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Subsequent pregnancy outcomes and fertility rates in the case series that underwent bilateral hypogastric artery ligation(BHGAL)due to severe postpartum hemorrhage

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Asian pacific Journal of Reproduction 2024年第1期13卷 28-33页

作者： OKUTUCU Gulcan EVSEN Mehmet S PEKER Nurullah YAMAN TUNC Senem ICEN Mehmet S Department of Obstetrics and Gynecology Division of PerinatologyTurkish Ministry of Health Ankara City HospitalAnkaraTurkey Department of Obstetrics and Gynecology Dicle UniversitySchool of MedicineDiyarbakirTurkey

Objective:To evaluate the effect of bilateral hypogastric artery ligation(BHGAL)on women's pregnancy outcomes and fertility rates in cases with severe postpartum hemorrhage.Methods:Patients hospitalized in a tertiary care center between 2007 and 2018 were included in the study.The records of cases were obtained from the hospital database,retrospectively.Maternal demographic data,morbidities or complications associated with BHGAL surgery,any additional haemostatic interventional or surgical procedures,preoperative admission and lowest postoperative haematocrit-hemoglobin values,blood products given,type of anaesthesia,intensive care unit(ICU)and length of hospital stay were recorded.In cases without surgical sterilization,future fertility and subsequent pregnancy outcomes were assessed for at least two years after operation.Information was obtained through face-to-face or telephone interviews with patients whose long-term fertility and subsequent pregnancy outcomes were assessed.Results:Sixty-eight patients with BHGAL surgery history were included in the study.26 Of 37 cases(70%)that did not undergo surgical sterilization had a desire for pregnancy after the surgery.Six of these cases(23%)were diagnosed with secondary infertility.The fertility rate of these cases was 77%,and subsequent pregnancy was detected in 20 women.A total of 25 pregnancies,including first and second pregnancies,developed,and 15 of these pregnancies resulted in term delivery,six preterm births,one stillbirth,and three abortions.Conclusions:The postoperative pregnancy rate was found to be higher than the rate of women with infertility problems,and this surgery does not seem to adversely affect pregnancy outcomes.This is a tertiary center experience and cohort studies with large patient series are needed.

关键词： Fertility Iliac artery Ligations Postpartum hemorrhage Pregnancy outcomes

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Current concepts and future strategies in the antimicrobial therapy of emerging Gram-positive spontaneous bacterial peritonitis

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World Journal of Hepatology 2017年第30期9卷 1166-1175页

作者： Marco Fiore Alberto Enrico Maraolo Ivan Gentile Guglielmo Borgia Sebastiano Leone Pasquale Sansone Maria Beatrice Passavanti Caterina Aurilio Maria Caterina Pace Department of Anesth-esiological Surgical and Emergency SciencesUniversity of Campania 'Luigi Vanvitelli' Department of Clinical Medicine and Surgery Section of Infectious DiseasesUniversity of Naples Federico Ⅱ division of Infectious Diseases 'San Giuseppe Moscati' Hospital

Spontaneous bacterial peritonitis(SBP) is the most common infection in end-stage liver disease patients.SBP is defined as an ascitic fluid infection with a polymorphonuclear leucocyte count ≥ 250/mm^3 without an evident intra-abdominal surgically treatable source.Several mechanisms contribute to SBP occurrence,including translocation of gut bacteria and their products,reduced intestinal motility provoking bacterial overgrowth,alteration of the gut's barrier function and local immune responses.Historically,Gram-negative enteric bacteria have been the main causative agents of SBP,thereby guiding the empirical therapeutic choice.However,over the last decade,a worryingly increasing prevalence of Gram-positive and multi-drug resistant(MDR) SBP has been seen.Recently,the microbiological spectrum of SBP seems to have changed in Europe due to a high prevalence of Gram-positive bacteria(48%-62%).The overall proportion of MDR bacteria is up to 22%-73% of cases.Consequently,empirical therapy based on thirdgeneration cephalosporins or amoxicillin/clavulanic acid,can no longer be considered the standard of care,as these drugs are associated with poor outcomes.Theaim of this review is to describe,with an epidemiological focus,the evidence behind this rise in Gram-positive and MDR SBP from 2000 to present,and illustrate potential targeted therapeutic strategies.An appropriate treatment protocol should include daptomycin plus ceftaroline and meropenem,with prompt stepdown to a narrower spectrum when cultures and sensitivity data are available in order to reduce both cost and potential antibiotic resistance development.

