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https://www.readbyqxmd.com/read/28740595/imaging-guided-percutaneous-interventions-in-hepatic-dome-lesions-tips-and-tricks
#1
REVIEW
Avinash Kambadakone, Vinit Baliyan, Hamed Kordbacheh, Raul N Uppot, Ashraf Thabet, Debra A Gervais, Ronald S Arellano
Percutaneous hepatic interventions are generally safe given the fact that liver closely abuts the abdominal wall and hence it is easily accessible. However, the superior portion of liver, adjacent to the diaphragm, commonly referred as the "hepatic dome", presents unique challenges for interventionists. Percutaneous access to the hepatic dome may be restricted by anatomical factors and special considerations may be required to avoid injury to the surrounding organs. The purpose of this review article is to discuss certain specific maneuvers and techniques that can enhance the success and safety of interventions in the hepatic dome...
July 8, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28736096/pneumoperitoneum-by-inguinal-laceration-after-traffic-accident
#2
Daesung Lim, Soo Hoon Lee, Sang Bong Lee, TaeJin Park
BACKGROUND: The leading cause of surgical pneumoperitoneum is hollow viscus perforation, which accounts for approximately 90% of cases. A nonsurgical etiology may account for up to about 10% of the causes of pneumoperitoneum. However, a pneumoperitoneum often poses significant management dilemmas for surgeons, especially when signs of peritonitis are absent or when the cause is unknown prior to laparotomy. We present the first case of pneumoperitoneum due to inguinal laceration without viscus perforation after a traffic accident...
July 20, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28733201/prone-percutaneous-nephrolithotomy-does-bolster-orientation-matter
#3
Daniel Sagalovich, Cecilia Besa, Timothy Tran, Haresh Thummar, Blake Le Grand, Bachir Taouli, Mantu Gupta
OBJECTIVES: To assess whether horizontal versus vertical bolster orientation affects kidney position during prone percutaneous nephrolithotomy as this could impact the need for supracostal access and therefore the likelihood of pleural injury. METHODS: In a prospective trial, ten subjects with 20 renal units underwent magnetic resonance imaging in prone position with standard cylindrical bolsters oriented vertically and then horizontally. Vertical bolsters were placed along the lateral aspect of the chest...
July 18, 2017: Urology
https://www.readbyqxmd.com/read/28724775/n-degradomic-analysis-reveals-a-proteolytic-network-processing-the-podocyte-cytoskeleton
#4
Markus M Rinschen, Ann-Kathrin Hoppe, Florian Grahammer, Martin Kann, Linus A Völker, Eva-Maria Schurek, Julie Binz, Martin Höhne, Fatih Demir, Milena Malisic, Tobias B Huber, Christine Kurschat, Jayachandran N Kizhakkedathu, Bernhard Schermer, Pitter F Huesgen, Thomas Benzing
Regulated intracellular proteostasis, controlled in part by proteolysis, is essential in maintaining the integrity of podocytes and the glomerular filtration barrier of the kidney. We applied a novel proteomics technology that enables proteome-wide identification, mapping, and quantification of protein N-termini to comprehensively characterize cleaved podocyte proteins in the glomerulus in vivo We found evidence that defined proteolytic cleavage results in various proteoforms of important podocyte proteins, including those of podocin, nephrin, neph1, α-actinin-4, and vimentin...
