Multispectral image analysis approach to detect adulteration of beef and pork in raw meats

The aim of this study was to investigate the potential of multispectral imaging supported by multivariate data analysis for the detection of minced beef fraudulently substituted with pork and vice versa. Multispectral images in 18 different wavelengths of 220 meat samples in total from four independent experiments (55 samples per experiment) were acquired for this work. The appropriate amount of beef and pork-minced meat was mixed in order to achieve nine different proportions of adulteration and two categories of pure pork and beef. After an image processing step, data from the first three experiments were used for partial least squares-discriminant analysis (PLS-DA) and linear discriminant analysis (LDA) so as to discriminate among all adulteration classes, as well as among adulterated, pure beef and pure pork samples. Results showed very good discrimination between pure and adulterated samples, for PLS-DA and LDA, yielding 98.48% overall correct classification. Additionally, 98.48% and 96.97% of the samples were classified within a ± 10% category of adulteration for LDA and PLS-DA respectively. Lastly, the models were further validated using the data of the fourth experiment for independent testing, where all pure and adulterated samples were classified correctly in the case of PLS-DA, while LDA was proved to be less accurate

An automated ranking platform for machine learning regression models for meat spoilage prediction using multi-spectral imaging and metabolic profiling

Over the past decade, analytical approaches based on vibrational spectroscopy, hyperspectral/multispectral imagining and biomimetic sensors started gaining popularity as rapid and efficient methods for assessing food quality, safety and authentication; as a sensible alternative to the expensive and time-consuming conventional microbiological techniques. Due to the multi-dimensional nature of the data generated from such analyses, the output needs to be coupled with a suitable statistical approach or machine-learning algorithms before the results can be interpreted. Choosing the optimum pattern recognition or machine learning approach for a given analytical platform is often challenging and involves a comparative analysis between various algorithms in order to achieve the best possible prediction accuracy. In this work, “MeatReg”, a web-based application is presented, able to automate the procedure of identifying the best machine learning method for comparing data from several analytical techniques, to predict the counts of microorganisms responsible of meat spoilage regardless of the packaging system applied. In particularly up to 7 regression methods were applied and these are ordinary least squares regression, stepwise linear regression, partial least square regression, principal component regression, support vector regression, random forest and k-nearest neighbours. MeatReg” was tested with minced beef samples stored under aerobic and modified atmosphere packaging and analysed with electronic nose, HPLC, FT-IR, GC–MS and Multispectral imaging instrument. Population of total viable count, lactic acid bacteria, pseudomonads, Enterobacteriaceae and B. thermosphacta, were predicted. As a result, recommendations of which analytical platforms are suitable to predict each type of bacteria and which machine learning methods to use in each case were obtained. The developed system is accessible via the link: http://elvis.misc.cranfield.ac.uk/SORF/

Amyand's hernia-a vermiform appendix presenting in an inguinal hernia: a case series

<p>Abstract</p> <p>Introduction</p> <p>A vermiform appendix in an inguinal hernia, inflamed or not, is known as Amyand's hernia. Here we present a case series of four men with Amyand's hernia.</p> <p>Case presentations</p> <p>We retrospectively studied 963 Caucasian patients with inguinal hernia who were admitted to our surgical department over a 12-year period. Four patients presented with Amyand's hernia (0.4%). A 32-year-old Caucasian man had an inflamed vermiform appendix in his hernial sac (acute appendicitis), presenting as an incarcerated right groin hernia, and underwent simultaneous appendectomy and Bassini suture hernia repair. Two patients, Caucasian men aged 36 and 43 years old, had normal appendices in their sacs, which clinically appeared as non-incarcerated right groin hernias. Both underwent a plug-mesh hernia repair without appendectomy. The fourth patient, a 25-year-old Caucasian man with a large but not inflamed appendix in his sac, had a plug-mesh hernia repair with appendectomy.</p> <p>Conclusion</p> <p>A hernia surgeon may encounter unexpected intraoperative findings, such as Amyand's hernia. It is important to be prepared and apply the appropriate treatment.</p

Isolated complete avulsion of the gallbladder (near traumatic cholecystectomy): a case report and review of the literature