关键词： Spontaneous bacterial peritonitis Multi-drug resistant bacteria End-stage liver disease Cirrhosis Critically ill patient

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Effect of Fucoidan Dietary Supplement on the Chemotherapy Treatment of Patients with Unresectable Advanced Gastric Cancer

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Journal of Cancer Therapy 2015年第11期6卷 1020-1026页

作者： Masahide Ikeguchi Hiroaki Saito Yasunari Miki Takayuki Kimura Tottori Prefectural Central Hospital Tottori Japan division of surgical Oncology Department of Surgery Faculty of Medicine Tottori University Yonago Japan Marine products Kimuraya Co. Ltd. Sakaiminato Japan

In Japan, S-1 plus cisplatin has become a standard regimen for the treatment of unresectable advanced gastric cancer;however, many patients are unable to continue effective chemotherapy because of the regimen’s severe side effects. Thus, control of drug toxicity is key to prolonging patient survival. Fucoidan is a major sulfated polysaccharide found in brown seaweeds and has a wide range of biological activities. In the present study, we analyzed the effect of fucoidan on suppressing the toxicity of chemotherapy drugs. Twenty-four patients with unresectable advanced gastric cancer underwent treatment with S-1 plus cisplatin and were randomly allocated into a fucoidan treatment group (n = 12) or a control group without fucoidan treatment (n = 12). The study results demonstrated that fucoidan controlled the occurrence of fatigue during chemotherapy and patients could continue chemotherapy for longer time periods by maintaining the patients’ favorable nourishment status. As a result, the survival of patients with fucoidan treatment was longer than that of patients without fucoidan. Thus, fucoidan should be included as a key food supplement for patients with gastrointestinal carcinomas who are suffering from the adverse side effects of chemotherapy.

关键词： Chemotherapy Fucoidan Gastric Cancer Toxicity Prognosis

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Robotic surgery in China

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The Innovation 2023年第5期4卷 19-20页

作者： Liangyou Gu Chengliang Yin Tongyu Jia Kunlun He Xin Ma Xu Zhang Department of Urology The Third Medical CentreChinese PLA General HospitalBeiing 100039China Medical Big Data Research Center Medical Innovation Research Division of PLA General HospitalBeijing 100853China National Engineering Research Center for Medical Big Data Aplication Technology Chinese PLA General HospitalBeijing 100853China National Medical products Administration Key Laboratory for Research and Evaluation of Artficial Iellience Medical Devices Chinese People's Liberation Army(PL A)General HospitalBeijing 100853China

Robotic surgery,succeeding open and laparoscopic surgery,stands as the third revolution in surgical techniques.To date,numerous robotic surgical systems have been approved for use,such as AESOP,ZEUS,Da Vinci,and Enhance.Among these systems,the Da Vinci surgical system,developed by Intuitive surgical,received US Food and Drug Administration(FDA)approval in 2000,marking the commencement of commercialization of surgical robots.Over four iterations,the Da Vinci surgical system has emerged as the most popular and widely used surgical robot worldwide.

关键词： Robotic robot surgery

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Effects of the number of neoadjuvant therapy cycles on clinical outcomes, safety, and survival in patients with metastatic colorectal cancer undergoing metastasectomy

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Oncology Research 2022年第2期30卷 65-76页

作者： YUNG-SUNG YEH HSIANG-LIN TSAI YEN-CHENG CHEN WEI-CHIH SU PO-JUNG CHEN TSUNG-KUN CHANG CHING-CHUN LI CHING-WEN HUANG JAW-YUAN WANG division of Trauma and surgical Critical Care Department of SurgeryKaohsiungMedical University HospitalKaohsiung Medical UniversityKaohsiungTaiwanChina Department of Emergency Medicine Faculty of Post-Baccalaureate MedicineCollege of MedicineKaohsiung Medical UniversityKaohsiungTaiwanChina Graduate Institute of Injury Prevention and Control College of Public HealthTaipei Medical UniversityTaipeiTaiwanChina division of Colorectal Surgery Department of SurgeryKaohsiung Medical University HospitalKaohsiung Medical UniversityKaohsiungTaiwanChina Department of Surgery Faculty of MedicineCollege of MedicineKaohsiung Medical UniversityKaohsiungTaiwanChina Graduate Institute of Clinical Medicine College of MedicineKaohsiung Medical UniversityKaohsiungTaiwanChina Department of Surgery Faculty of Post-Baccalaureate MedicineCollege of MedicineKaohsiung Medical UniversityKaohsiungTaiwanChina Graduate Institute of Medicine College of MedicineKaohsiung Medical UniversityKaohsiungTaiwanChina Center for Cancer Research Kaohsiung Medical UniversityKaohsiungTaiwanChina Pingtung Hospital Ministry of Health and WelfarePingtungTaiwanChina