July 19, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28723751/early-laparotomy-and-timely-reconstruction-for-patients-with-abdominal-electrical-injury-five-case-reports-and-literature-review
#5
Pi-Hong Zhang, Zan Liu, Li-Cheng Ren, Ji-Zhang Zeng, Geng-Wen Huang, Mu-Zhang Xiao, Jie Zhou, Peng-Fei Liang, Ming-Hua Zhang, Xiao-Yuan Huang
INTRODUCTION: High-tension electricity can cause devastating injuries that may result in abdominal wall loss, visceral damage, and sometimes major threat to life. The visceral organ may be exposed after debridement and require flap cover, but the tensile strength of abdominal wall may be lack even if flap transplanted. METHODS: From April 2007 through May 2015, 5 patients with severe abdominal electrical injury were treated at our hospital. Exploratory laparotomy was performed based on their clinical manifestations and debridement findings of abdominal wall at early stage, and decision regarding technique for reconstruction of abdominal wall was based on an assessment of the location and extent of the defect...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28720378/a-novel-technique-carbon-dioxide-gas-assisted-total-peritonectomy-diaphragm-and-intestinal-meso-stripping-in-open-surgery-for-advanced-ovarian-cancer-%C3%A3-ukurova-technique
#6
Ghanim Khatib, Ahmet Baris Guzel, Umran Kucukgoz Gulec, Mehmet Ali Vardar
OBJECTIVE: Most of the ovarian cancers are diagnosed at advanced stages. As peritoneal carcinomatosis increases, especially when it extends to the diaphragm and intestinal mesos, probability of obtaining complete cytoreduction is reduced. Complete cytoreduction (residue zero: R0) is one of the main factors affecting survival [1-3]. Here we present a novel technique of stripping the peritoneal surfaces as a part of cytoreductive surgery in such cases. METHODS: A 55year-old woman diagnosed with peritoneal carcinomatosis was considered appropriate for primary cytoreduction after assessment of her thorax-abdominopelvic tomography, which revealed resectable intra-abdominal disease...
July 15, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28712584/the-advantage-of-early-plication-in-children-diagnosed-with-diaphragm-paresis
#7
Alejandro A Floh, Intikhab Zafurallah, Cathy MacDonald, Osami Honjo, Chun-Po S Fan, Peter C Laussen
BACKGROUND: In this single-center study, we sought to determine the frequency of phrenic nerve injury leading to diaphragm paresis (DP) in children following open cardiac surgery over the last 10 years, and to identify possible variables that predict the need for plication and associated clinical outcomes. METHODS: Patients diagnosed with DP were identified from departmental databases and a review of clinical diaphragm ultrasound images. A cohort was analyzed for predictors of diaphragm plication and associations with clinical outcomes...
June 15, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28711602/contribution-of-5-ht2a-receptors-on-diaphragmatic-recovery-after-chronic-cervical-spinal-cord-injury
#8
Kun-Ze Lee, Elisa J Gonzalez-Rothi
Unilateral C2 spinal cord hemisection (C2Hx) interrupts bulbospinal respiratory pathways innervating ipsilateral phrenic motoneurons, resulting in cessation of ipsilateral diaphragm motor output. Plasticity within the spinal neural circuitry controlling the diaphragm can induce partial recovery of phrenic bursting which correlates with the time-dependent return of spinal serotonin (5-HT) immunoreactivity in the vicinity of phrenic motoneurons. The 5-HT2A receptor subtype is present on phrenic motoneurons and its expression is up-regulated after cervical spinal cord injury; however the functional role of these receptors following injury has not been clearly defined...
July 12, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28690974/laparoscopy-in-blunt-abdominal-trauma-for-whom-when-and-why
#9
REVIEW
Viktor Justin, Abe Fingerhut, Selman Uranues
The management of blunt abdominal trauma has evolved over time. While laparotomy is the standard of care in hemodynamically unstable patients, stable patients are usually treated by non-operative management (NOM), incorporating adjuncts such as interventional radiology. However, although NOM has shown good results in solid organ injuries, other lesions, namely those involving the hollow viscus, diaphragm, and mesentery, do not qualify for this approach and need surgical exploration. Laparoscopy can substantially reduce additional surgical aggression...
2017: Current Trauma Reports
https://www.readbyqxmd.com/read/28681368/a-case-of-incarcerated-and-perforated-stomach-in-delayed-traumatic-diaphragmatic-hernia
#10
Shinjiro Wakai, Hiroyuki Otsuka, Hiromichi Aoki, Takeshi Yamagiwa, Yoshihide Nakagawa, Sadaki Inokuchi
The patient was an emergency transported, 57-year-old man complaining of left thoraco-lateroabdominal pain, with a history of blunt chest trauma 3 months prior. Thoracoabdominal computed tomography (CT) resulted in a diagnosis of diaphragmatic hernia with incarceration and perforation of the stomach, and same-day emergency surgery was performed. The surgery was performed via an abdominal approach, and after manually repositioning the stomach incarceration, the perforated region was resected and the diaphragm sutured closed...
