RESUMEN
Objective: As the population of patients aged 65 years and older increases, the number of older adult patients undergoing surgery also increases. Older adults are vulnerable to hypothermia due to age-related changes in the thermoregulatory center, which leads to reduced subcutaneous fat tissue, vasomotor response, and heat production. Thus, they are more likely to suffer complications, including cardiovascular changes, blood coagulation disorders, infections, and delayed recovery from surgery. The study investigated the effect of preventive active warming. Methods: This retrospective cohort study conducted at Chungbuk National University Hospital investigated clinical data from older adult patients undergoing spinal surgery from January 1, 2020, to December 13, 2022. In this study, we explored the use of prophylactic active warming during anesthesia induction and post-surgery warming in older adult patients (≥65 years) who experienced hypothermia during and after surgery under general anesthesia. Results: The control group of patients who experienced hypothermia increased from 20% after 10 minutes to 80% after 30 minutes and 100% after 60 minutes. The percentage of patients in the treatment group who initially experienced hypothermia increased from 10% after 30 min to 40% after 60 minutes. However, notably, 90% of these patients had returned to a normal body temperature upon their arrival at the recovery room. The difference in the percentage of patients who developed hypothermia was statistically significant between the two groups. Conclusions: Hypothermia prevention via an air-forced warming blanket was effective for older adult patients undergoing spinal surgery under general anesthesia.
RESUMEN
Peritoneal metastasis from breast cancer is a relatively rare life-threatening condition. The gold standard for diagnosing peritoneal metastasis is a direct peritoneal biopsy. In this report, we describe an interesting case of peritoneal inflammation mimicking peritoneal metastasis in a patient with breast cancer, as confirmed by laparoscopic peritoneal biopsy. A 45-year-old woman with a history of right breast cancer presented with a peritoneal wall mass seen on an abdominal computed tomography (CT) in routine follow-up. She underwent right skin-sparing mastectomy with sentinel lymph node biopsy with direct to implant reconstruction 6 years prior and underwent right salpingo-oophorectomy 2 years before. Positron emission tomography-computed tomography (PET-CT) and abdominopelvic CT showed multiple enhancing nodules in small bowel mesentery and right peritoneal wall with a small amount of ascites, which led to a strong suspicion of peritoneal metastasis. After a multidisciplinary conference, the possibility of peritoneal seeding became doubtful. Laparoscopic biopsy was performed, and peritoneal wall mass biopsy was subsequently performed. Pathologic results showed no evidence of peritoneal metastasis of breast cancer. The peritoneal biopsy specimen revealed postoperative fibrosis and inflammation with some meal content. Although rare in breast cancer, peritoneal metastasis can produce a devastating outcome if left undiagnosed. Despite the imaging findings strongly suggesting metastasis, biopsy confirmation for the suspected lesion was necessary. This not only verifies true metastasis but also determines the treatment options available for the patient and thus unnecessary treatment can be avoided.
RESUMEN
Facet joint synovial cysts can cause significant back pain and radiculopathy. Treatment options for symptomatic facet joint synovial cysts include surgical excision, facet joint steroid injections, and cyst aspiration. Herein, we report our experience of successfully rupturing a lumbar facet joint synovial cyst through a percutaneous approach with two needles using forceful pressure under C-arm fluoroscopic guidance. The patient experienced immediate symptom improvement that persisted throughout the 24-month follow-up. Our experience highlights that the volume effect technique is a valuable treatment option for symptomatic facet joint synovial cysts under fluoroscopic guidance.
RESUMEN
The co-culture of beta cells and endothelial cells in constructing a pancreatic pseudo-tissue can provide a functional advancement for in vitro diabetic-related drug testing and biological studies or in vivo transplantation. In order to mimic the pancreatic tissue more similar to in vivo, it is necessary to control the microenvironment, including cell-cell and cell-extracellular matrix interactions. In this study, we report a geometrically controlled three-dimensional (3D) pancreatic model where MIN6 and MS1 cells are co-cultured within a micropatterned collagen sheet. In 4-10 days, depending on the cell seeding concentration, the MIN6 cells formed islet-like clusters surrounded by an endothelial MS1 cell monolayer. The MS1 cells also formed monolayers at the edge of the micropatterns connecting between the clusters, resulting in a blood vessel-like structure in which no cells were found. It was confirmed that the 3D co-culture structure was not formed in a non-patterned sheet and the structure also helped insulin secretion of MIN6 cells. By simply embedding the cell mixture and the hexagonal micropattern into the collagen sheet, we were also able to achieve the highly reproducible fabrication of a 3D pancreatic pseudo-tissue construct for in vivo and in vitro applications.
RESUMEN
PURPOSE: To compare the short term effects of bevacizumab and ranibizumab injections on the regression of corneal neovascularization (NV). METHODS: Sixteen eyes of 16 patients with corneal NV were randomly assigned for an injection with 2.5 mg of bevacizumab (group 1, n = 8) or 1 mg of ranibizumab (group 2, n = 8) through subconjunctival and intrastromal routes. The patients were prospectively followed-up for one month after the injections. Corneal NV areas, as shown on corneal slit-lamp photographs stored in JPEG format, were calculated using Image J software before the injection, one week after the injection, and one month after the injection. The corneal NV areas were compared before and after the injections. RESULTS: Seven women and nine men, with an average age of 51 years, presented with corneal NV secondary to herpetic keratitis (7 cases), graft rejection (6), chemical burn (1), pemphigoid (1), and recurrent ulcer (1). In group I, the preoperative corneal NV area (8.75 ± 4.33%) was significantly decreased to 5.62 ± 3.86% one week after the injection and to 6.35 ± 3.02% one month after the injection (p = 0.012, 0.012, respectively). The corneal NV area in group 2 also exhibited a significant change, from 7.37 ± 4.33% to 6.72 ± 4.16% one week after the injection (p = 0.012). However, no significant change was observed one month after the injection. The mean decrease in corneal NV area one month after injection in group 1 (28.4 ± 9.01%) was significantly higher than in group 2 (4.51 ± 11.64%, p = 0.001). CONCLUSIONS: Bevacizumab injection resulted in a more effective and stable regression of corneal NV compared to the ranibizumab injection. The potency and dose of these two drugs for the regression of corneal NV require further investigation.