The controversial outcomes in patients with metastatic colorectal cancer(mCRC)highlight the need for developing effective systemic neoadjuvant treatment strategies to improve clinical results.The optimal treatment cycles in patients with mCRC for metastasectomy remain undeﬁned.This retrospective study compared the efﬁcacy,safety,and survival of cycles of neoadjuvant chemotherapy/targeted therapy for such patients.Sixty-four patients with mCRC who received neoadjuvant chemotherapy/targeted therapy following metastasectomy were enrolled between January 2018 and April 2022.Twenty-eight patients received 6 cycles of chemotherapy/targeted therapy,whereas 36 patients received≥7 cycles(median,13;range,7–20).Clinical outcomes,including response,progression-free survival(PFS),overall survival(OS),and adverse events,were compared between these two groups.Of the 64 patients,47(73.4%)were included in the response group,and 17(26.6%)were included in the nonresponse group.The analysis revealed chemotherapy/targeted therapy cycle and pretreatment serum carcinoembryonic antigen(CEA)level as independent predictors of the response as well as overall survival and chemotherapy/targeted therapy cycle as an independent predictor of progression(all p0.05).The median OS and PFS were 48 months(95%CI,40.855–55.145)and 28 months(95%CI,18.952–37.48)in the≥7-cycle group and 24 months(95%CI,22.038–25.962)and 13 months(95%CI,11.674–14.326)in the 6-cycle group,respectively(both p<0.001).The oncological outcomes in the≥7-cycle group were signiﬁcantly better than those in the 6-cycle group,without signiﬁcant increases in adverse events.However,prospective randomized trials are mandatory to conﬁrm the potential advantages of cycl

关键词： Metastatic colorectal cancer Neoadjuvant chemotherapy/targeted therapy Treatment cycles Metastasectomy

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Over-the-scope clips in the treatment of gastrointestinal tract iatrogenic perforation: A multicenter retrospective study and a classification of gastrointestinal tract perforations

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World Journal of Gastrointestinal Surgery 2016年第4期8卷 315-320页

作者： Benedetto Mangiavillano Angelo Caruso Raffaele Manta Roberto Di Mitri Alberto Arezzo Nico Pagano Giuseppe Galloro Filippo Mocciaro Massimiliano Mutignani Carmelo Luigiano Enrico Antonucci Rita Conigliaro Enzo Masci Gastroenterology and Gastrointestinal Endoscopy Borea Hospital Gastroenterology and Gastroin-testinal Endoscopy Sant’Agostino Estense Gastrointestinal Endoscopy Operative Endoscopy Unit Niguarda-Ca Granda Hospital Gastroenterology and Endo-scopy Unit ARNAS Civico Hospital Department of surgical Sciences University of Torino Unit of Gastroenterology S.Orsola-Malpighi Univer-sity Hospital Department of Clinical Medicine and Surgery Special Unit of Surgical Digestive Endoscopy University of Naples Federico Ⅱ - School of Medicine Gastrointestinal Endoscopy San Paolo Univer-sitary Hospital division of surgical and gastrointetsinal products Euromedical s.r.l Gastroenterology and Gastrointestinal Endoscopy National Tumori Institute

AIM: To determine the outcome of the management of iatrogenic gastrointestinal tract perforations treated by over-the-scope clip(OTSC) placement.METHODS: We retrospectively enrolled 20 patients(13 female and 7 male; mean age: 70.6 ± 9.8 years) in eight high-volume tertiary referral centers with upper or lower iatrogenic gastrointestinal tract perforation treated by OTSC placement. Gastrointestinal tract perforation could be with oval-shape or with round-shape. Ovalshape perforations were closed by OTSC only by suction and the round-shape by the "twin-grasper" plus suction. RESULTS: Main perforation diameter was 10.1 ± 4.3 mm(range 3-18 mm). The technical success rate was 100%(20/20 patients) and the clinical success rate was 90%(18/20 patients). Two patients(10%) who did not have complete sealing of the defect underwent surgery. Based upon our observations we propose two types of perforation: Round-shape "type-1 perforation" and oval-shape "type-2 perforation". Eight(40%) out of the 20 patients had a type-1 perforation and 12 patients a type-2(60%). CONCLUSION: OTSC placement should be attempted after perforation occurring during diagnostic or therapeutic endoscopy. A failed closure attempt does not impair subsequent surgical treatment.

