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Kumar Rajnish, Sathasivam Sureshkumar, Manwar S Ali, Chellappa Vijayakumar, Sundaramurthi Sudharsanan, Chinnakali Palanivel
Introduction Laparoscopic cholecystectomy (LC) is the most commonly done, minimally invasive surgical procedure. Routinely used electrocautery produces more smoke, which masks the operating field, thereby prolongs the surgery and posing an increased risk of gallbladder (GB) perforation. The titanium clips used for clipping the cystic artery and cystic duct have a risk of slippage, which may lead to bleeding, and an increased risk for bile leakage. In addition, it may act as a nidus for stone formation. Advanced energy sources, such as the harmonic scalpel, though expensive, may provide the advantage of shorter operating time by reducing smoke, bloodless dissection in the GB bed, lower risk of bleeding from the cystic artery due to secure vessel sealing, and avoiding the use of a larger number of titanium clips...
January 18, 2018: Curēus
Alex D Hwang, Merve Tuccar-Burak, Robert Goldstein, Eli Peli
Purpose: Oncoming headlight glare (HLG) reduces the visibility of objects on the road and may affect the safety of nighttime driving. With cataracts, the impact of oncoming HLG is expected to be more severe. We used our custom HLG simulator in a driving simulator to measure the impact of HLG on pedestrian detection by normal vision subjects with simulated mild cataracts and by patients with real cataracts. Methods: Five normal vision subjects drove nighttime scenarios under two HLG conditions (with and without HLG: HLGY and HLGN, respectively), and three vision conditions (with plano lens, simulated mild cataract, and optically blurred clip-on)...
2018: Frontiers in Psychology
Marwan Mannaa, Lajos Markó, András Balogh, Emilia Vigolo, Gabriele N'diaye, Mario Kaßmann, Laura Michalick, Ulrike Weichelt, Kai M Schmidt-Ott, Wolfgang B Liedtke, Yu Huang, Dominik N Müller, Wolfgang M Kuebler, Maik Gollasch
Transient receptor potential vanilloid 4 (TRPV4) cation channels are functional in all renal vascular segments and mediate endothelium-dependent vasorelaxation. Moreover, they are expressed in distinct parts of the tubular system and activated by cell swelling. Ischaemia/reperfusion injury (IRI) is characterized by tubular injury and endothelial dysfunction. Therefore, we hypothesised a putative organ protective role of TRPV4 in acute renal IRI. IRI was induced in TRPV4 deficient (Trpv4 KO) and wild-type (WT) control mice by clipping the left renal pedicle after right-sided nephrectomy...
March 20, 2018: Scientific Reports
Savita Yadav, Pinaki Chakraborty, Prabhat Mittal, Udit Arora
AIM: Parents sometimes show young children YouTube videos on their smartphones. We studied the interaction of 55 Indian children born between December 2014 and May 2015 who watched YouTube videos when they were 6-24 months old. METHODS: The children were recruited by the researchers using professional and personal contacts and visited by the same two observers at four ages, for at least 10 minutes. The observers recorded the children's abilities to interact with touch screens and identify people in videos and noted what videos attracted them the most...
March 20, 2018: Acta Paediatrica
Ales Hlavka, Jaroslav Vanasek, Karel Odrazka, Jan Stuk, Martin Dolezel, Vit Ulrych, Martina Vitkova, Jiri Mynarik, Iveta Kolarova, Zdenka Vilasova
Image guided radiation therapy (IGRT) enables the achievement of higher precision in radiation delivery, a reduction in safety margins and a reduced risk of toxicity in healthy tissues. The present study investigated the magnitude of safety margins for the radiation boost setup on skin marks or metal clips implanted into the tumor bed during breast cancer surgery. One hundred eighty-four patients after breast conserving surgery with implanted metal clips into tumor bed were analyzed. The present study investigated the difference in safety margin required for the treatment setup on skin marks and metal clips...
April 2018: Oncology Letters
Mark Anczurowski, Yuki Yamashita, Munehide Nakatsugawa, Toshiki Ochi, Yuki Kagoya, Tingxi Guo, Chung-Hsi Wang, Muhammed A Rahman, Kayoko Saso, Marcus O Butler, Naoto Hirano
While the principles of classical antigen presentation via MHC class II are well-established, the mechanisms for the many routes of cross-presentation by which endogenous antigens become associated with class II molecules are not fully understood. We have recently demonstrated that the single amino acid polymorphism HLA-DPβ84Gly (DP84Gly ) is critical to abrogate class II invariant chain associated peptide (CLIP) region-mediated binding of invariant chain (Ii) to DP, allowing endoplasmic reticulum (ER)-resident endogenous antigens to constitutively associate with DP84Gly such as DP4...
