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Sichuan Da Xue Xue Bao. Yi Xue Ban =... May 2022Endoscopic submucosal dissection (ESD) has been widely used in the clinical treatment of early-stage and precancerous lesions of the digestive tract. Compared with... (Review)
Review
Endoscopic submucosal dissection (ESD) has been widely used in the clinical treatment of early-stage and precancerous lesions of the digestive tract. Compared with traditional open surgery, the procedure has a number of advantages, including low postprocedural recurrence rate, the location and scope of lesions not posing much restrictions on the procedure, and quick patients recovery afterwards. The procedure has hence become one of the minimally-invasive procedures commonly performed with gastrointestinal endoscope. However, due to the influence of various factors, complications such as intraoperative and postoperative bleeding, perforation, electrocoagulation syndrome and lumen stenosis may occur. Delayed postoperative bleeding, in particular, may induce cardiovascular and other related diseases due to the insidious nature of its onset, resulting in serious consequences. It is critically important for the further development of ESD that we should acquire thorough understanding and mastery of the relevant influencing factors and preventive measures of delayed bleeding after ESD of early-stage gastrointestinal cancer. We herein summarized and discussed the latest research findings in the preventative and treatment measures.
Topics: Dissection; Endoscopic Mucosal Resection; Gastrointestinal Neoplasms; Humans; Postoperative Hemorrhage; Retrospective Studies
PubMed: 35642142
DOI: 10.12182/20220560503 -
Canadian Journal of Gastroenterology =... Dec 2013Endoscopic submucosal dissection is a minimally invasive endoscopic technique for the removal of gastrointestinal tumours that is increasingly being used for colonic... (Review)
Review
Endoscopic submucosal dissection is a minimally invasive endoscopic technique for the removal of gastrointestinal tumours that is increasingly being used for colonic neoplasms to spare resection of colon in selected patients. Colonic endoscopic submucosal dissection is technically challenging and was initially pioneered in Japan but increasingly used in selected western centres. Its use in Canada is currently limited, and the authors review the challenges and opportunities, in addition to the unique training infrastructure required to practice the procedure under supervision. Specific tools are required to perform endoscopic submucosal dissection and meticulous attention to detail is essential. The authors provide a combined Japanese and Canadian perspective to this technique, and discuss training and performance of endoscopic submucosal dissection as well as potential indications.
Topics: Canada; Carcinoma; Colonoscopy; Colorectal Neoplasms; Dissection; Feasibility Studies; Humans; Intestinal Mucosa
PubMed: 24340310
DOI: 10.1155/2013/536190 -
Current Problems in Cardiology Mar 2024In this study we correlated changes of risk factors for cardiovascular diseases with trends of age standardized mortality rates and burden for aortic aneurysms and... (Review)
Review
BACKGROUND
In this study we correlated changes of risk factors for cardiovascular diseases with trends of age standardized mortality rates and burden for aortic aneurysms and dissections.
METHODS
We analyzed data from the Global Burden of Diseases and EUROSTAT.
FINDINGS
There was a significant increase of expenditure for health from 1980 and 2019. In the period 1980-2000, despite higher health spending, age standardized mortality rates increased in almost all European countries. During the period 2000-2019, in Western European Countries and in Poland, Estonia, Latvia, Slovenia there was a correlation between higher health expenditure and decrease of ASMR. The most important changes between the period 1980-2000 and the period 2000-2019 was the proportion of health expenditure devoted to preventive care and to the increased use of aspirin and statins.
INTERPRETATION
Information about risk factors for cardiovascular diseases have leads to decreased aortic aneurysm related mortality and burden.