关键词： Over-the-scope clip OVESCO Perforation Gastrointestinal tract

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Effect of Collagen Type I or Human Fibronectin on Imatinib Cytotoxicity in Oral Squamous Cell Carcinoma

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Pharmacology & Pharmacy 2016年第7期7卷 255-263页

作者： Masahiko Morioka Mai Hazekawa Tomoyo Kawakubo-Yasukochi Takuya Nishinakagawa Seiji Nakamura Manabu Nakashima Department of Immunological and Molecular Pharmacology Faculty of Pharmaceutical Science Fukuoka University Fukuoka Japan Section of Oral and Maxillofacial Oncology Division of Maxillofacial Diagnostic and Surgical Sciences Faculty of Dental Science Kyushu University Fukuoka Japan

Extracellular matrix (ECM) components are critical for all aspects of cell proliferation, adhesion, and morphological alteration. Recent progress has yielded multiple molecular drugs that specifically target gene products which are expressed at high levels in tumor cells. We investigated whether the sensitivity of tumor cells to molecular target drugs could be altered when cells were cultured on surfaces with various coating conditions such as lysine, laminin, Matrigel, collagen type I, and human fibronectin (HFN). This study evaluates the IC50 values of imatinib in oral squamous cell carcinoma (OSCC) cell lines when cells are cultured on plates coated with ECM components such as collagen type I and HFN. Four OSCC cell lines—SQUU-A, SQUU-B, SAS, and NA— are used. Cell proliferation was assessed using WST-8 reagent. Collagen type I and HFN significantly enhanced OSCC cell proliferation compared with control. Imatinib cytotoxicity was demonstrated following culture of OSCCs in culture plates coated with collagen type I or HFN. However, there were no significant changes in imatinib IC50 values between collagen type I and HFN. These results indicate that some molecular target drugs exhibit cancer cell cytotoxicity without being influenced by cell environment factors such as the ECM. These results may aid in the search for molecular target drugs to apply in the clinical chemotherapy of OSCC.

关键词： Collagen Type I Human Fibronectin Imatinib Cytotoxicity Oral Squamous Cell Carcinoma

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Intraoperative thromboelastography as a tool to predict postoperative thrombosis during liver transplantation

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World Journal of Transplantation 2020年第11期10卷 345-355页

作者： Lesley De Pietri Roberto Montalti Giuliano Bolondi Valentina Serra Fabrizio Di Benedetto Department of General Surgery Division of Anaesthesiology and Intensive Care UnitNuovo Ospedale Civile di SassuoloSassuolo 41049ModenaItaly Department of Public Health Hepato-Pancreato-Biliary Surgery SectionFederico II University of NaplesNapoli 80138Italy Surgery and Trauma Department Intensive Care UnitOspedale Bufalini CesenaCesena 47521Italy Surgery Department Hepato-Pancreato-Biliary SurgerySurgical Oncology and Liver Transplantation UnitAzienda Ospedaliero Universitaria di ModenaUniversity of Modena and Reggio EmiliaModena 41125Italy

BACKGROUND Thromboembolic complications are relatively common causes of increased morbidity and mortality in the perioperative period in liver transplant patients.Early postoperative portal vein thrombosis(PVT,incidence 2%-2.6%)and early hepatic artery thrombosis(HAT,incidence 3%-5%)have a poor prognosis in transplant patients,having impacts on graft and patient survival.In the present study,we attempted to identify the predictive factors of these complications for early detection and therefore monitor more closely the patients most at risk of thrombotic complications.AIM To investigate whether intraoperative thromboelastography(TEG)is useful in detecting the risk of early postoperative HAT and PVT in patients undergoing liver transplantation(LT).METHODS We retrospectively collected thromboelastographic traces,in addition to known risk factors(cold ischemic time,intraoperative requirement for red blood cells and fresh-frozen plasma transfusion,prolonged operating time),in 27 patients,selected among 530 patients(≥18 years old),who underwent their first LT from January 2002 to January 2015 at the Liver University Transplant Center and developed an early PVT or HAT(case group).Analyses of the TEG traces were performed before anesthesia and 120 min after reperfusion.We retrospectively compared these patients with the same number of nonconsecutive control patients who underwent LT in the same study period without developing these complications(1:1 match)(control group).The chosen matching parameters were:Patient graft and donor characteristics[age,sex,body mass index(BMI)],indication for transplantation,procedure details,United Network for Organ Sharing classification,BMI,warm ischemia time(WIT),cold ischemia time(CIT),the volume of blood products transfused,and conventional laboratory coagulation analysis.Normally distributed continuous data are reported as the mean±SD and compared using one-way Analysis of Variance(ANOVA).Nonnormally distributed continuous data are reported as the median(interquartile range)and comp