March 19, 2018: Scientific Reports
Viviana Betti, Maurizio Corbetta, Francesco de Pasquale, Vincent Wens, Stefania Della Penna
Networks hubs represent points of convergence for the integration of information across many different nodes and systems. While a great deal is known on the topology of hub regions in the human brain, little is known about their temporal dynamics. Here, we examine the static and dynamic centrality of hub regions when measured in the absence of a task (rest) or during the observation of natural or synthetic visual stimuli. We used Magnetoencephalography (MEG) in humans (both sexes) to measure static and transient regional and network-level interaction in α and β band limited power (BLP) in three conditions: visual fixation (rest), viewing of movie clips (natural vision), and time-scrambled versions of the same clips (scrambled vision)...
March 19, 2018: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
Guido Woeste
Most procedures in gastrointestinal (GI) surgery require reconstruction with an anastomosis. Depending on the location within the GI tract, the perfusion and comorbidities of the patients there is a risk for anastomotic leakage. In case of peritonitis with sepsis usually a surgical treatment is required. A stable patient can be treated nonoperatively. In the following overview different treatment options of anastomotic leakage after surgery of the GI tract are described. In case of a leakage of an esophagojejunal or esophagogastric anastomosis after resection of the esophagus or stomach endoscopic treatment can be successful using either clip or stent or negative pressure therapy (NPT)...
March 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Jiajia Shan, Junbo Zhao, Lifen Liu, Yituo Zhang, Xue Wang, Fengchang Wu
Hyperspectral imaging technology has been investigated as a possible way to detect microplastics contamination in soil directly and efficiently in this study. Hyperspectral images with wavelength range between 400 and 1000 nm were obtained from soil samples containing different materials including microplastics, fresh leaves, wilted leaves, rocks and dry branches. Supervised classification algorithms such as support vector machine (SVM), mahalanobis distance (MD) and maximum likelihood (ML) algorithms were used to identify microplastics from the other materials in hyperspectral images...
March 16, 2018: Environmental Pollution
Virginia A Hill, G Neil Stowe, Ryan B Paulsen, Michael Schaffer
Analysis of nail clippings may be a useful back-up for hair analysis when hair is unavailable. One aspect of using nails or hair is the ability to analyze whether drug present is from ingestion or from contamination. A common method of three 15-s rinses in methanol failed to remove drug from nails that had been soaked in either 5 or 50 μg/mL cocaine, methamphetamine or morphine for 1 h. While methanol rinsing did not remove contaminating drug, washing the nails soaked with 5 and 50 μg/mL of these drugs with an extended wash, a method developed for hair analysis and consisting of a 15-min isopropanol wash, and three 30-min and two 60-min phosphate buffer-0...
March 15, 2018: Journal of Analytical Toxicology
Junhui Chen, Chunlei Zhang, Peipei Li, Lei Chen, Yuhai Wang
Giant intracranial aneurysms have always been remain the most difficult cerebrovascular lesions to treat, especially for giant cavernous carotid aneurysm (CCA). The treatment of giant CCA is a greatest challenge for neurosurgeons. Surgical clipping morbidity and mortality rates are relatively high, and endovascular embolization also have a high complication. The authors reported a special 74-year-old female patient who presented with blurred vision and double vision for 3 years, a giant CCA was found by digital subtraction angiography and computed tomography angiography...
March 16, 2018: Journal of Craniofacial Surgery
Andrea M Pakula, Matthew J Martin
Groin hernia repair is one of the most common general surgical procedures performed worldwide. Though only a small percentage will become incarcerated or strangulated this is an indication for repair. Minimally invasive surgery is becoming standard of care for most procedures and we believe this to be a safe and feasible approach for incarcerated or strangulated groin hernias. We present a description of our recommend approach with technical details and accompanying video clips to highlight these techniques...
March 16, 2018: Journal of Trauma and Acute Care Surgery
Shiu Ming Pang, Jonathan Yi Yu Pang, Stephanie Fook-Chong, Ai Ling Tan
INTRODUCTION: Tinea unguium is a common nail infection. We conducted a retrospective ten-year study of the patient demographics and species distribution of dermatophytes causing tinea unguium in a tertiary hospital from Singapore. METHODS: Results of fungal nail cultures were retrieved from our hospital's microbiology department. Samples from nail scrapings and clippings were inoculated onto agar plates (Sabouraud dextrose agar with chloramphenicol and Mycosel agar)...
