ABSTRACT
OBJECTIVE: Various techniques and instruments have been developed to provide safe and secure closure of laparoscopic wounds. Herein we describe a simple method to close laparoscopic supraumbilical wounds with the aid of a laparoscopic port. METHOD: This was a retrospective review of prospective data, which were from 151 patients who underwent laparoscopic cholecystectomy for symptomatic gallstone disease from December 2009 to December 2010 in Sultanah Bahiyah Hospital. A senior consultant hepato-pancreato-biliary (HPB) surgeon and two HPB trainee surgeons performed the operations. Postoperatively, all patients were followed up at 4 weeks. RESULTS: All patients successfully underwent closure of the supraumbilical wound with the assistance of a 5mm laparoscopic port. None of the patients had incisional hernia on follow up. CONCLUSION: Port assisted closure of supraumbilical laparoscopic wounds is a feasible and safe technique.
ABSTRACT
OBJECTIVE: Conventional laparoscopic cholecystectomy (LC) involves the use of four ports, but the number of ports has gradually been reduced to one for cosmetic reasons. however, single-incision LC is technically demanding, and there is a substantial learning curve associated with its successful application. The aim of this clinical study was to evaluate the safety and feasibility of a less demanding alternative LC technique with a faster learning curve. METHODS: This prospective descriptive study was performed from September 2009 to February 2011 at Sultanah Bahiyah hospital in Kedah, Malaysia. A total of 58 patients underwent two-incision threeport laparoscopic cholecystectomy (TILC), which was performed by the senior consultant hepato-pancreato-biliary surgeon and two hepato-pancreato-biliary trainees. Study end points included operative time, postoperative pain, length of hospital stay and early postoperative complications. The follow-up period was 4 weeks. RESULTS: The overall operative time taken was 44 ± 18 minutes. none of the patients had major complication or incisional hernia postoperatively. All but one of the patients were discharged within 24 h. nonsteroidal anti-inflammatory drugs were the main postoperative analgesic used. CONCLUSION: TILC is feasible and safe cholecystectomy technique.
ABSTRACT
Hepatic angiosarcoma is a rare primary mesenchymal malignancy. Prognosis is poor and mortality occurs early. The diagnosis is challenging. Our case was an asymptomatic 70 year-old man referred, with incidental ultrasonography finding of multiple liver nodules. Diagnostic laparoscopic liver biopsy and the histopathological examination reported a haemangioma. Six months later, he became symptomatic and his health condition deteriorated rapidly.
Subject(s)
Hemangiosarcoma/diagnosis , Liver Neoplasms/diagnosis , Aged , Cytodiagnosis , Humans , Male , Tomography, X-Ray ComputedABSTRACT
B and T lymphocyte attenuator (BTLA) has been recently identified as a new inhibitory receptor of the CD28 superfamily, with similarities to cytotoxic T lymphocyte activation antigen (CTLA)-4 and programmed death (PD)-1. Engagement of BTLA on T lymphocytes can profoundly reduce the T cell receptor (TCR)-mediated activation. In this study, we generated four monoclonal antibodies (mAbs) against human BTLA. Using the produced mAb 8H9, the BTLA molecule was found to distinctly express on many subgroups of immunocytes and show a regulatory expression, which was in accordance with its unique ligand herpes virus entry mediator (HVEM) in the process of T cell activation. In addition, the expression of BTLA was increased in the CD4(+) and CD8(+) T cells of pleural fluid in lung cancer patients. Furthermore, we showed that the BTLA-induced negative signals could be triggered by mAb 7D7. Cross-linking of BTLA with mAb 7D7 suppressed T lymphocyte proliferation, downregulated the expression of T cell activation marker CD25, and inhibited the production of interferon (IFN)-gamma, interleukin (IL)-2, IL-4, and IL-10.
Subject(s)
Receptors, Immunologic/physiology , T-Lymphocytes/immunology , Animals , Antibodies, Monoclonal/pharmacology , CD4-Positive T-Lymphocytes/chemistry , CD4-Positive T-Lymphocytes/immunology , CD8-Positive T-Lymphocytes/chemistry , CD8-Positive T-Lymphocytes/immunology , Cell Proliferation/drug effects , Epitopes/immunology , Humans , Interleukin-2 Receptor alpha Subunit/antagonists & inhibitors , Interleukins/antagonists & inhibitors , Lung Neoplasms/immunology , Lymphocyte Activation/drug effects , Mice , Receptors, Immunologic/analysis , Receptors, Immunologic/antagonists & inhibitors , T-Lymphocytes/drug effectsSubject(s)
Blood Circulation , Hand/blood supply , Thermography , Adult , Aged , Body Temperature , Female , Humans , Infrared Rays , Male , Middle AgedABSTRACT
Freeze-dried human placental grafts, when grafted onto the rabbit femoral artery, have a patency rate of 85 percent at 2 weeks that drops to 55 percent at 3 months. Histologic and scanning electron microscopic studies show that the original graft disintegrates and is replaced by a new fibrous layer on top of it.
Subject(s)
Arteries/transplantation , Placenta/blood supply , Transplantation, Heterologous , Animals , Arteries/ultrastructure , Female , Femoral Artery/surgery , Freeze Drying , Graft Occlusion, Vascular/pathology , Humans , Pregnancy , RabbitsABSTRACT
A case report of a successful autotransplantation of a forearm and hand at the distal third of the forearm is presented. The plan of repair is described and the functional result is demonstrated.
