The authors present the case of a 9-year-old boy who sustained a gunshot injury to the pericardium by an air gun. The penetrative wound to the pericardium was, according to the performed pre-operative diagnostic methods, initially believed to be a penetrative wound into the cardiophrenic angle of the left pleural cavity. The stabilized patient was indicated for an extraction of the projectile through a left anterior minithoracotomy, during which the projectile was found and successfully removed from the pericardium. The limits of pre-operative assessment, optimal treatment procedures, and surgical approaches in pediatric patients with gunshot injuries to the chest and heart are discussed.
- MeSH
- cizí tělesa * chirurgie MeSH
- dítě MeSH
- lidé MeSH
- perikard diagnostické zobrazování chirurgie MeSH
- poranění hrudníku * chirurgie MeSH
- střelné rány * diagnostické zobrazování chirurgie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
Anastomotic leakage is a dreadful complication in colorectal surgery. It has a negative impact on postoperative mortality, long term life quality and oncological results. Nanofibrous polycaprolactone materials have shown pro-healing properties in various applications before. Our team developed several versions of these for healing support of colorectal anastomoses with promising results in previous years. In this study, we developed highly porous biocompatible polycaprolactone nanofibrous patches. We constructed a defective anastomosis on the large intestine of 16 pigs, covered the anastomoses with the patch in 8 animals (Experimental group) and left the rest uncovered (Control group). After 21 days of observation we evaluated postoperative changes, signs of leakage and other complications. The samples were assessed histologically according to standardized protocols. The material was easy to work with. All animals survived with no major complication. There were no differences in intestinal wall integrity between the groups and there were no signs of anastomotic leakage in any animal. The levels of collagen were significantly higher in the Experimental group, which we consider to be an indirect sign of higher mechanical strength. The material shall be further perfected in the future and possibly combined with active molecules to specifically influence the healing process.
- Publikační typ
- časopisecké články MeSH
BACKGROUND/AIM: The aim of the study was to evaluate the influence of primary tumour location and clinical risk factors for long-term results of surgery for colorectal liver metastases (CLMs). PATIENTS AND METHODS: Overall survival (OS) and recurrence-free survival (RFS) were evaluated in 636 patients. Patients were divided by tumour location (right-/left-sided colorectal cancer: RCRC/LCRC; rectal cancer), and age, gender, number and size of CLMs, type of liver surgery and interval from primary operation were evaluated. RESULTS: One-, 3- and 5-year OS and RFS were independent of primary tumour location (p<0.59). CLM diameter was negatively associated with OS for the whole cohort (p<0.002), and RCRC (p<0.03) and LCRC (p<0.04) groups, as well as for RFS of those with LCRC (p<0.04). CLM number was negatively associated with RFS for the whole cohort (p<0.0001), RCRC (p<0.02), LCRC (p<0.0001) and RC (p<0.02). Radiofrequency ablation and combined procedures led to worse OS for the whole cohort (p<0.03), and to worse RFS for the whole cohort (p<0.0003) and for those with LCRC (p<0.03). A shorter interval between primary colorectal cancer surgery and CLMs procedure was risky for poor OS and RFS of patients with CLMs from RCRC (p<0.05), LCRC (p<0.05) and RC (p<0.02). CONCLUSION: Primary tumour location together with clinical risk factors are important for long-term results of surgery CLMs.
- MeSH
- hepatektomie MeSH
- kolorektální nádory * chirurgie MeSH
- lidé MeSH
- míra přežití MeSH
- nádory jater * chirurgie MeSH
- nádory rekta * MeSH
- rizikové faktory MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Extáze, MDMA (3,4-methylendioxymetamfetamin) je syntetická, psychoaktivní látka, chemicky podobná stimulanciu metamfetaminu a halucinogenu meskalinu. MDMA uplatňuje svůj účinek především v mozku na neuronech, které používají ke komunikaci s jinými neurony serotonin. Serotoninový systém hraje významnou úlohu při regulaci nálady, agresivity, sexuální aktivity, spánku a citlivosti na bolest. Výzkumy na zvířatech ukazují, že MDMA má neurotoxický účinek; zda to platí také pro člověka, je v současné době intenzivně studováno. MDMA může být nebezpečná a vzácně může způsobit i smrt. Ve vysokých dávkách narušuje MDMA schopnost těla regulovat teplotu. To může vést k rychlému zvýšení tělesné teploty (hypertermie) a způsobit selhání jater, ledvin a kardiovaskulárního systému. Konzumenti MDMA tak čelí stejnému nebezpečí jako konzumenti jiných stimulancií jako je kokain nebo amfetaminy. Tyto zvyšují srdeční frekvenci a krevní tlak, což může být nebezpečné zejména pro osoby s oběhovými problémy a nemocemi srdce, a vyvolávají i další symptomy jako svalové napětí, nechtěné svírání zubů, nucení ke zvracení, rozmazané vidění, mdloby, třesavku a pocení.
Ecstasy, MDMA (3,4-methylenedioxymetamphetamine) is a synthetic, psychoactive substance, chemically similar to the stimulant metamphetamine and hallucinogen mescaline. MDMA exerts its effects particularly in the brain or in neurons, which use serotonin for their communication with other neurons. The serotonin system plays an important role in the control of the mood, aggressivity, sexual activity, sleep and sensitivity to the pain. The research on animals demonstrated that MDMA exerts neurotoxic effects; the question, if this also holds for man is currently being intensively studied. MDMA can be dangerous and it also can rarely cause the death. In high doses, MDMA disturbs the ability of the organism to control the body temperature. This can lead to a rapid increase in the body temperature (hyperthermia) with subsequent failures of the liver, kidney and cardiovascular systems. Thus, consumers of MDMA face the same danger as consumers of other stimulants, such as cocaine or amphetamines. They increase the heart frequency and blood pressure, which can be dangerous particularly for persons with circulation problems and myocardium diseases and they also induce further symptoms, such as muscular tone, twitching of teeth, vomiting, blurred vision, faints, tremor and sweating.
