaluated, and ultrastructural analysis was carried out for all samples. RESULTS: Serum AST was significantly lower, and hepatic PtiO2 values were significantly higher in the mild hypothermia group than in the normothermia group during liver ischemia-reperfusion periods (P=0.032, P=0.028). Meanwhile, the histopathologic injury of liver induced by ischemia-reperfusion was significantly improved in the mild hypothermia group, compared with that in the normothermia group. CONCLUSION: Mild hypothermia can protect the liver from ischemia-reperfusion injury in pigs.


Assuntos
Hipertermia Induzida , Circulação Hepática , Hepatopatias/prevenção & controle , Traumatismo por Reperfusão/prevenção & controle , Animais , Feminino , Hepatopatias/metabolismo , Hepatopatias/patologia , Masculino , Oxigênio/metabolismo , Traumatismo por Reperfusão/metabolismo , Traumatismo por Reperfusão/patologia , Suínos
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