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S Truong

Publications and source records attributed to S Truong.

At least 19 recordsLinked to original sources

Study of Langmuir-Blodgett phospholipidic films deposited on surface enhanced Raman scattering active gold nanoparticle monolayers.

Surface enhanced Raman scattering (SERS) was used to study phospholipid monolayers transferred by the Langmuir-Blodgett (LB) technique to SERS active substrates. These substrates, which were constituted of gold colloidal nanoparticles bound to polysilane films grafted onto glass plates, showed a uniform and homogeneous layer with strong interacting particles as revealed from UV-visible extinction spectra and atomic force microscopy images. Laser excitation at 632.8 nm within the red part of the localized surface plasmon resonance leads to intense and reproducible SERS spectra of trans-1,2-bis(4-pyridyl)ethylene (BPE). From SERS measurements at different pHs it was possible to determine the apparent pK(a) of BPE adsorbed on gold-coated silanized substrates in the absence and presence of one LB monomolecular layer of phospholipids. These SERS titrations allowed the estimation of the pH at the metal-LB film interface.

Gold↗

[Sigmoid diverticulitis. Emergency intervention in abscess, hemorrhage and stenosis].

Interventional techniques in treatment of complicated diverticulitis gain more and more importance. In particular abscesses and bleeding are treated successfully. In case of diverticular abscess (Hinchey classification stage I and II) percutaneous drainages are placed sonographically or CT guided. Interventional drainage offers the possibility of elective one-stage surgical treatment of diverticulitis with significant reduce of mortality and morbidity rates. Diverticular bleeding is usually diagnosed and treated endoscopically. Only if endoscopy is not able to manage bleeding, angiography or nuclear scan is demanded. In case of stenosis endoscopic treatment has not jet gained clinical relevance.

Abscess↗

Inferior oblique muscle location after enucleation and evisceration.

PURPOSE: To report the location of the inferior oblique muscle after enucleation without primary attachment of the muscle to the orbital implant and after evisceration. METHODS: Interventional case series. Retrospectively, eight orbital magnetic resonance imaging (MRI) studies were analyzed, four after enucleation and four after evisceration, to assess the position of the inferior oblique muscle relative to the orbital implant and the point of insertion. RESULTS: In the enucleation patients, the inferior oblique muscle was anteriorly displaced and the muscle appeared to insert into an inferior subconjunctival scar mass in three of the four patients. In all four of the evisceration patients, the inferior oblique muscle appeared normally positioned and inserted onto the implant in the normal location. CONCLUSION: Enucleation without suturing of the inferior oblique muscle to the implant is associated with healing in an abnormal anterior location and into an inferior subconjunctival scar mass. Evisceration does not appear to disrupt the normal position or insertion of the inferior oblique muscle.

Eye Enucleation↗

[Panorama ultrasonography of the abdominal wall for delineation of the anatomy and diagnosis of pathological findings].

PURPOSE: To assess extended field-of-view sonography for delineation of the anatomic structures of the abdominal wall and for the diagnosis of hernia. MATERIAL AND METHODS: In 34 cases (24 probands, 10 patients with abdominal wall defects) extended field-of-view sonography of the abdominal wall was performed with a 7.5 MHz transducer. Dynamic alignment of real-time images allows for depiction of regions of up to 60 cm in a single extended field-of-view image. A standardized axial image was obtained above and below the arcuate line and at the level of the defect, respectively. All images were evaluated by two blinded readers regarding the visibility of the anatomic structures and the delineation and extent of pathological changes. RESULTS: The abdominal wall was delineated with extended field-of-view sonography in all patients with a good image quality. The linea alba, the rectus muscle and the three lateral abdominal muscles, the rectus sheath, the peritoneum, and the subcutaneous fatty tissue were visible. In the patients with abdominal wall defects, the hernial sac with its contents, the extension of the defect, and the surrounding structures were clearly delineated. CONCLUSION: Extended field-of-view sonography allows for easily surveyed and reproducible documentation of the ultrasound examination of the abdominal wall. It is especially useful for the preoperative planning in patients with abdominal wall defects.

Abdominal Muscles↗

[Role of surgical biliary bypass for palliation of pancreatic cancer - a retrospective study of 107 cases].

UNLABELLED: BACKGROUNDS AND STUDY AIMS: At the time of diagnosis most patients with pancreatic cancer are still irresectable for cure. The aim of this study was to evaluate surgical palliation, in particular against the background of endoscopic stent placement. PATIENTS AND METHODS: This retrospective study analyses the therapeutic results in 107 patients with an irresectable pancreatic carcinoma operated on between 1990 and 1998. RESULTS: 104 patients showed primary therapeutic success with adequate bile drainage. In 97 % a simultaneous gastrojejunostomy was performed. The overall complication rate was 24 % and the hospital mortality 3.7 %. Median survival after surgical treatment was 201 days. CONCLUSIONS: Because of a decrease in perioperative morbidity and mortality, surgical palliation of irresectable pancreatic carcinoma still remains an effective therapy, especially for patients expected to survive 6 months or more. The surgical procedure offers the better chance for long-term palliation of obstructive jaundice and duodenal obstruction compared to the endoscopic approach. However, to consider both, the surgical and the endoscopic treatment, complementing each other, seems to be important to guarantee optimal palliation for the individual patient.

