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Liver graft vascular variant with 3 extra-hepatic arteries

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Hepatobiliary & Pancreatic Diseases International 2010年第3期9卷 319-320页

作者： paulo N martins Department of Surgery Division of Hepatobiliary Surgery and TransplantationNew York Medical College

Vascular anatomy of the liver is varied,and the 'standard'anatomy is seen in 55%-80%of *** is very important that extrahepatic arteries are identified precisely at the time of graft procurement to avoid injuries that might compromise the liver *** the present case the liver donor had the vascular anatomy of Michels typeⅦ,e.g.a hepatic artery originating from the celiac trunk and going to the left lobe,an accessory left hepatic artery coming from the left gastric artery,and a replaced right hepatic artery coming from the superior mesenteric *** pattern of vascular supply is uncommon,representing less than 5%of *** replaced hepatic artery was reconstructed in the back-table with polypropylene suture 7.0 by connecting it to the stump of the splenic artery,and the celiac trunk of the graft was anastomosed to the recipient common hepatic artery.

关键词： liver transplantation liver anatomy vascular variations right replaced artery accessory artery

Follicular dendritic cell sarcoma of the liver:unusual presentation of a rare tumor and literature review

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Hepatobiliary & Pancreatic Diseases International 2011年第4期10卷 443-445页

作者： paulo N martins Sanjay reddy Ann-Britt martins Marcelo Facciuto Department of Surgery Division of Hepatobiliary Surgery and TransplantationNew York Medical CollegeNew YorkUSA Department of Surgery New York Medical CollegeSt.Vincent's Catholic Medical CenterNew YorkUSA

BACKGrOUND:Hepatic follicular dendritic cell (FDC) sarcoma is an extremely rare *** commonly,FDC sarcoma presents as a solitary mass in lymph nodes,however,several extra-nodal locations have been ***:We report a case of a 53-year-old female who presented with symptoms of abdominal pain,fever,anemia,and *** an extensive review of the literature,we have found only 12 cases of hepatic FDC ***:The tumor was 11.5 cm in diameter and composed of spindle and epithelioid cells with ovoid nuclei and associated with mixed inflammatory *** stains were positive for CD35 and *** patient underwent a left hepatic ***:Liver follicular dendritic cell sarcoma is a very rare *** cases present with abdominal pain and weight loss,and most of them can be managed by hepatic resection with excellent short-term outcomes.

关键词： follicular dendritic cell tumor liver neoplasms sarcoma jaundice

Xanthogranulomatous cholecystitis mimicking gallbladder cancer and causing obstructive cholestasis

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Hepatobiliary & Pancreatic Diseases International 2012年第5期11卷 549-552页

作者： paulo N martins Patricia Sheiner Marcelo Facciuto Department of Surgery Transplant DivisionMassachusetts General HospitalHarvard Medical School Department of Surgery Division of Hepatobiliary Surgery and TransplantationNew York Medical College Division of Transplantation Mount Sinai Hospital

BACKGrOUND: Xanthogranulomatous cholecystitis (XGC) is a destructive inflammatory disease of the gallbladder that can mimic gallbladder carcinoma. METHODS: We present the case of a 35-year-old Hispanic male complaining of right upper quadrant pain and jaundice for 2 months prior to admission. He denied a history of fever, nausea/ vomiting, and weight loss. The past medical history was relevant only for diabetes. He had no previous history of jaundice or previous operations. rESULTS: CA19-9 was slightly elevated (52 U/mL). Abdominal ultrasonography showed an irregular thickening of the gallbladder wall and no gallstones were detected. CT scan also revealed an irregular thickening of the wall of the gallbladder body suggestive of malignancy. At laparotomy, the mass was adherent to the duodenum and colon, and although the frozen section biopsy was negative, the intraoperative findings were suggestive of malignancy, and the patient underwent left liver trisegmentectomy, resection of the common bile duct and roux-en-Y hepaticojejunostomy. Pathological examination unexpectedly revealed XGC without malignancy. CONCLUSIONS: Preoperative and intraoperative differential diagnosis of XGC from gallbladder carcinoma remains a challenge when it is associated with inflammatory involvement of surrounding tissues. Since gallbladder carcinoma and XGC may coexist, radical resection is justified when malignancy cannot be completely ruled out.