Topics: Humans; Aortic Aneurysm; Estonia; Aspirin; Risk Factors; Dissection
PubMed: 38184128
DOI: 10.1016/j.cpcardiol.2024.102384 -
Folia Morphologica 2019Klingler's technique was discovered in the 1930s. It is a modified method of brain fixation and dissection, based on freezing and thawing of the brain tissue, subsequent... (Review)
Review
Klingler's technique was discovered in the 1930s. It is a modified method of brain fixation and dissection, based on freezing and thawing of the brain tissue, subsequent peeling away of white matter fibres and the gradual exposure of white matter tracts. The added value of this technique is that it is carried out in a stratigraphic manner. This fact makes it an invaluable tool for an in-depth understanding of the complex anatomical organisation of the cerebral hemispheres. The purpose of this paper is to provide a review of Klingler's method while taking into account the original description of the technique and its value for medical training. The historical background, the concise outline of white matter organisation, as well as our own experience in using this procedure for research and teaching activities were also included. The fibre dissection technique may still be considered an excellent complementary research tool for neuroanatomical studies. Numerous detailed observations about the white matter topography and spatial organisation have been recently made by applying this method. Using this technique may also improve understanding of the three-dimensional intrinsic structure of the brain, which is particularly important both in under- and postgraduate training in the field of neuroanatomy.
Topics: Brain; Dissection; Humans; Neuroanatomy; Neuroimaging; Neurosurgery
PubMed: 30536356
DOI: 10.5603/FM.a2018.0113 -
Neurology India 2014Though the necessity of cadaver dissection is felt by the medical fraternity, and described as early as 600 BC, in India, there are no practical guidelines available in... (Review)
Review
Though the necessity of cadaver dissection is felt by the medical fraternity, and described as early as 600 BC, in India, there are no practical guidelines available in the world literature for setting up a basic cadaver dissection laboratory for neurosurgery skills training. Hands-on dissection practice on microscopic and endoscopic procedures is essential in technologically demanding modern neurosurgery training where ethical issues, cost constraints, medico-legal pitfalls, and resident duty time restrictions have resulted in lesser opportunities to learn. Collaboration of anatomy, forensic medicine, and neurosurgery is essential for development of a workflow of cadaver procurement, preservation, storage, dissection, and disposal along with setting up the guidelines for ethical and legal concerns.
Topics: Cadaver; Dissection; Humans; India; Neurosurgery
PubMed: 25033845
DOI: 10.4103/0028-3886.136897 -
BMC Gastroenterology Dec 2022Effective traction is an important prerequisite for successful endoscopic submucosal dissection (ESD). The combined orthodontic rubber band (ORB) and clip method was...
BACKGROUND AND AIMS
Effective traction is an important prerequisite for successful endoscopic submucosal dissection (ESD). The combined orthodontic rubber band (ORB) and clip method was effective in colorectal cancer ESD. To date, the method was not reported in gastric ESD. This study aimed to investigate its efficacy and safety for gastric neoplasms ESD.
METHODS
We retrospectively analyzed data of 118 patients with gastric neoplasms treated by ESD from November 2020 to April 2022, 43 by ORB-ESD and 75 by the conventional ESD. The primary outcome measure was the ESD procedure time. Clinical data on efficacy and safety were also collected and analyzed. Propensity score matching (PSM) matched the patients in both groups.
RESULTS
PSM successfully matched 31 pairs of patients. The ORB-ESD operation time was shorter (median [interquartile range], 35 [30-48] vs. 49 [40-70] min, P < 0.001) and dissection speed was higher (median [interquartile range], 22.6 [14.4-29.3] vs. 13.5 [9.6-17.9] mm/min, P < 0.001) than in the conventional ESD. The groups were similar in muscular injury rate, frequency and time of use of thermal hemostatic forceps, postoperative adverse events, en bloc resection, and R0 resection rate (P > 0.05).
CONCLUSIONS
Compared to the conventional ESD, ORB-ESD significantly reduced the procedure time and increased the dissection speed, proving beneficial to gastric ESD.
Topics: Humans; Endoscopic Mucosal Resection; Stomach Neoplasms; Retrospective Studies; Surgical Instruments; Dissection; Treatment Outcome
PubMed: 36528595
DOI: 10.1186/s12876-022-02606-1 -
SLAS Technology Aug 2017We present a mesodissection platform that retains the advantages of laser-based dissection instrumentation with the speed and ease of manual dissection. Tissue...
