This study was performed to compare the efficacy of carboxymethylchitosan fabric (CMCF) with that of the combination of CMCF and low molecular weight heparin (LMWH) for the prevention of postoperative uterine adhesion in rats. Adhesions were induced by suturing both the uterine serosa and peritoneum abrased until petechial bleeding occurred. Fourteen days later, adhesions were evaluated clinically and histopathologically. The mean tensile strength was significantly decreased in the CMCF and CMCF+LMWH groups compared to that of control group, and the CMCF+LMWH group had the lowest tensile strength. The distance of adhesion site was highest in the CMCF group and slightly decreased in the CMCF+LMWH group comparing to that of control group. The inflammatory cell infiltration and neovascularization of the CMCF group were significantly lower than those of the control group. It was observed that the damage at intestinal serosa was significantly decreased in the CMCF+LMWH group comparing to that of control group. Therefore, it was concluded that CMCF and LMWH may be useful to prevent postoperative uterine adhesion in rats.
Proceedings of the Korean Society of Embryo Transfer Conference
/
2000.05a
/
pp.64-75
/
2000
During the last three decades considerable advances has been made in goat embryo production and transfer technology. The Korean native black goat is the most useful domestic ruminant in this country for biological investigation and application because it has a lot of merits such as relatively short generation period (1 vs 2 year for a cow), easy of handling, well adaptation, high fertility, convenient and inexpensive. This article covers the methods of superovulation, estrus synchronization, embryo collection and transfer techniques, pregnancy diagnosis and subsequent pregnancy and kidding rates for the production of transgenic Korean native black goats. More than one hundred goat kids have been produced as a result of our transgenic goat project via microinjection of foreign gene into pronuclei, in vitro culture, transfer of various stages of fresh and frozen-thawed microinjected embryos into oviducts or uteri of recipient does. We have got two transgenic goats carrying a transgene targeting the expression of recombinant human granulocyte colony stimulating factor (hG-CSF) to the mammary gland so far. Since collection and transfer of embryos in this species is usually accomplished by laparotomy, exteriorization of the reproductive tract for surgical embryo collection leads to the formation of post-operative adhesions. Nonsurgical or laparoscopic technique to reduce adhesions from repeated surgeries has great advantages in improving embryo production and transfer especially from valuable donors. We will discuss this later.
Proceedings of the Korean Society of Embryo Transfer Conference
/
2000.06a
/
pp.64-75
/
2000
During the last three decades considerable advances has been made in goat embryo production and transfer technology. The Korean native black goat is the most useful domestic ruminant in this country for biological investigation and application because it has a lot of merits such as relatively short generation period(1 vs 2 year for a cow), easy of handling, well adaptation, high fertility, convenient and inexpensive. This article covers the methods of superovulation, estrus synchronization, embryo collection and transfer techniques, pregnancy diagnosis and subsequent pregnancy and kidding rates for the production of transgenic Korean native black goats. More than one hundred goat kids have been produced as a result of our transgenic goat project via microinjection of foreign gene into pronuclei, in vitro culture, transfer of various stages of fresh and frozen-thawed microinjected embryos into oviducts or uteri of recipient does. We have got two transgenic goats carrying a transgene targeting the expression of recombinant human granulocyte colony stimulating factor(hG-CSF) to the mammary gland so far. Since collection and transfer of embryos in this species is usually accomplished by laparotomy, exteriorization of the reproductive tract for surgical embryo collection leads to the formation of post-operative adhesions. Nonsurgical or laparoscopic technique to reduce adhesions from repeated surgeries has great advantages in improving embryo production and transfer especially from valuable donors. We will discuss this later.
Purpose: This study analyzes the impact of laparoscopic liver resection on intra-abdominal adhesion. Methods: Patients who underwent salvage liver transplantation after liver resection for hepatocellular carcinoma from January 2012 to October 2017 at our institution were included. Information about the severity of intra-abdominal adhesions was collected from a prospectively maintained database. Intra-abdominal adhesions were graded after the agreement of 2 surgeons who participated in the salvage liver transplantation based on predetermined criteria. Adhesion severity and demographic, operative, and postoperative data were compared between the laparoscopic group and the open group. Multivariate logistic regression was performed to consider potential factors related to severe adhesion during salvage transplantation. Results: Sixty-two patients who underwent salvage liver transplantation after liver resection were included in this study. Among them, 52 patients underwent open surgery, and 10 patients underwent laparoscopy. Adhesion was significantly more severe in the open group than in the laparoscopy group (P = 0.029). A multivariate logistic regression model including potential factors related to severe adhesion showed that laparoscopy (odds ratio, 0.168; 95% confidence interval, 0.029-0.970; P = 0.048) was the only significant factor. Conclusion: Laparoscopic liver resection for hepatocellular carcinoma can minimize intra-abdominal adhesion during salvage liver transplantation.