<p>Abstract</p> <p>Introduction</p> <p>Injury of the gallbladder after blunt abdominal trauma is an unusual finding; the reported incidence is less than 2%. Three groups of injuries are described: simple contusion, laceration, and avulsion, the last of which can be partial, complete, or total traumatic cholecystectomy.</p> <p>Case presentation</p> <p>A case of isolated complete avulsion of the gallbladder (near traumatic cholecystectomy) from its hepatic bed in a 46-year-old Caucasian man without any other sign of injury is presented. The avulsion was due to blunt abdominal trauma after a car accident. The rarity of this injury and the stable condition of our patient at the initial presentation warrant a description. The diagnosis was made incidentally after a computed tomography scan, and our patient was treated successfully with ligation of the cystic duct and artery, removal of the gallbladder, coagulation of the bleeding points, and placement of a drain.</p> <p>Conclusions</p> <p>Early diagnosis of such injuries is quite difficult because abdominal signs are poor, non-specific, or even absent. Therefore, a computed tomography scan should be performed when the mechanism of injury is indicated.</p

Radial probe endobronchial ultrasound assisted conventional transbronchial needle aspiration in the diagnosis of solitary peribronchial pulmonary lesion located in the segmental bronchi

Background: The diagnosis of peribronchial pulmonary lesions located in the tertiary bronchi, also known as segmental bronchi, as well as, the 4th order and 5th order segmental bronchi is very difficult. Histopathological specimens cannot be easily obtained by endobronchial biopsies (EBBX) due to the patent but small segmental bronchial lumen. The aim of the present study was to evaluate the diagnostic accuracy and safety of the novel technique with radial probe endobronchial ultrasound (R-EBUS) assisted conventional transbronchial needle aspiration (C-TBNA) in the diagnosis of solitary peribronchial pulmonary lesions located in segmental bronchi from 3th to 5th order. Methods: From December 2014 to December 2015, 16 patients with solitary peribronchial pulmonary lesions in the segmental bronchi from 3th to 5th order confirmed by computed tomography (CT) were enrolled. The lesions were located using radial probe endobronchial ultrasound (R-EBUS) to determine the sites of conventional transbronchial needle aspiration (C-TBNA), then, histopathological specimens were obtained using the technique of C-TBNA. The final pathological diagnosis was made based on the findings from the surgical specimens. Statistical analyses were performed for specimen results and complications. Results: On pathological evaluation, 14 of the 16 specimens were malignant, including 8 adenocarcinomas, 4 squamous cell carcinomas, and 2 small cell carcinomas, while 2 were non-malignant diseases. The diagnostic accuracy rate, sensitivity and missed diagnosis rates were 87.5%, 87.5% and 12.5%, respectively. When Combined the results of cytology with histologic samples obtained from C-TBNA the total diagnostic accuracy rate, sensitivity and missed diagnosis rate were 93.75%, 93.75% and 6.25%, respectively. There were 2 cases of bleeding complications \u3e5 mL after C-TBNA, and both were resolved with endobronchial management. Conclusions: The combination of R-EBUS with C-TBNA was advantageous and safe for the diagnosis of solitary peribronchial pulmonary lesions located in the segmental bronchi. However, possible bleeding complications should be anticipated with needle aspiration. Further verification of this combined application should be investigated in larger clinical trials

A Review of Primary Thyroid Lymphoma: Molecular Factors, Diagnosis and Management

Purpose/aim: To focus on current aspects of primary thyroid lymphoma (PTL), which is a rare clinical entity usually manifested by a rapidly growing mass in the neck that can cause pressure symptoms. Materials and Methods: Relevant papers in PubMed published through June 2017 were selected to track updated information about PTL with an emphasis on diagnosis and novel therapeutic management. Results: The most frequent cases include non-Hodgkin lymphoma derived from B-cells, mainly diffuse large B-cell lymphoma (DLBCL) followed by mucosa-associated lymphoid tissue (MALT) lymphoma or a mixed type. Other subtypes are less common. Lymphomas derived from T-cells and Hodgkin lymphomas are extremely rare. Hashimoto's autoimmune thyroiditis has been implicated as a risk factor for lymphoma. At the molecular level, the Wnt5a protein and its receptor Ror2 are involved in the course of the disease. Ultrasonography, fine needle aspiration (FNA) biopsy, and core or open biopsy combined with new diagnostic facilities contribute to an accurate diagnosis. An increased potential exists for a cure without the need for a radical surgical procedure. Modern chemoradiation therapy plus the monoclonal antibody rituximab, which acts against CD20, have limited the need for surgical interventions and provide an excellent outcome in most cases. However, some cases have resulted in treatment failure or recurrence. Conclusions: A multidisciplinary approach must be used to define the management policy in each case. Future efforts by researchers are likely to be focused on the molecular level