We present a mesodissection platform that retains the advantages of laser-based dissection instrumentation with the speed and ease of manual dissection. Tissue dissection in clinical laboratories is often performed by manually scraping a physician-selected region from standard glass slide mounts. In this manner, costs associated with dissection remain low, but spatial resolution is compromised. In contrast, laser microdissection methods maintain spatial resolution that matches the requirements for analysis of important tissue heterogeneity but remains costly and labor intensive. We demonstrate a microfluidic tool for rapid extraction of histological regions of interest from formalin-fixed paraffin-embedded tissue, which uses a simple and automated method that is compatible with most downstream enzymatic reactions, including protocols used for next-generation DNA sequencing.
Topics: Automation, Laboratory; Dissection; Humans; Microfluidics; Molecular Diagnostic Techniques; Neoplasms; Pathology, Molecular
PubMed: 27864340
DOI: 10.1177/2211068216680208 -
Journal of Visualized Experiments : JoVE Sep 2014A significant portion of post-embryonic development in the fruit fly, Drosophila melanogaster, takes place within a set of sac-like structures called imaginal discs....
A significant portion of post-embryonic development in the fruit fly, Drosophila melanogaster, takes place within a set of sac-like structures called imaginal discs. These discs give rise to a high percentage of adult structures that are found within the adult fly. Here we describe a protocol that has been optimized to recover these discs and prepare them for analysis with antibodies, transcriptional reporters and protein traps. This procedure is best suited for thin tissues like imaginal discs, but can be easily modified for use with thicker tissues such as the larval brain and adult ovary. The written protocol and accompanying video will guide the reader/viewer through the dissection of third instar larvae, fixation of tissue, and treatment of imaginal discs with antibodies. The protocol can be used to dissect imaginal discs from younger first and second instar larvae as well. The advantage of this protocol is that it is relatively short and it has been optimized for the high quality preservation of the dissected tissue. Another advantage is that the fixation procedure that is employed works well with the overwhelming number of antibodies that recognize Drosophila proteins. In our experience, there is a very small number of sensitive antibodies that do not work well with this procedure. In these situations, the remedy appears to be to use an alternate fixation cocktail while continuing to follow the guidelines that we have set forth for the dissection steps and antibody incubations.
Topics: Animals; Cell Polarity; Cell Proliferation; Dissection; Drosophila melanogaster; Imaginal Discs; Immunohistochemistry; Microscopy, Fluorescence
PubMed: 25285379
DOI: 10.3791/51792 -
Romanian Journal of Morphology and... 2022Tumors of the parotid gland are a rare occurrence among head and neck tumors (only 3-8%), and the vast majority are benign. Most benign tumors of the parotid gland are...
UNLABELLED
Tumors of the parotid gland are a rare occurrence among head and neck tumors (only 3-8%), and the vast majority are benign. Most benign tumors of the parotid gland are pleomorphic adenoma (PA), followed by Warthin's tumor (WT) and they occur in the superficial lobe. The only reasonable treatment is considered to be total tumor removal, but the appropriate surgical approach remains a matter of controversy. Over time, it went from enucleation to superficial parotidectomy (SP) and then to extracapsular dissection (ECD). SP is often considered to be the "gold standard"; however, the risk of intraoperative damage to the facial nerve (FN) cannot be ignored. Lately, ECD - which does not expose the main trunk of the FN - has been regarded as a safe technique for the treatment of small benign parotid tumors.