关键词： xanthogranulomatous cholecystitis gallbladder cancer obstructive cholestasis

Fracture Loci in Sheet Metal Forming: A review

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Acta Metallurgica Sinica(English Letters) 2015年第12期28卷 1415-1425页

作者： M.Beatriz Silva Kerim Isik A.Erman Tekkaya paulo A.F.martins IDMEC Instituto Superior Técnico Universidade de Lisboa Institute of Forming Technology and Lightweight Construction Technical University of Dortmund

Fracture in sheet metal forming usually occurs as ductile fracture, rarely as brittle fracture, at the operating temperatures and rates of loading that are typical of real processes in two different modes：（1） tensile and（2） in-plane shear（respectively, the same as modes I and II of fracture mechanics）. The circumstances under which each mode will occur are identified in terms of plastic flow and ductile damage by means of an analytical approach to characterize fracture loci under plane stress conditions that takes anisotropy into consideration. Fracture loci was characterized by means of the fracture forming limit line and by the shear fracture forming limit line in the fracture forming limit diagram. Experiments were performed with single point incremental forming and double-notched test specimens loaded in tension, torsion and in-plane shear give support to the presentation and allow determining the fracture loci of AA1050-H111 aluminium sheets with1 mm thickness. The relation between fracture toughness and the fracture forming limits was also investigated by comparing experimental values of the strains at fracture obtained from a truncated conical part produced by single point incremental forming and from double-notched test specimens loaded in tension.

关键词： Sheet forming Fracture Fracture forming limit diagram

Axillary recurrence after intramammary sentinel lymph nodes metastases with capsular extravasation

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Journal of Cancer Metastasis and Treatment 2019年第1期4卷 13-17页

作者： paulo r.De Alcantara Filho Stephania martins Bezerra Breast Surgery Department Hospital Sirio-LibanesSao Paulo 01308-050Brazil Pathology Department ACCamargo Cancer CenterSao Paulo 01509-010Brazil

Axillary recurrence is a rare event in patients treated with sentinel lymph node biopsy alone with the majority occurring in the first 5 years after surgery. Intramammary lymph node (IMLN) can be the primary sites of metastasis and sentinel lymph nodes, but the clinical significance, including prognosis and therapeutic approach is yet unclear, even more with capsular extravasation. IMLN metastases are strongly correlated with axillary lymph nodes involvement and therefore a guide for further surgical management of the axillary nodes.

关键词： Breast cancer sentinel lymph node lymph node dissection metastasis locoregional neoplasm recurrence

Machine perfusion of the liver:Putting the puzzle pieces together

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World Journal of Gastroenterology 2021年第34期27卷 5727-5736页

作者： Yuri L Boteon paulo N martins Paolo Muiesan Andrea Schlegel Liver Unit Hospital Israelita Albert EinsteinSão Paulo 05652-900Brazil Instituto Israelita de Ensino e Pesquisa Albert Einstein Faculdade Israelita de Ciências da Saúde Albert EinsteinSão Paulo 05652-900Brazil Department of Surgery Transplant DivisionUniversity of Massachusetts Medical SchoolWorcesterMA 01655United States Hepatobiliary Unit Careggi University HospitalUniversity of FlorenceFlorence 50134Italy Department of Visceral Surgery and Transplantation University Hospital ZurichSwiss HPB and Transplant CenterZurich 8091Switzerland

The realm of extended criteria liver transplantation created the'adjacent possible'for dynamic organ *** perfusion of the liver greatly expanded donor organ preservation possibilities,reaching before unattainable goals,including the mitigation of ischemia-reperfusion injury,viability assessment,and organ reconditioning prior to ***,current scientific evidence lacks uniformity between studies,perfusion protocols,and acceptance *** of collaborative research networks for sharing knowledge should,therefore,enable the development of high-level evidence and guidelines for machine perfusion utilization,including donor acceptance ***,this approach shall guarantee conditions for further progress to occur.

关键词： Machine perfusion of the liver Liver transplantation Organ donation Extended criteria donors Liver preservation Clinical trials

Current knowledge on esophageal atresia

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World Journal of Gastroenterology 2012年第28期18卷 3662-3672页

作者： paulo Fernando martins Pinheiro Ana Cristina Simoes e Silva regina Maria Pereira Department of Pediatric Surgery Odilon Behrens HospitalAvenida JoséBonifácioSão CristovãoBelo Horizonte31210-690 Minas GeraisBrazil Department of Pediatrics Faculty of MedicineFederal University of Minas GeraisBelo Horizonte30130-100 Minas GeraisBrazil

Esophageal atresia (EA) with or without tracheoesophageal fistula (TEF) is the most common congenital anomaly of the esophagus. The improvement of survival observed over the previous two decades is multifactorial and largely attributable to advances in neonatal intensive care, neonatal anesthesia, ventilatory and nutritional support, antibiotics, early surgical intervention, surgical materials and techniques. Indeed, mortality is currently limited to those cases with coexisting severe life-threatening anomalies. The diagnosis of EA is most commonly made during the first 24 h of life but may occur either antenatally or may be delayed. The primary surgical correction for EA and TEF is the best option in the absence of severe malformations. There is no ideal replacement for the esophagus and the optimal surgical treatment for patients with long-gap EA is still contro-versial. The primary complications during the postoperative period are leak and stenosis of the anastomosis, gastro-esophageal reflux, esophageal dysmotility, fistula recurrence, respiratory disorders and deformities of the thoracic wall. Data regarding long-term outcomes and follow-ups are limited for patients following EA/TEF repair. The determination of the risk factors for the complicated evolution following EA/TEF repair may positively impact long-term prognoses. Much remains to be studied regarding this condition. This manuscript provides a literature review of the current knowledge regarding EA.