Current Molecular and Genetic Aspects of Pancreatic Cancer, the Role of Metastasis Associated Proteins (MTA): A Review

Purpose/aim: To focus on current molecular and genetic aspects and MTA proteins, since pancreatic cancer is a lethal malignant with poor prognosis. Early diagnosis is essential step, contributing to potential curative resection. Materials and methods: A PubMed search of relevant articles published up to August 2016 was performed to identify current information about pancreatic cancer regarding molecular biomarkers, with emphasis on carcinogenesis, novel therapeutic targets, and MTA proteins. Results: Understanding the mechanisms involved in the process of carcinogenesis at the molecular level and the recognition of various oncogenes has opened new horizons for both diagnosis and targeted therapy. Metastasis associated (MTA) proteins (MTA1, MTA2, MTA3) comprise a well-established family of biomarkers. The oncogene MTA1 and its expression product MTA1 protein are the most important and adequately studied in the current research. It defines the growth, local invasiveness, lymphatic spread, and metastatic capacity of various malignancies such as colorectal or gastric cancer including also pancreatic cancer. This protein is associated with malignant potential and biological behavior. Consequently, it could contribute to cancer detection since the first stages of carcinogenesis, as well as in prediction of its malignant differentiation grade. The pre-operative information of the possibility of lymph node involvement may also affect the attempt and the extent of curative resection and lymphadenectomy. Conclusions: Carcinogenesis and implicated oncogenes, either activators or repressors, concentrate much research interest, as well as being useful as biomarkers and for targeted therapy. MTA proteins could become useful diagnostic and prognostic biomarkers in current management of pancreatic cancer

The effect of bevacizumab on colon anastomotic healing: experimental study in rats