Hysterosalpingograms (H.S.G.) have been done for several decades to determine causative factors in female infertility. However, the H.S.G. only reverals uterine cavity and tubal patency or inpatency. The author prefers to find more details in regard to the status and condition of the female reproductive organs and their surrounding tissue as they pertain to infertility. H.S.G. in combination with laparoscopic examination reveals the following results. Preparation and method of performance of H.S.G. during laparoscopy in a healthy reproductive age women are as follows. When laparoscopy is not contraindicated, NPO is ordered with routine bowel preparation. Analgesics administered by injection prior to procedure are valium 10mgs and pethidine 50-100mgs. The radiographic procedure is the same as for any HSG technique. During laparoscopy a solution of 3 to 10 ccs. of 60% hypaque sodium is used. Fluroscopic scout films are obtained A-P and oblique views as well as a delayed check film. 1. Age distribution of primary and secondary infertility in this studies involving tubal factors was as follows: 20-29 age group showed 46% incidence and in the 30-39 age group, 50% incidence. Duration of infertility in this study group was the following: 1-2 years showed 26.7%, 3-5 years 53.8%, and 6-9 years 13.3%. 2. Indications of laparoscopic examination were as follows: Secondary infertility in 35% of the cases, obscure tubal occlusion on previous H.S.G. in 25%, unknown origin in 11.7%, and the remaining cases included pelvic pain, small masses, dysmenorrhea, and uterine anomaly. The laparoscopic examination showed clearly the reproductive organs and the surrounding tissues in the pelvic cavity. The abnormal tubal findings there revealed were tuberculous salpingitis and hydrosalpinx in 10% each, endometriosis and peritubabl adhesions in 6.7% each, biconuate uterus in 3.3%. The remaining 58.3% of the cases showed normal findings. Laparoscopic observation for possible myoma nodules, streak ovary, and peritubal adhesions was also done at this time. 3. Comparative tubal findings in combined H.S.G. and laparoscopic examination revealed the following. Bilateral tubal occlusion was present in 14% (7cases) on laparoscopic examination but on H.S.G. 38% (19 cases) were noted. However, tubal occlusion and peritubal adhesions were found in 26% (13 cases) upon laparoscopy and only 8% (4 cases) on H.S.G. examination alone. Normal pelvic findings were present in 60% (27 cases).
Zheng, Wenhao;Dong, Xiaoqiao;Wang, Din;Hu, Qiang;Du, Quan
Journal of Korean Neurosurgical Society
/
v.64
no.6
/
pp.966-974
/
2021
Objective : To explore the clinical efficacy and safety of microvascular decompression (MVD) combined with internal neurolysis (IN) in the treatment of recurrent trigeminal neuralgia (TN) after MVD. Methods : Sixty-four patients with recurrent TN admitted to the hospital from January 2014 to December 2017 were divided into two groups according to the surgical method. Twenty-nine patients, admitted from January 2014 to December 2015, were treated with MVD alone, whereas 35 admitted from January 2016 to December 2017 were treated with MVD+IN. The postoperative efficacy, complications, and pain recurrence rate of the two groups were analyzed. Results : The efficacy of the MVD+IN and MVD groups were 88.6% and 86.2%, and the cure rates were 77.1% and 65.5% respectively. There was no statistically significant difference between the two groups (p>0.05). The cure rate (83.3%) of patients in the MVD+IN group, who were only found thickened arachnoid adhesions during the operation that could not be fully released, was significantly higher than that of the MVD group (30.0%) (p<0.05), while the efficacy (91.7% vs. 70%) of the two groups was not statistically different (p>0.05). For patients whose arachnoid adhesions were completely released, there had no significant difference (p>0.05) in the efficacy (87% vs. 94.7%) and recurrence rate (5.0% vs. 11.1%). The incidence of postoperative facial numbness (88.6%) in the MVD+IN group was higher than that in the MVD group (10.3%) (p<0.01). The long-term incidence of facial numbness was not statistically significant (p>0.05). In the 18-36 months follow-up, the recurrence rate of patients in the MVD+IN group (9.7%) and in the MVD group (16%) were not statistically different (p>0.05). Conclusion : A retrospective comparison of patients with recurrent TN showed that both MVD and MVD combined with IN can effectively treat recurrent TN. Compared with MVD alone, MVD combined with IN can effectively improve the pain cure rate of patients with recurrent TN who have only severe arachnoid adhesions. The combination does not increase the incidence of long-term facial numbness and other complications.