March 19, 2018: Singapore Medical Journal
Marcin Zieliński, Tomasz Nabialek, Juliusz Pankowski
Background: The aim of the study is a description of surgical technique of uniportal transcervical video-assisted thoracoscopic surgery (VATS) for pulmonary lobectomy. Methods: We used a collar neck incision (transcervical) of an average length 5-8 centimeters. The manubrium of the sternum is elevated with a hook connected to the Zakopane II frame (Aesculap-Chifa, B. Braun, Nowy Tomyśl, Poland). The first step is a transcervical extended mediastinal lymphadenectomy (TEMLA), for improved staging and possible improved survival...
2018: Journal of Visualized Surgery
Yew-Weng Fong, Szu-Kai Hsu, Chih-Ta Huang, Cheng-Ta Hsieh, Ming-Hong Chen, Jing-Shan Huang, Chih-Ju Chang, I-Chang Su
OBJECTIVE: mThree-dimensional (3D) rotational angiography (RA), a gold-standard imaging tool for the post-clipping evaluation of cerebral aneurysms, can currently be performed intraoperatively in a hybrid operating room (OR). However, its role in intraoperative aneurysmal surgery is unclear. We aimed to study the value of intraoperative two-dimensional digital subtraction angiography (2D-DSA) and 3D-RA for the post-clipping evaluation of aneurysms, in terms of clip repositioning. METHODS: We included patients with cerebral aneurysms who were treated via microsurgical clipping in a hybrid OR...
March 13, 2018: World Neurosurgery
Sarah K Schäfer, Frank R Ihmig, Karen A Lara H, Frank Neurohr, Stephan Kiefer, Marlene Staginnus, Johanna Lass-Hennemann, Tanja Michael
BACKGROUND: Specific phobias are among the most common anxiety disorders. Exposure therapy is the treatment of choice for specific phobias. However, not all patients respond equally well to it. Hence, current research focuses on therapeutic add-ons to increase and consolidate the effects of exposure therapy. One potential therapeutic add-on is biofeedback to increase heart rate variability (HRV). A recent meta-analysis shows beneficial effects of HRV biofeedback interventions on stress and anxiety symptoms...
March 16, 2018: Trials
Vinayak Narayan, Hima Pendharkar, Bhagavatula Indira Devi, Dhananjaya I Bhat, Dhaval P Shukla
Background: The conventional medical management of cerebral vasospasm following aneurysmal subarachnoid hemorrhage (SAH) is associated with uncertainty of outcome and complications. Aims and Objectives: To examine the effect of direct intra-arterial nimodipine therapy on outcome in patients with delayed cerebral ischemia (DCI). Settings and Design: The retrospective observational study was conducted at a single neurosurgical unit and interventional neuroradiolgy suite of a center managing SAH...
March 2018: Neurology India
Kalyan B Bhattacharyya
Walter Edward Dandy did pioneering work in Neurosurgery in the early part of the 19th century. He worked all his life at the Johns Hopkins Hospital in USA and contributed extensively to research in hydrocephalus, the physiology of the cerebrospinal fluid and devised the technique of pneumoencephalography, apart from performing the first clipping operation in cerebral aneurysm and the division of the trigeminal nerve in neuralgic pain. This article summarizes his immense contributions in the field of Neurosurgery...
March 2018: Neurology India
Jan Friso Nast, Christoph Berliner, Thomas Rösch, Daniel von Renteln, Tania Noder, Guido Schachschal, Stefan Groth, Harald Ittrich, Jan F Kersten, Gerhard Adam, Yuki B Werner
BACKGROUND: The newly developed technique of peroral endoscopic myotomy (POEM) has been shown to be effective in several short- and mid-term studies. Limited information is available about the adequacy of immediate post-POEM monitoring tests. METHODS: POEM was performed under general anesthesia in 228 patients (59.6% male, mean age 45.6 ± 15.5 years). Post-procedural checks comprised clinical and laboratory examination, and, during post-procedure days 1-5, endoscopy and-in the first 114 cases-radiologic examination using water-soluble contrast (1st group); the remaining patients underwent post-procedure controls without radiology (2nd group)...
March 15, 2018: Surgical Endoscopy
Jeroen G V Habets, Roel H L Haeren, Suen A N Lie, Noel J C Bauer, Jim T A Dings
BACKGROUND: We present a case of orbital compartment syndrome (OCS) leading to monocular irreversible blindness following a pterional craniotomy for clipping of an anterior communicating artery (ACoA) aneurysm. OCS is an uncommon but vision-threatening entity requiring urgent decompression to reduce the risk of permanent visual loss. Iatrogenic orbital roof defects are a common finding following pterional craniotomies. However, complications related to these defects are rarely reported...
March 12, 2018: World Neurosurgery
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