The angiogenesis plays an important role in both wound healing and metastatic invasion and spread of malignant cells by supplying the cells with the required nutrients and oxygen. The VEGF (Vascular Endothelial Growth Factor) has a significant value in the angiogenesis process in normal conditions such as in wound healing, as well as in malignant diseases. The levels of VEGF have been found particularly high in the vast majority of malignant tumors including colorectal cancer; this is in relation with the increased metastatic capability of the tumor and with poorer prognosis. Therefore, inhibition of angiogenesis could limit the extent of the malignant development by restricting the growth and metastasis of tumor cells. Bevacizumab is a recombinant humanized monoclonal antibody (IgG1) that binds VEGF-A, forming a complex molecule, and inhibits binding of VEGF-A with VEGF tyrosine kinase receptors (VEGFRs), resulting in blockage of VEGF-mediated signaling pathways leading to angiogenesis. The antiangiogenetic agent bevacizumab is used with increasing frequency in the management of advanced colorectal cancer and in other malignancies; however, taking in view any concern of negative effect on wound healing, it is not well defined which is the actual time for its use from operation. Despite the recommendations and current clinical practice, there has not been any evidence based optimal time for its safe use. This initiative experimental study in rats was designed to investigate the effect of angiogenesis inhibitor bevacizumab on colon anastomotic healing by assessing some specific factors implicated in wound healing process, highlighting ultimately the degree of healing capability. Forty Wistar rats were used. All animals received premedication with light ether and were anaesthetized with intraperitoneal injection of ketamine at dose 40 mg per Kg BW. Under aseptic conditions the surgeon performed a laparotomy by midline incision (average length of 4-5 cm), controlled the peritoneal cavity, found the colon; then resection a part of it and an end-to-end anastomosis in one layer with interrupted sutures with atraumatic Prolene 6-0. The closure of the abdominal wound was achieved in two layers with continuous Prolene 2-0. It was followed by recovery and monitoring of the animals. The rats were randomly divided into four groups of 10 animals each. The A and B groups were the study groups. In these groups, after the performance of anastomosis and before the closure of the abdomen, a solution of the substance bevacizumab (Avastin, Roche Pharma AG, Grenzach-Wyhlen, Germany) in a single dose of 5 mg/kg of body weight was administered intraperitoneally. The C and D groups were the control groups. In these groups instead of the above mentioned bevacizumab solution, only normal saline in equal amount was administered intraperitoneally. All animals recovered well, gained weight and remained healthy throughout the experiment. No bleeding events were noted in any case. Group A and Group C animals were sacrificed on the 7th postoperative day, whereas those of Group B and Group D were sacrificed on the 14th postoperative day. Upon sacrifice, inspection and recording of wound healing score and reopening of the midline incision was performed, followed by careful inspection of the peritoneal cavity for adhesions or collections particularly in the anastomotic area. Following a resection of a 5 cm segment of the colon including the anastomosis was performed and prepared appropriately for bursting pressure measurement; after ligation of the one end and connection of the other end with mercury manometer dipping into water. After that, one-third of the anastomosis tissue was fixed in 10 % formalin solution and sent for histological examination. The rest of the anastomosis tissue placed in sterile Eppendorf tubes and were stored at -70°C. By paracentesis 