July 20, 2017: Tokai Journal of Experimental and Clinical Medicine
https://www.readbyqxmd.com/read/28664547/vitamin-d3-ameliorates-podocyte-injury-through-the-nephrin-signalling-pathway
#11
Ourania Trohatou, Effie-Fotini Tsilibary, Aristidis Charonis, Christos Iatrou, Garyfalia Drossopoulou
Renal podocytes form the main filtration barrier possessing unique phenotype maintained by proteins including podocalyxin and nephrin, which are modulated in pathological conditions. In diabetic nephropathy (DN), podocytes become structurally and functionally compromised. Nephrin, a structural backbone protein of the slit diaphragm, acts as regulator of podocyte intracellular signalling with renoprotective role. Vitamin D3 through its receptor, VDR, provides renal protection in DN but limited data exist about its effect on podocytes...
June 29, 2017: Journal of Cellular and Molecular Medicine
https://www.readbyqxmd.com/read/28659464/impact-of-glutamatergic-and-serotonergic-neurotransmission-on-diaphragm-muscle-activity-after-cervical-spinal-hemisection
#12
Carlos B Mantilla, Heather M Gransee, Wen-Zhi Zhan, Gary C Sieck
Incomplete cervical spinal cord hemisection at C2 (SH) disrupts descending excitatory drive to phrenic motoneurons, paralyzing the ipsilateral diaphragm muscle. Spontaneous recovery over time is associated with increased phrenic motoneuron expression of glutamatergic N-methyl-D-aspartate (NMDA) and serotonergic 5-HT2A receptors. We hypothesized that NMDA and 5-HT2A receptor-mediated neurotransmission play a role in ipsilateral diaphragm muscle activity post-SH. Adult male Sprague-Dawley rats were implanted with bilateral diaphragm EMG electrodes for chronic EMG recordings up to 28 days post-SH (SH 28D)...
June 28, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28639250/regulation-of-nephrin-phosphorylation-in-diabetes-and-chronic-kidney-injury
#13
Benoit Denhez, Pedro Geraldes
Diabetes is the leading cause of microalbuminuria and end-stage renal failure in industrial countries. Disruption of the filtration barrier, seen in almost all nephrotic diseases and diabetes, is the result of the loss or effacement of the podocyte foot process, notably damage of proteins within the slit diaphragm such as nephrin. For many years, nephrin has been viewed as a structural component of the slit diaphragm. It is now well recognized that nephrin contains several tyrosine residues in its cytoplasmic domain, which influences the development of glomerular injury...
June 22, 2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28630645/the-use-of-laparoscopy-in-managing-penetrating-thoracoabdominal-injuries-in-africa-83-cases-reviewed
#14
Zach M Koto, Fusi Mosai, Oleh Y Matsevych
BACKGROUND: The use of laparoscopy in managing haemodynamically stable patients with penetrating thoracoabdominal injuries in developed countries is wildly practiced, but in Africa, the use of laparoscopy is still in its infancy stage. We reviewed a single centre experience in using laparoscopy in Africa for management of patients with both isolated diaphragmatic injuries as well as diaphragmatic injuries associated with intra-abdominal injuries requiring intervention. METHODS: A retrospective analysis of prospectively collected data of patients presenting with penetrating thoracoabdominal injuries was done...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28615341/high-frequency-epidural-stimulation-across-the-respiratory-cycle-evokes-phrenic-short-term-potentiation-after-incomplete-cervical-spinal-cord-injury
#15
Elisa J Gonzalez-Rothi, Kristi A Streeter, Marie H Hanna, Anna C Stamas, Paul J Reier, David M Baekey, David D Fuller
C2 spinal hemilesion (C2Hx) paralyzes the ipsilateral diaphragm, but recovery is possible through activation of "crossed spinal" synaptic inputs to ipsilateral phrenic motoneurons. We tested the hypothesis that high frequency epidural stimulation (HF-ES) would potentiate ipsilateral phrenic output after subacute and chronic C2Hx. HF-ES (300 Hz) was applied to the ventrolateral C4 or T2 spinal cord ipsilateral to C2Hx in anesthetized and mechanically ventilated adult rats. Stimulus duration was 60-sec and currents ranged from 100-1000 µA...