关键词： Thromboelastography Hepatic artery thrombosis Portal vein thrombosis Liver transplantation Risk factors Cirrhosis

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Helicobacter pylori and gastric mucosa-associated lymphoid tissue lymphoma:Recent progress in pathogenesis and management

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World Journal of Gastroenterology 2013年第45期19卷 8181-8187页

作者： Shotaro Nakamura Takayuki Matsumoto Department of R/D for surgical Support System Center for Advanced Medical Innovation Kyushu University Fukuoka 812-8582 Japan Department of Medicine and Clinical Science Graduate School of Medical Sciences Kyushu UniversityFukuoka 812-8582 Japan division of Gastroenterology Department of Internal Medicine Iwate Medical University Morioka 020-8505 Japan

Recent progress in the research regarding the molecular pathogenesis and management of gastric mucosaassociated lymphoid tissue(MALT)lymphoma is reviewed.In approximately 90%of cases,Helicobacter pylori(H.pylori)infection plays the causative role in the pathogenesis,and H.pylori eradication is nowadays the first-line treatment for this disease,which leads to complete disease remission in 50%-90%of cases.In H.pylori-dependent cases,microbe-generated immune responses,including interaction between B and T cells involving CD40 and CD40L co-stimulatory molecules,are considered to induce the development of MALT lymphoma.In H.pylori-independent cases,activation of the nuclear factor-κB pathway by oncogenic products of specific chromosomal translocations such as t(11;18)/API2-MALT1,or inactivation of tumor necrosis factor alpha-induced protein 3(A20)are considered to contribute to the lymphomagenesis.Recently,a largescale Japanese multicenter study confirmed that the long-term clinical outcome of gastric MALT lymphoma after H.pylori eradication is excellent.Treatment modalities for patients not responding to H.pylori eradication include a"watch and wait"strategy,radiotherapy,chemotherapy,rituximab immunotherapy,and a combination of these.Because of the indolent behavior of MALT lymphoma,second-line treatment should be tailored in consideration of the clinical stage and extent of the disease in each patient.

关键词： Gastric lymphoma Mucosa-associated lymphoid tissue lymphoma Helicobacter pylori Nuclear factor κB

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Analysis of opto-thermal interaction of porcine stomach tissue with 808-nm laser for endoscopic submucosal dissection

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Journal of Innovative Optical Health Sciences 2015年第6期8卷 81-91页

作者： Seongjun Kim M.Tamim Hossain Don Haeng Lee Jung Kyung Kim Department of Mechanical Engineering Graduate School Kookmin University Seoul 136-702Republic of Korea Department of Integrative Biomedical Science and Engineering Graduate SchoolKookmin University Seoul 136-702Republic of Korea division of Gastroenterology Department of Internal Medicine Inha University School of Medicine National Center of Efficacy Evaluation for the Development of Health products Targeting Digestive Disorders Utah-Inha DDS&Advanced Therapeutics Research Center 27 Inhang-ro Jung-guIncheon 400-711Republic of Korea Department of Mechanical Engineering Kookmin University Seoul 136-702 Republic of Korea

In endoscopic submucosal dissection(ESD),the narrow gastrointestinal space can cause difficulty in surgical interventions.Tissue ablation apparatuses with high-power CO_(2) lasers or Nd:YAG lasers have been developed to facilitate endoscopic surgical procedures.We studied the interaction of 808-nm laser light with a porcine stomach tissue,with the aim of developing a therapeutic medical device that can remove lesions at the gastrointestinal wall by irradiating a near-infrared laser light incorporated in an endoscopic system.The perforation depths at the porcine fillet and the stomach tissues linearly increased in the range of 2–8mm in proportion to the laser energy density of 63.7–382 kJ/cm^(2).Despite the distinct structural and compositional di®erence,the variation of the perforation depth between the stomach and the fillet was not found at 808-nm wavelength in our measurement.We further studied the laser–tissue interaction by changing the concentration of the methyl blue solution used conventionally as a submucosal fluidic cushion(SFC)in ESD procedures.The temperature of the mucosal layer increased more rapidly at higher concentration of the methyl blue solution,because of enhanced light absorption at the SFC layer.The insertion of the SFC would protect the muscle layer from thermal damage.We confirmed that more effective laser treatment should be enabled by tuning the opto-thermal properties of the SFC.This study can contribute to the optimization of the driving parameters for laser incision techniques as an alternative to conventional surgical interventions.

关键词： Near-infrared laser surgical intervention laser-tissue interaction submucosal fluid cushion temperature distribution

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