3-5 cc of blood from Inferior Vena Cava was taken for assessing the studied parameters. A part of the skin from the abdominal wound was resected for histological examination and tissue hydroxyproline assessment; finally euthanasia follows. Deeply frozen anastomoses tissues were homogenized and processed for the assays according to manufacturer instructions of the relevant kits. The biochemical measurements included VEGF, endothelin- 1 (ET-1), C-reactive protein (CRP), prooxidant - antioxidant balance (PAB), carbonylated proteins and hydroxyproline. Histological sections of anastomoses and skin tissues were prepared from paraffin blocks and staining with haematoxylin - eosin. Light microscopy identified the presence of epithelial cells (epithelialization), fibroblasts, collagen and granular tissue. For statistical analysis the Mann Whitney U test was used (s.s. when p<0.05). Hydroxyproline is useful for routine measurement of collagen content in tissue specimens extracts; the presence of it, on 14th day was higher than on 7th day in both control and study groups as expected, but without statistical significance (s.s.). Likewise, it did not differ s.s. between Avastin and Placebo groups. Bevacizumab did not influence anastomotic tissue hydroxyproline level and subsequently the collagen concentrations. The integrity of anastomosis in all cases, in combination with no s.s. differences in histopathological examination (inflammation, fibroblasts, collagen, fibrosis) score or adhesion score, indicate adequate healing capability in all experimental animals, which were not finally affected by bevacizumab administration. However, the bursting strength is the most relevant clinical parameter. The use of Avastin had no substantial effect on anastomotic strength, since the bursting pressure was lower in Avastin groups compared with Placebo groups both on 7th and 14th postoperative days, without statistical significance. VEGF was found increased in Avastin group with s.s. on 7th day, but inactive, when compared with placebo group on 7th day (p=0.010). Also, in control group without Avastin it was detected higher on 14th day than on 7th day with s.s. (p=0.047), indicating a continuing angiogenetic activity. Parallel and in accordance with VEGF measurements were those of CRP. It was found increased s.s. on 7th day in Avastin group compared with placebo group (p=0.007). Likewise, it was higher with s.s. in control group without Avastin on 14th day than on 7th day (p=0.009). ET-1, which is an ischemic marker, was found higher with s.s. in Avastin group on 14th day than on 7th day (p=0.027). The PAB was found in Avastin group decreased s.s. on 14th day compared with 7th day (p=0.021) indicating a decline in the degree of the oxidative stress. Carbonyl proteins, which are a general biomarker of severe oxidative protein damage, were found increased s.s. in placebo group on 7th day, when compared with both Avastin group on 7th day (p=0.003) and placebo group on 14th day (p=0.009). Likewise, bevacizumab had no influence on abdominal wound healing also, by inspection as well as by neither histopathology nor hydroxyproline levels. In serum the values of CRP were higher s.s. in control group without Avastin on 14th day than on 7th day (p=0.009) and then in Avastin group on 14th day (p=0.002). Also, carbonyl proteins were higher s.s. in Avastin group on 14th day than on 7th day (p=0.023). The rest of the above parameters in serum and those of ET-1 and PAB did not have any s.s. difference. Bevacizumab, when administered intraperitoneally during the operation, had no significant proven effect on colon anastomotic healing in rats. This experimental study has proved, despite the caused transient ischemia and oxidative stress, no significant alterations in collagen synthesis and fibrosis or in bursting pressure, indicating no crucial impairment of wound healing process. Also, it seems that it has no substantial influence on the abdominal wound healing.