June 14, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28614863/-anesthetic-management-in-thoracic-trauma-patients
#16
Alf Kozian, Astrid Bergmann, Thomas Hachenberg, Thomas Schilling
In daily practice, management of patients with blunt thoracic trauma is challenging for the anesthetist. Injuries of airways, lungs, diaphragm, heart and large vessels are the main difficulties.Respiratory and circulatory physiology in general is affected by general anesthesia, which may result in an increased number of perioperative complications. Therefore, anesthetic management of patients with thoracic trauma needs to address different clinical topics: management of difficult airways, intrinsic effects of anesthetics and mechanical ventilation on respiratory and cardiac function, the adequate replacement of blood loss as well as type and extent of the surgical intervention...
June 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28604827/a-novel-in-vivo-method-to-quantify-slit-diaphragm-protein-abundance-in-murine-proteinuric-kidney-disease
#17
Raphael Haase, Sebastian Alexander Potthoff, Catherine Meyer-Schwesinger, Clara Frosch, Thorsten Wiech, Ulf Panzer, Eva Königshausen, Johannes Stegbauer, Lorenz Sellin, Lars Christian Rump, Ivo Quack, Magdalena Woznowski
Injury of the glomerular filter causes proteinuria by disrupting the sensitive interplay of the glomerular protein network. To date, studies of the expression and trafficking of glomerular proteins have been mostly limited to in vitro or histologic studies. Here, we report a novel in vivo biotinylation assay that allows the quantification of surface expression of glomerular proteins in mice. Kidneys were perfused in situ with biotin before harvest. Afterwards glomeruli were isolated and lyzed. The protein of interest was separated by immunoprecipitation and the amount of surface-expressed protein was quantified by Western blot analysis with streptavidin staining...
2017: PloS One
https://www.readbyqxmd.com/read/28587496/review-article-a-practical-approach-to-the-clinical-management-of-nsaid-enteropathy
#18
Ashish Srinivasan, Peter De Cruz
Co-prescription of acid suppressive therapy, together with advances in small bowel imaging techniques, have shifted the burden of NSAID-related toxicity from gastro-duodenal to more distal small bowel injury. Due to predominantly subclinical disease, NSAID enteropathy remains under-recognised, with an incidence of 53-80% amongst healthy short-term users, and a prevalence of 50-71% following long-term (>3 months) use. Despite their distinct pathogenesis, those at risk of NSAID-related gastro-duodenal and small bowel complications share several risk factors...
June 6, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28570440/successful-reinnervation-of-the-diaphragm-after-intercostal-to-phrenic-nerve-neurotization-in-patients-with-high-spinal-cord-injury
#19
Kulvir S Nandra, Martin Harari, Thea P Price, Patrick J Greaney, Michael S Weinstein
OBJECTIVE: Our objective in this study was to extend diaphragmatic pacing therapy to include paraplegic patients with high cervical spinal cord injuries between C3 and C5. INTRODUCTION: Diaphragmatic pacing has been used in patients experiencing ventilator-dependent respiratory failure due to spinal cord injury as a means to reduce or eliminate the need for mechanical ventilation. However, this technique relies on intact phrenic nerve function. Recently, phrenic nerve reconstruction with intercostal nerve grafting has expanded the indications for diaphragmatic pacing...
August 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28548606/anatomical-recruitment-of-spinal-v2a-interneurons-into-phrenic-motor-circuitry-after-high-cervical-spinal-cord-injury
#20
Lyandysha V Zholudeva, Jordyn S Karliner, Kimberly J Dougherty, Michael A Lane
More than half of all spinal cord injuries (SCIs) occur at the cervical level, often resulting in impaired respiration. Despite this devastating outcome, there is substantial evidence for endogenous neuroplasticity after cervical SCI. Spinal interneurons are widely recognized as being an essential anatomical component of this plasticity by contributing to novel neuronal pathways that can result in functional improvement. The identity of spinal interneurons involved with respiratory plasticity post-SCI, however, has remained largely unknown...
June 29, 2017: Journal of Neurotrauma
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