Adenocarcinoma↗

Endoscopic ultrasonography in the preoperative staging of gastric cancer: accuracy and impact on surgical therapy.

BACKGROUND: Endoscopic ultrasonography (EUS) is a standard procedure in the preoperative staging of patients with gastric carcinomas. Herein we present our experience with EUS and discuss the results and their implications for surgical therapy. METHODS: A total of 116 patients with histologically confirmed gastric adenocarcinoma were referred to EUS and classified prospectively by the TNM system. The results of the preoperative endosonographic staging were compared with the definitive histopathological results after the operation. RESULTS: The overall accuracy of EUS for determination of the T stage was 78%. The accuracy for the T1 and T2 stages was 80% and 63%, respectively. With 20% and 30%, there was a relatively high rate of overstaging in these cases. The accuracy for T3 and T4 tumors was 95% and 83%, respectively. The accuracy of EUS for determination of the N stage was 77%, with a sensitivity of 91% and a specificity of 84%. Resectability was predicted correctly with a sensitivity of 94% and a specificity of 83%. CONCLUSIONS: Generally accepted standards for the therapy of advanced gastric carcinomas do not exist. In cases where the therapeutic strategy is surgical exploration, no preoperative staging is necessary. In cases with differentiated treatment strategies, the accuracy of EUS is not sufficient for the selection of patients for endoscopic resection. Its accuracy for submucosal cancer invasion and for the detection of lymph node metastases needs to be further enhanced. If only multimodal therapy is considered, EUS staging seems to be absolutely mandatory. Patients classified preoperatively as T1 to T3 can be operated on primarily with sufficient security. In patients where radical resection of the tumor seems doubtful, we recommend that a diagnostic laparoscopy be performed to confirm the diagnosis.

Adult↗

Ultrasound-based volumetric evaluation of fluid retention after inguinal hernia repair.

BACKGROUND: Daily routine has shown that there are differences between the aspirated volumes of subcutaneous liquid retention after inguinal hernia repair and the results of sonographic-based volumetry using the standard rotating ellipsoid formula. METHODS: In 83 patients, subcutaneous fluid retention after Shouldice repair was visualized by ultrasound and calculated as cuboid, cylinder, and rotating ellipsoid, respectively. The results were compared to the aspirated volume. Data were analyzed retrospectively. RESULTS: The volume obtained by percutaneous punction averaged 12.18 +/- 1.50 ml. The calculated volumes were distinctly less: cuboid, 11.98 +/- 1.59 ml; cylinder, 10.26 +/- 1.45 ml; rotating ellipsoid, 5.99 +/- 0.80 ml. We found different coefficients of regression for the aspirated and the calculated volumes (cuboid; 0.75; cylinder; 0.82; rotating ellipsoid; 1.50). The coefficients of correlation, however, were 0.79 for all modes of calculation. CONCLUSION: Because its results were closest to the aspirated volumes, we recommend the cuboid formula for the ultrasound-based calculation of liquid retention after inguinal hernia repair.

Edema↗

Value of intravenous cholangiography prior to laparoscopic cholecystectomy.

We performed a retrospective study on 163 patients for evaluation of the benefit of intravenous cholangiography prior to laparoscopic cholecystectomy. Radiographic evaluation of the various areas of the biliary system was classified regarding resolution of anatomic structures: well detailed (excellent), impaired image but reliable interpretation possible (good), insufficient contrast with limited assessment (poor), no reliable judgment possible (insufficient). The common bile duct could be described as "good" in 96.3%, whereas the cystic duct could be described as "good" in only 54.6%. Concrements of the gallbladder were recognized in 72.4%, and common bile duct stones were diagnosed in only two of three patients. A distal junction of the cystic duct was found in nine cases, but there was no influence on the following operative procedure. Only one of two patients with a short cystic duct was identified. We found no improvement after routine use of intravenous cholangiography concerning the evidence of common bile duct stones or the avoidance of lesions of the common bile duct. Hence routine use of intravenous cholangiography prior to laparoscopic cholecystectomy is not justified.

Bile Ducts, Intrahepatic↗

[Jejuno-jejunal invagination after Dennis tube insertion for ileus--a rare complication].