Η αγγειογένεση παίζει σημαντικό ρόλο, τόσο στην επούλωση του τραύματος, όσο και την μεταστατική διασπορά των κακοήθων όγκων που αφορά την διήθηση και εξάπλωση των καρκινικών κυττάρων. Η αναστολή της στοχεύει στον περιορισμό του όγκου και την καλύτερη θεραπευτική προσέγγιση. Στα πλαίσια της στοχευμένης θεραπείας, ο νεότερος αντιαγγειογενετικός παράγοντας bevacizumab χρησιμοποιείται με αυξανόμενη συχνότητα, σε συνδυασμό με άλλα χημειοθεραπευτικά φάρμακα, στην σύγχρονη αντιμετώπιση κυρίως του προχωρημένου ορθοκολικού καρκίνου, αλλά και άλλων κακοηθειών. Λαμβάνοντας όμως υπόψη την ενδεχόμενη αρνητική επίδραση του στην επούλωση του τραύματος, δεν είναι επακριβώς καθορισμένος ο πραγματικός χρόνος της χρήσης του από την εγχείρηση. Παρά τις συστάσεις και την ακολουθούμενη τακτική στην σύγχρονη κλινική πράξη, δεν υπάρχει ιδανικός χρόνος για την ασφαλή της χρήση που να βασίζεται σε αποδείξεις. Η μελέτη αυτή σχεδιάσθηκε για να διερευνήσει την επίδραση της αναστολής της αγγειογένεσης από την bevacizumab, ένα ανθρωποποιημένο μονοκλωνικό αντίσωμα εναντίον του αγγειακού ενδοθηλιακού αυξητικού παράγοντα (anti-VEGF), στην επούλωση των αναστομώσεων του παχέος εντέρου, με τον προσδιορισμό ορισμένων ειδικών παραγόντων που εμπλέκονται. Χρησιμοποιήθηκαν ως πειραματόζωα 40 άρρενες επίμυες τύπου Wistar, τα οποία έλαβαν προνάρκωση με αιθέρα και αναισθησία με ενδοπεριτοναϊκή χορήγηση κεταμίνης 40 mg/Kgr Β.Σ. Υπό άσηπτες συνθήκες εκτελούνταν μέση λαπαροτομία μήκους 4-5 cm, ανεύρεση και διατομή του σιγμοειδούς κόλου, καθώς και Τ.Τ. αναστόμωση σε ένα στρώμα με μεμονωμένες ραφές ατραυματικού Prolene 6-0. Ακολουθούσε σύγκλειση του κοιλιακού τραύματος σε δύο στρώματα με συνεχή ραφή Prolene 2-0, ανάνηψη και παρακολούθηση του πειραματόζωου. Οι επίμυες χωρίσθηκαν σε τέσσερις ομάδες των 10 πειραματόζωων έκαστη. Η Α και Β ομάδα αποτελούσαν τις ομάδες μελέτης. Σε αυτές μετά την ολοκλήρωση της αναστόμωσης και πριν την σύγκλειση της κοιλιάς, χορηγήθηκε ενδοπεριτοναϊκά bevacizumab (σκεύασμα Avastin της εταιρίας Roche) σε δόση 5 mg/Kgr Β.Σ. Η Γ και Δ ομάδα αποτελούσαν τις ομάδες ελέγχου και χορηγήθηκε ενδοπεριτοναϊκά ισόποση ποσότητα φυσιολογικού ορού (placebo). Όλα τα πειραματόζωα ανένηψαν καλώς, ανέκτησαν βάρος και ολοκλήρωσαν το πείραμα. Τα πειραματόζωα της ομάδας Α και της ομάδας Γ θυσιάσθηκαν την 7η μετεγχειρητική ημέρα και αυτά της ομάδας Β και της ομάδας Δ την 14η μετεγχειρητική ημέρα. Εκτελούνταν επισκόπηση για εκτίμηση της επούλωσης τραύματος και διάνοιξη της προηγηθείσας τομής, επιμελής έλεγχος της περιτοναϊκής κοιλότητας για συμφύσεις, εκτομή του παχέος εντέρου με την αναστόμωση σε μήκος 5 cm και μέτρηση της πίεσης διάσπασης, αφού το ένα άκρο του εντέρου απολινώνονταν, το άλλο συνδέονταν με υδραργυρικό μανόμετρο και τοποθετούνταν μέσα σε νερό. Το ένα τρίτο της αναστόμωσης τέθηκε σε διάλυμα φορμόλης 10% και απεστάλη για ιστολογική εξέταση. Τα υπόλοιπα δύο τρίτα της αναστόμωσης τοποθετήθηκαν σε ειδικά φιαλίδια με φυσιολογικό ορό, διατηρήθηκαν σε βαθιά κατάψυξη (-70°C) και πραγματοποιήθηκε μετά ομογενοποίηση και ειδική επεξεργασία προσδιορισμός στον ιστό συγκεκριμένων παραμέτρων με χρησιμοποίηση αναλόγων KIT. Από την κάτω κοίλη φλέβα με παρακέντηση λήφθηκαν 3-5 cc αίμα και προσδιορίσθηκαν οι υπό μελέτη παράμετροι. Ακολούθως λαμβάνονταν τεμάχιο δέρματος από την τομή για ιστολογική εξέταση και ιστικό προσδιορισμό υδροξυπρολίνης, καθώς και ευθανασία του πειραματόζωου. Οι βιοχημικές μετρήσεις περιλάμβαναν VEGF, ET-1, CRP, ισορροπία οξειδωτικών - αντιοξειδωτικών παραγόντων, καρβονυλιωμένες πρωτεΐνες και υδροξυπρολίνη. Για την στατιστική ανάλυση των αποτελεσμάτων χρησιμοποιήθηκε το Mann Whitney test (όριο σημαντικότητας p<0,05). Η τιμή της υδροξυπρολίνης, που εκφράζει το περιεχόμενο κολλαγόνο σε ιστούς, στην αναστόμωση την 14η ημέρα ήταν υψηλότερη από αυτή την 7η ημέρα και