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Peripheral Nerve Microcirculation
Published in John H. Barker, Gary L. Anderson, Michael D. Menger, Clinically Applied Microcirculation Research, 2019
The basis of much peripheral nerve surgery is to provide a better environment for the nerve by avoiding tension or tethering and to place the nerve in a well-vascularized bed. It would be very advantageous to the surgeon if the nerve could be positioned and monitored for functioning blood flow at the same time. Similarly, in cases where the surgeon performs a vascular nerve graft (either as a free or pedicle nerve graft), it would be useful to determine the integrity of the circulation by monitoring the microcirculation. The advances in endoscopic surgery may lead to techniques to aid the surgeon in assessing the state of the nerves prior to extensive surgery. Coupled with objective measures of flow such as laser Doppler and other potential photometric techniques to assess the oxygenation of the issue, useful information in the diagnosis and treatment should be possible.
Gynecologic Robotic Surgery: Intraoperative Complication and Conversion Rates
Published in Journal of Investigative Surgery, 2022
Alexandros Fotiou, Christos Iavazzo
With great deal of interest we read the published article entitled “Intraoperative complications and conversion to laparotomy in gynecologic robotic surgery” [1]. The authors analyzed their single center single surgeon 2-year experience in robotic gynecologic procedures that were underwent from July of 2016 to July of 2018. They focused on their complication and conversion rates. Regarding the mentioned complications, they were defined and recorded as: failure in entry, vascular, nerve, visceral or solid organ injury, tumor fragmentation or anesthetic complication. Interestingly the only complication that lead in conversion to open was anesthesiologically related. All the others were managed. Moreover, 1 out of 83 procedures and 4 out of 83 were converted in either laparoscopy or laparotomy, respectively. Only 1 procedure was converted due to robotic platform related complication (robotic arm malfunction). The overall conversion rate was calculated at 6.02%.
Alleviative effects of foraging exercise on depressive-like behaviors in chronic mild stress-induced ischemic rat model
Published in Brain Injury, 2022
Xi Tao, Siyuan Wu, Wenjing Tang, Lu Li, Lijun Huang, Danheng Mo, Chujuan Liu, Tao Song, Shuling Wang, Jia Wang, Juan He
The immune-inflammatory response, including the activation of microglia, plays an important role in the pathophysiology of PSD (19,20). As a resident immune cell with phagocytic abilities, structural and functional changes in microglia participate in the development of depression (38). In general, microglial cells perceive subtle changes in the peripheral microenvironment through synaptic branches in a resting state (38,39). When a unit of vascular nerve is stimulated by ischemia, hypoxia, infection or inflammatory factors, the resting microglia are synaptically activated through the perception of changes in the microenvironment, then forming a phagocytic amoeba (38). According to the degree and duration of the stressors, the microglia in the early M1 polarized state secrete pro-inflammatory cytokines (IL-6, TNF-α and IL-1β), which could promote the occurrence and development of depression, while the microglia in the M2 polarized state secrete anti-inflammatory cytokines (IL-10, IL-4 and TNF-β), which could alleviate the development of depression (40). These polarization states indicate that microglia have two-way regulation on depression (40). The overexpression of microglia suggests an imbalance of the immune-inflammatory response in the central nervous system (41).
Complete remission of a case of high-grade myxofibrosarcoma with lung metastases after modified MAID regimen chemotherapy
Published in Journal of Chemotherapy, 2020
Yunpeng Cui, Yuanxing Pan, Xuedong Shi
A 44-years-old man presented with a left thigh mass (approximately 3 cm in diameter) in September 2015 with no other clinical symptom. This mass had been growing gradually and the patient was admitted to our hospital on September 15th, 2017. Physical examination showed a huge mass in the left thigh. The mass was relatively immobile without tenderness. Electrocardiogram and blood chemistry were normal. Magnetic resonance imaging (MRI) showed a large mixed T1 and long T2 signal lesion at the middle and lower left thigh, with increased signal intensity on Diffusion-weighted imaging (DWI). The lesion measured 8.8 cm × 12.8 cm × 18.5 cm (transverse, antero-posterior, longitudinal, respectively). Vastus lateralis, vastus intermedius muscle, rectus femoris muscle and biceps femoris muscle were compressed by the mass. On fsT2WI, patchy bright spots with poorly defined boundaries were seen in the lateral femoral muscle near the proximal end of the lesion, intermuscular septum near the distal end of lesion and soft tissue near lateral parapatellar. The lesion did not invade femoral vascular, nerves and femur (Figure 1A). Chest computed tomography (CT) showed multiple nodules of lung, and the largest one was located in the basal segment of the right lower lobe, with a diameter of about 1.7 cm (Figure 1B). B-mode ultrasound guided percutaneous biopsy of the primary tumour in the left thigh showed spindle cells hyperplasia, accompanied by multinucleated giant cells and strange nuclear cells with mucus-like stroma. The pathological diagnosis was mesenchymal tumour, which is suspicious for malignancy.