关键词： Esophageal atresia Tracheoesophageal fistula Esophageal stenosis Long-gap Gastro-esophageal reflux

Improving sexual and reproductive health knowledge and practice in Mozambican families with media campaign and volunteer family health champions

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Family Medicine and Community Health 2019年第4期7卷 18-23页

作者： paulo Henrique Pires ronald Siemens martins Mupueleque Health Sciences Faculty Lúrio University Lúrio UniversityNampulaMozambique University of Saskatchewan College of Medicine SaskatoonSaskatchewanCanada Universidade Mussa bin Bique NampulaNampulaMozambique

Objective To increase knowledge,attitudes and practice of sexual and reproductive health and family planning and to reduce maternal and neonatal mortality rates in *** An implementation research project’s intermediate evaluation,applying two cross-sectional *** surveys were planned for 316 subjects before and after *** research performed in Natikiri district of Nampula province in northern Mozambique,targeting a suburban and rural populations in their *** 452 people were surveyed(91 before,361 after),all belonging to the Macua ethnic *** A media campaign(2 weekly radio spots,bimonthly theatre performances)was performed for 8 months(2017 to 2018)and family health champions’teachings(monthly home visits)performed for 3 months,on sexual and reproductive health and family *** measures planned and measured were adolescent’s and adult’s knowledge,attitudes and practice about *** were analysed by gender,age group and frequencies,using a CI of 95%(presults radio spots,community theatre and volunteer champions increased population’s knowledge about sexual and reproductive health and led to a more positive attitude toward family *** attitude,results show differences between adults’proportions before and after:(1)did you hear about sexual and reproductive health(p=0.0425);(2)knows project key messages(prenatal visits importance(p=0.0301);(4)access to contraceptives was easy(prences before and after:(1)knows project key messages(praceptives was easy(p=0.0361).Family planning practice did not increase in both *** A health education intervention,using a media campaign and local volunteers,is useful to promote mother and child *** is an unmet need for family planning and the use of modern contraception is below desired pra

关键词： knowledge media campaign

Antiglycation,antioxidant,antiacne,and photoprotective activities of crude extracts and triterpene saponin fraction of Sapindus saponaria ***:An in vitro study

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Asian Pacific Journal of Tropical Biomedicine 2022年第9期12卷 391-399页

作者： regildo M.G.Silva Gustavo r.martins Laura M.B.Nucci Filipe O.Granero Célia C.M.Figueiredo Patrícia S.Santiago Luciana P.Silva Laboratory of Herbal Medicine and Natural Products Department of BiotechnologyFaculty of SciencesHumanities and LanguagesSão Paulo State UniversityAssisSão PauloBrazil Institute of Chemistry São Paulo State UniversityAraraquaraSão PauloBrazil São paulo State University Campus de RegistroRegistroSão PauloBrazil Fundação Educacional do Município de Assis AssisSão PauloBrazil

Objective:To evaluate the photoprotective,antioxidant,antiglycation,and antiacne activities of crude extract(CESs)and triterpene saponin fraction(TSSs)of Sapindus ***:HPLC-MS purification was performed on a Symmetry TM C18 *** saponins were identified by a UV *** activity was evaluated by DPPH and O_(2)^(−)radicals scavenging,and FrAP and TBArS *** activity was assessed by relative electrophoretic mobility and inhibition of advanced glycation end products(AGEs)***,antiacne activity was determined by inhibition of Cutibacterium acnes,and photoprotective effect was evaluated by Mansur’s ***:Most of the triterpene saponins detected in the fraction by HPLC-MS analysis were hederagenin as the *** and TSSs presented varying antioxidant activity in DPPH(CESs:75.69%and TSSs:83.65%),FrAP(CESs:425.39μM TE/g DW and TSSs:649.36μM TE/g DW),TBArS(CESs:42.96%and TSSs:52.16%)and O_(2)^(−)radicals scavenging(CESs:61.33%and TSSs:86.69%)*** and TSSs also exhibited antiglycation activity comparable to bovine serum albumin treated with *** addition,CESs and TSSs showed inhibition of AGE formation(34.48%and 61.85%,respectively).Antiacne activity against Cutibacterium acnes was observed with a minimum inhibitory concentration equal to minimum bactericidal concentration(CESs:36.11µg/mL and TSSs:18.34µg/mL).In photoprotective assays,CESs and TSSs showed maximum absorbance of 1.42 to 0.20 and 2.80 to 1.30,respectively,in the wavelength range of 260 to 400 ***,CESs and TSSs showed sun protection factors of 8.89 and 14.89,***:Sapindus saponaria fruit extracts show strong antioxidant potential and antiglycation activity against bovine serum albumin glycation and AGE ***,they presented antibacterial activity against Cutibacterium acnes and photoprotective effect against UV-A and UV-B.

关键词： Photoprotective AGE formation Free radical Antioxidant Triterpene saponin Sapindus saponaria