στις ομάδες ελέγχου και στις ομάδες μελέτης, αλλά χωρίς στατιστικά σημαντική διαφορά. Η bevacizumab δεν επηρέασε τα επίπεδα της υδροξυπρολίνης στον ιστό της αναστόμωσης. Η διαβάθμιση της ιστολογικής εξέτασης (φλεγμονή, ινοβλάστες, κολλαγόνο, ίνωση) ή η διαβάθμιση των συμφύσεων, δεν επηρεάσθηκε από τη χορήγηση της bevacizumab. Η χορήγηση της bevacizumab δεν είχε ουσιαστική επίδραση στην ισχύ της αναστόμωσης, αφού η πίεση διάσπασης ήταν χαμηλότερη στις ομάδες μελέτης (Avastin) σε σύγκριση με τις ομάδες ελέγχου (placebo) και στις δύο, την 7η ημέρα και την 14η ημέρα, αλλά χωρίς στατιστική σημαντικότητα. Οι τιμές του VEGF στην αναστόμωση βρέθηκαν αυξημένες στατιστικά σημαντικά στην ομάδα μελέτης (Avastin) την 7η ημέρα, αλλά αδρανείς, σε σύγκριση με αυτές στην ομάδα ελέγχου (placebo) την 7η ημέρα. Στην ομάδα ελέγχου χωρίς Avastin οι τιμές του VEGF ήταν υψηλότερες στατιστικά σημαντικά την 14η ημέρα από, ότι την 7η ημέρα. Παράλληλα και σε αντιστοιχία με τα ευρήματα του VEGF βρέθηκαν και οι μεταβολές της CRP στην αναστόμωση. Αυτή βρέθηκε αυξημένη στατιστικά σημαντικά στην ομάδα μελέτης (Avastin) την 7η ημέρα σε σύγκριση με την ομάδα ελέγχου (placebo) την 7η ημέρα. Παρομοίως, η CRP ήταν υψηλότερη στατιστικά σημαντικά την 14η ημέρα από, ότι την 7η ημέρα στην ομάδα ελέγχου χωρίς Avastin. Η ενδοθηλίνη-1, που είναι δείκτης του βαθμού ισχαιμίας, βρέθηκε στην αναστόμωση στην ομάδα μελέτης (Avastin) υψηλότερη στατιστικά σημαντικά την 14η ημέρα, από ότι την 7η ημέρα. Η ισορροπία οξειδωτικών-αντιοξειδωτικών παραγόντων βρέθηκε στην αναστόμωση στην ομάδα μελέτης (Avastin) ελαττωμένη στατιστικά σημαντικά την 14η ημέρα, από ότι την 7η ημέρα. Οι καρβονυλιωμένες πρωτεΐνες, που θεωρούνται βιολογικός δείκτης βαριάς οξειδωτικής πρωτεϊνικής βλάβης, βρέθηκαν στην αναστόμωση αυξημένες στατιστικά σημαντικά στην ομάδα ελέγχου (placebo) την 7η ημέρα σε σύγκριση και με τις δύο, την ομάδα μελέτης (Avastin) την 7η ημέρα και την ομάδα ελέγχου (placebo) την 14η ημέρα. Η bevacizumab δεν επηρέασε, ούτε την επούλωση του κοιλιακού τραύματος, τόσο μακροσκοπικά, όσο και ιστολογικά. Οι τιμές της υδροξυπρολίνης στον ιστό δεν διέφεραν στατιστικά σημαντικά. Στο αίμα οι τιμές της CRP ήταν υψηλότερες στατιστικά σημαντικά στην ομάδα ελέγχου την 14η ημέρα, από ότι την 7η ημέρα, καθώς και, από ότι την 14η ημέρα στην ομάδα Avastin. Επίσης οι καρβονυλιωμένες πρωτεΐνες ήταν υψηλότερες στατιστικά σημαντικά στην ομάδα Avastin την 14η ημέρα, από ότι την 7η ημέρα. Οι υπόλοιπες τιμές στο αίμα αυτών των παραμέτρων, καθώς και της ET-1 και της ισορροπίας οξειδωτικών - αντιοξειδωτικών παραγόντων δεν διέφεραν στατιστικά σημαντικά. Συμπερασματικά, η διεγχειρητική ενδοπεριτοναϊκή χορήγηση της bevacizumab δεν είχε σημαντική αποδεδειγμένη επίδραση στην επούλωση των αναστομώσεων του παχέος εντέρου και του κοιλιακού τραύματος σε επίμυες. Η μελέτη αυτή παρά την προκαλούμενη παροδική ισχαιμία και το οξειδωτικό stress, δεν απέδειξε σημαντικές μεταβολές στην σύνθεση του κολλαγόνου και την ίνωση, ούτε στην πίεση διάσπασης που εκφράζει την ισχύ της αναστόμωσης

The role of laparoscopic surgery in gastric cancer

The laparoscopic surgery in gastric cancer is applied with increasing frequency nowadays; noticeable reports come mainly from Korea and Japan with satisfactory results. This review presents briefly the issue by evaluating its role. A PubMed search of relevant articles published up to 2010 was performed to identify current information. Most data come from Far East, where gastric cancer occurs more often, and the proportion of early gastric cancer is high. Laparoscopic approach includes both the diagnostic laparoscopy and laparoscopic resection. Laparoscopic gastrectomy has currently limited application for gastric cancer in the West; it is not widely accepted and raises important considerations necessitating the planning of multicentre randomised control trials based mainly on the long-term results