A comprehensive overview of radioguided surgery using gamma detection probe technology

The concept of radioguided surgery, which was first developed some 60 years ago, involves the use of a radiation detection probe system for the intraoperative detection of radionuclides. The use of gamma detection probe technology in radioguided surgery has tremendously expanded and has evolved into what is now considered an established discipline within the practice of surgery, revolutionizing the surgical management of many malignancies, including breast cancer, melanoma, and colorectal cancer, as well as the surgical management of parathyroid disease. The impact of radioguided surgery on the surgical management of cancer patients includes providing vital and real-time information to the surgeon regarding the location and extent of disease, as well as regarding the assessment of surgical resection margins. Additionally, it has allowed the surgeon to minimize the surgical invasiveness of many diagnostic and therapeutic procedures, while still maintaining maximum benefit to the cancer patient. In the current review, we have attempted to comprehensively evaluate the history, technical aspects, and clinical applications of radioguided surgery using gamma detection probe technology

Validation of an automated assay for the measurement of cupric reducing antioxidant capacity in serum of dogs

BACKGROUND: The objective of the present study was to optimize and validate an automated method to assess the total antioxidant capacity (TAC) in serum of dogs using the cupric reducing antioxidant capacity (CUPRAC) methodology (TAC(c)) with bathocuproinedisulfonic acid disodium salt as chelating agent, evaluating also possible variations due to the use of two different automated analyzers. The method is based on the reduction of Cu(2+) into Cu(1+) by the action of the non-enzymatic antioxidants that are present in the sample. RESULTS: Imprecision was low in both apparatus utilized, and the results were linear across serial Trolox and canine serum samples dilutions. Lipids did not interfere with the assay; however, hemolysis increased the TAC(c) concentrations. When TAC(c) concentrations were determined in ten healthy (control) dogs and in twelve dogs with inflammatory bowel disease (IBD), dogs with IBD had lower TAC(c) concentrations when compared with the healthy dogs. CONCLUSIONS: The method validated in this paper is precise, simple, and fast and can be easily adapted to automated analyzers

Major Surgery with Guillain-Barré Syndrome: A Case Report

Guillain-Barré syndrome (GBS) is an acute demyelinating polyneuropathy characterized by progressive muscle weakness and areflexia. The pathogenesis of GBS is unknown, but it is generally believed to result from aberrant humoral and cellular immune responses against components of the peripheral nervous system. The overall prognosis of GBS is quite good with approximately 85% of survivors making a good functional recovery. When a diagnosis of GBS has been made, appropriate treatment should be started as early as possible. This may include supportive care in intensive care units, ventilatory assistance, monitoring of blood pressure, fluid status, cardiac rhythm, nutritional supports and medical therapy. Our patient reached maximum deficiency 3 weeks after the onset of GBS. Full recovery took 8 months. The occurrence of GBS after major surgery is rare. We believe that major surgical stress may be the potential triggering factor for the occurrence of GBS in this case report. </jats:p

Neurokinin B and pre-eclampsia: a decade of discovery

ABSTRACT: At the start of the last decade, we provided evidence that levels of the peptide neurokinin B were highly elevated in pre-eclampsia. We hypothesized that elevated levels of neurokinin B may be an indicator of pre-eclampsia and that treatment with certain neurokinin receptor antagonists may be useful in alleviating the symptoms. At the time of the original hypothesis many questions remained outstanding. These included - Does neurokinin B have any diagnostic value in the detection and diagnosis of pre-eclampsia? - What is the cause of the elevated levels of neurokinin B during pre-eclampsia? - What is the physiological significance of neurokinin B in the placenta? This review discusses the answers to these questions taking into account the subsequent developments of the past ten years and analyzing the plethora of discoveries that have arisen from those initial observations

Evaluation of risk factors for mortality in perforated peptic ulcer in Ankara Numune Teaching Hospital, Ankara, Turkey

Objective: To assess the risk factor that influence mortality from perforated peptic ulcer. Design: Retrospective study. Setting: Ankara Numune Teaching and Research Hospital, Ankara, Turkey. Subjects: A total of 342 patients with perforated peptic ulcer disease were identified from April 1997 to January 2004. Data for the patients were extracted from the hospital records, operative notes and clinic charts. Main outcome measures: Age, sex, coexisting medical illness, use of non-steroidal antiinflammatory drugs (NSAID) or steroids, preoperative shock, delay in treatment location of ulcer size, type of operation time, albumin concentration postoperative complications, postoperative hospitals stay and mortality results for all patients were obtained. Results: Patients were aged from 17 to 80 years (mean 63 years, median 68 years) there were 210 males and 132 females. The mortality rate was 8.8% (30/342), and 62 patients had postoperative complications. Multivariate analysis showed that co-existing medical illness, preoperative shock, delay in treatment and low albumin concentrations were independent risk factors that significantly contributed to mortality. Conclusion: This study confirms co-existing medical illness, preoperative shock, delay in treatment and low albumin concentration as significant risk factors that increase mortality in patients with perforated peptic ulcers. These factors could serve as a guide to opine the risk and to improve the outcome in patients with perforated peptic ulcer. Mortality could be reduced by preventing delay in diagnosis and treatment for any co-existing medical illness and providing appropriate nutrition support. East African Medical Journal Vol.81(12) 2004: 634-63

Solid Gastric Emptying after Highly Selective Vagotomy and Pyloroplasty in Patients with Obstructing Duodenal Ulcer

Before being superseded by medical management, highly selective vagotomy (HSV) without drainage was the procedure of choice for uncomplicated duodenal ulcer. It is also justified for complications, including perforation and bleeding in selected cases. This prospective study evaluated the effects of HSV plus drainage on solid gastric emptying in 20 patients with chronic duodenal ulcer and pyloric stenosis. Patients were treated with HSV plus pyloroplasty (Heineke-Mikulicz pyloroplasty in five patients, Finney pyloroplasty in six patients and Jaboulay gastroduodenostomy in nine patients) and underwent solid-phase gastric emptying scintigraphic studies pre-operatively and 2 months and 6 months post-operatively. Results were compared with those from 10 controls. No significant differences were observed between the different types of pyloroplasty, although emptying was slightly faster in the gastroduodenostomy group. Gastric emptying returned to normal by 6 months post-operatively. In conclusion, HSV plus pyloroplasty is effective and can be used for the relief of stenosis in selected cases of duodenal ulcer. </jats:p

Factors Influencing Mortality in Spontaneous Gastric Tumour Perforations

Spontaneous perforation of gastric cancer is a serious complication with a very high incidence of mortality. In order to evaluate the prognostic factors influencing mortality in patients with gastric tumour perforations and to clarify the optimal surgical treatment, the records of patients at one centre during a 5-year period were evaluated retrospectively. Between 1995 and 2000, 14 patients with perforated gastric cancer were operated on in the Emergency Surgical Unit of a Turkish Hospital. This figure represents 3% of all the patients with gastric cancer who were treated during the same period. The hospital mortality was 36% in patients with perforations. The duration of symptoms suggesting perforation and the presence of pre-operative shock were predictive factors of mortality. It was concluded that those patients with pre-operative shock and delayed diagnosis should be treated with extra caution to decrease mortality. Perforation and peritonitis must be treated initially and elective radical surgery delayed. </jats:p