PATIENTS, MATERIALS AND METHODS
The study retrospectively reviewed all parotidectomies for benign parotid tumors of the superficial lobe performed in the Department of ENT, Municipal Emergency Clinical Hospital, Timişoara, Romania, between January 2014 and December 2018. The following patient data were collected: age; sex; follow-up duration; extension of the resection; use of FN monitoring and lesion features, including position, pathology, and size. Preoperative investigation protocol included a computed tomography (CT) scan to assess the size and location of the tumor helping the treatment planning. The same surgical team performed both standard SP and ECD for the treatment of these tumors. All cases were confirmed as benign parotid tumors. Recurrences of any kind and tumors involving the deep lobe of the gland were excluded from the study. All patients underwent a macroscopically complete resection of the tumor. The main outcome was the postoperative complications in the two groups. Data regarding these complications were recorded on follow-up visits at one, six, 12 and 24 months.
RESULTS
Ninety-five patients with benign parotid tumors were operated by the same surgical team at the Department of ENT, Municipal Emergency Clinical Hospital, Timişoara, between January 2014 and December 2018 but only 89 (38 men and 51 women) met the follow-up criteria and were included in the study. Sixteen (18%) patients underwent ECD, and 73 (82%) patients underwent SP as a primary intervention. The mean lesion size for ECD group was 2.0±0.9 cm and 4.2±1.7 cm in the SP group, and it was statistically significant (p<0.05). As expected, the most common type of tumor was PA but the distribution between the groups was different: in the SP group, PA represents 83% (61∕73) of cases but only 44% (7∕16) of cases in the ECD group. Median follow-up time was comparable in the two groups - 33±8 months for the ECD group and 39±11 months for the SP group. There were also differences between the two groups regarding the postoperative complication rate. There were significantly more transient and permanent FN paralysis, transient and permanent great auricular nerve (GAN) dysfunctions and Frey's syndrome (FS) in the SP group.
CONCLUSIONS
A comparison between ECD and SP as surgical procedures for the treatment of benign tumors of the parotid seems inappropriate as their indications do not overlap. ECD showed similar effectiveness and fewer side effects than SP and can be considered the treatment of choice for small, superficial and/or marginal tumors located in the lateral lobe of the parotid gland.
Topics: Male; Humans; Female; Parotid Gland; Parotid Neoplasms; Retrospective Studies; Dissection; Postoperative Complications; Adenoma, Pleomorphic
PubMed: 36588495
DOI: 10.47162/RJME.63.3.11 -
BioMed Research International 2021On the basis of the available literature, we proposed the hypothesis that the number of muscle bellies is morphologically constant. The main purpose of this study was to...
BACKGROUND
On the basis of the available literature, we proposed the hypothesis that the number of muscle bellies is morphologically constant. The main purpose of this study was to examine the morphological variability of the SM and to create a new classification of it based on number of muscle bellies.
METHODS
Sixty-six adult cadavers of Central European population (45 females, 21 males) were obtained and fixed in 10% formalin before examination.
RESULTS
The SM was found in all 66 specimens (45 females, 21 males, 31 left and 35 right sides). After meticulous dissection, we distinguished nine types on the basis of number of bellies. Type I was characterized by single belly and occurred in 1.5%. Type II had a double belly and was present in 3%. Type III, the most common type, occurring in almost 32% of the studied population, had three bellies. The frequency of type IV, characterized by four bellies, was also high, just over 30%. The following types were less frequent: type V with five bellies (18.2%), type VI with six bellies (7.6%), type VII with seven bellies (3%), type VIII with eight bellies (1.5%), and type IX with nine bellies (3%). All of the types had origin on the anterior surface of the scapula.
CONCLUSIONS
The SM is morphologically variable in the number of its bellies. Evolutionary changes are probably the reason. The most common type was the SM with three bellies, in line with Larson's model of the division of the SM into three parts. Subsequent studies should be carried out based on MRI or ultrasonography examination to confirm if it is possible to show all types (presented in this study) among group of patients during MRI.
Topics: Aged; Aged, 80 and over; Cadaver; Dissection; Female; Humans; Male; Middle Aged; Muscle, Skeletal; Scapula
PubMed: 34931169
DOI: 10.1155/2021/7450000