Background: Focal adhesions (FAs) is the most important process in the first step of osseointegration between preosteoblasts and titanium (Ti). FAs improvement and pre-osteoblasts cell proliferation leads to successful Ti-based dental implants. This study aimed to confirm the applicability of rosmarinic acid (RA) as a functional substance for improving FAs and cell proliferation of MC3T3-E1 preosteoblasts on Ti surfaces during the first stage of osseointegration for successful Ti-based dental implants. Methods: We used MC3T3-E1 preosteoblasts on Ti discs incubated in a medium supplemented with or without 14 ㎍/ml to decipher the effects of RA on FAs and cell proliferation. FAs and proliferation of MC3T3-E1 cells on Ti discs were assessed via MTT assay. Actin-labeled cells and paxillin contacts were observed and imaged by fluorescent microscopy, and the associated signaling pathways were revealed through western blot analysis. Results: In RA-treated MC3T3-E1 cells on Ti discs, FAs between MC3T3-E1 preosteoblasts and Ti surfaces and the expression of focal adhesion kinase (FAK), phosphorylated FAK and paxillin proteins and filamentous-actin formation increased. RA increased the proliferation of MC3T3-E1 preosteoblasts on the Ti surface as well as the expression of Grab2, Ras, pERK1/2, and ERK1/2. In addition, the expression of secretory leukocyte protease inhibitor and thymosin b4, known as nanomolecules that enhance the interaction between implanted Ti materials and preosteoblasts in the RA-treated MC3T3-E1 preosteoblasts, increased. RA not only increased the FAs of MC3T3-E1 preosteoblasts on the Ti surface through the FAK/Paxillin signaling pathway, but also increased cell proliferation and mitosis through the FAK/Grab2/Ras/ERK1/2 signaling pathway. Conclusion: RA can be applied as an effective functional substrate to improve the FAs and proliferation of MC3T3-E1 preosteoblats on Ti surfaces, which are essential in the first step of osseointegration between implanted Ti and bone tissue for the clinical success of Ti based dental implants.
Intraoperative events can occur during video-assisted thoracoscopic surgery (VATS) lobectomy due to unfavorable surgical anatomy, such as dense adhesions or calcifications around the pulmonary arteries. Troubleshooting intraoperative complications is essential for performing safe and successful VATS pulmonary resection and lymph node dissection. If continuous bleeding occurs or VATS does not proceed despite all measures, conversion to open thoracotomy should not be delayed.
Marchesini, Maurizio;Flaviano, Edoardo;Bellini, Valentina;Baciarello, Marco;Bignami, Elena Giovanna
The Korean Journal of Pain
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v.31
no.4
/
pp.296-304
/
2018
Epiduroscopy is defined as a percutaneous, minimally invasive endoscopic investigation of the epidural space. Periduroscopy is currently used mainly as a diagnostic tool to directly visualize epidural adhesions in patients with failed back surgery syndrome (FBSS), and as a therapeutic action in patients with low back pain by accurately administering drugs, releasing inflammation, washing the epidural space, and mechanically releasing the scars displayed. Considering epiduroscopy a minimally invasive technique should not lead to underestimating its potential complications. The purpose of this review is to summarize and explain the mechanisms of the side effects strictly related to the technique itself, leaving aside complications considered typical for any kind of extradural procedure (e.g. adverse reactions due to the administration of drugs or bleeding) and not fitting the usual concept of epiduroscopy for which the data on its real usefulness are still lacking. The most frequent complications and side effects of epiduroscopy can be summarized as non-persistent post-procedural low back and/or leg discomfort/pain, transient neurological symptoms (headache, hearing impairment, paresthesia), dural puncture with or without post dural puncture headache (PDPH), post-procedural visual impairment with retinal hemorrhage, encephalopathy resulting in rhabdomyolysis due to a dural tear, intradural cyst, as well as neurogenic bladder and seizures. We also report for first time, to our knowledge, a case of symptomatic pneumocephalus after epiduroscopy, and try to explain the reason for this event and the precautions to avoid this complication.
This study was performed to evaluate the efficacy of 0.8% sodium hyaluronic acid solution and crosslinked hyaluronic acid mixture for the prevention of postoperative intraperitoneal adhesion in rats. Forty-five animals were divided into three groups ; 0.9% saline treated control group, 1% sodium carboxymethyl cellulose treated group (SCMC), and 0.8% sodium hyaluronic acid solution and crosslinked hyaluronic acid mixture treated group (SHCH). Adhesions were induced by suturing both the ileal serosa and peritoneum abrased until petechial bleeding occurred. Fourteen days later, adhesions were evaluated clinically and histopathologically. The mean tensile strength was significantly decreased in the SCMC and SHCH groups compared to the control group (p < 0.05), and the SHCH group had the lowest tensile strength. The distance of adhesion site was highest in the control group and significantly decreased in the SHCH group comparing control group (p < 0.05). The inflammatory cell infiltration, collagen hyperplasia and neovascularization of the SCMC and SHCH groups were significantly lower than the control group (p < 0.05). Therefore, it was concluded that the SHCH may be useful to prevent postoperative intraperitoneal adhesion in rats.
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