In contrast to childhood intussusception, the clinical signs of intussusception in adults are nonspecific. Generally organic alterations of the small bowel cause intussusception in adults. In this case report on a retrograde jejunojejunal intussusception in a 61-year-old male, following removal of an intraoperatively placed intestinal tube for ileus therapy, the clinical symptoms, diagnostic methods and therapy for intussusception are described. Sonography is not only the diagnostic tool of choice in children, but also led to the correct diagnosis in this case. In contrast to childhood intussusception, operative treatment is preferred in adults.

Adult↗

[Duodenal fistula following Port-à-cath--a rare complication of regional hepatic chemotherapy].

Arterial port systems are frequently used in the adjuvant and palliative therapy of colorectal hepatic metastasis. Specific complications are rarely documented in literature. The perforation of an arterial Port-à-cath followed by duodenal fistula is an uncommon complication of regional hepatic chemotherapy. Besides systemic disorders caused by the chemotherapeutic agents, such as vomiting, sickness, or gastritis and duodenitis, gastroduodenal ulcers can occur as a local complication of treatment. Thrombosis of the hepatic artery or occlusion of the port device are the most common reasons for withdrawal of treatment in our series. Based on our experience and the case report of a duodenal fistula we recommend angiography of the port system prior to each cycle of chemotherapy.

Angiography↗

[Results of sonographically guided percutaneous catheter drainage of intra-abdominal abscesses in surgery].

The results of a retrospective study concerning percutaneous catheter drainage of 62 intra-abdominal abscesses in 60 patients were demonstrated, including the procedure and complications. For the first access a thin needle was used to perform an aspiration biopsy under sonographic control. We placed a pigtail or van Sonnenberg catheter by Seldinger or trocar technique into the abscesses. The primary success rate of percutaneous drainage was 85 %. Complications occurred in 6.4 % of the cases with a mortality of 0 %. This method is an acceptable alternative to surgery for many patients. Ultrasound-guided percutaneous catheter drainage is the method of choice for uncomplicated abscesses, especially in the critically ill patient.

Abdominal Abscess↗

Pneumatosis cystoides intestinalis: confirmation of diagnosis by endoscopic puncture a review of pathogenesis, associated disease and therapy and a new theory of cyst formation.

Pneumatosis cystoides intestinalis (PCI) is the term for the formation of intramural gas filled cysts of unclear pathogenesis in the wall of the gastrointestinal tract. We report two patients with PCI where the diagnosis was confirmed by endoscopic puncture of a lesion, resulting in a complete deflation of the cyst, and two patients who underwent surgery. Endoscopy offers a safe and quick way to confirm the diagnosis of PCI. The immunohistochemical study revealed histiocytic cells and foreign body giant cells in the cystic wall, corresponding to a secondary histiocytic organization of gas-filled pseudocysts rather than to the widespread theory of gas-filled lymph vessels.

Adult↗

[Value of colonoscopy in tumor after-care after colorectal carcinoma].

The significance of colonoscopic follow up is discussed controversially. Colonoscopy after resection of colorectal cancer offers the possibility of direct inspection and to take biopsies for the early detection of local recurrence or additional neoplasms. In a retrospective study we examined the benefit of regular colonoscopies. Between 1/1995 and 4/1996 237 colonoscopies were performed on 164 patients after resection of colorectal cancer. The evaluation was done due to the stage of the primary tumor, the age of the patients, the time after operation and the number of previous colonoscopies. 54 adenomas were found in 35 of 164 patients. 32% of the adenomas were diagnosed in the ascending colon or colon transversum. Additionally three carcinomas were found. There were two local recurrences and one metachronous neoplasm. Two patients were diagnosed without clinical symptoms and were able to undergo potential curative resection again. Because of the number and the localisation of diagnosed neoplasms colonoscopic surveillance should be performed every six months in the first two years after resection of colorectal cancer.

Adenomatous Polyposis Coli↗

[Value of intraluminal intestinal decompression by endoscopic placement of a Dennis tube in therapy of ileus. Retrospective clinical study of 174 patients].

For determination of the efficacy of intraluminal bowel decompression by an endoscopically placed Dennis tube, 174 patients with paralytic ileus or different kinds of partial small bowel obstruction were reviewed retrospectively. There were 66 cases (37.9%) of early postoperative ileus (A), 27 (15.5%) of late postoperative ileus (B), 38 (21.8%) of paralytic ileus (C), 31 (17.8%) with obstruction due to advanced intraabdominal tumors (D), and 12 (6.8%) of obstructive ileus caused by inflammatory stenosis of the small bowel in Crohn's disease (E). Successful endoscopic placement of the intestinal tube was achieved in 97.2% of patients. Placement of the tube was impossible in 5 cases. A total of 95 patients (54.6%) were successfully managed by long intestinal tube decompression. Success rates for the individual groups were 71.2% (A), 18.5% (B), 86.8% (C), 16.1% (D), and 41.7% (E). Some 75 patients (43.1%) had to be operated on because of insufficient conservative therapy. Four patients with advanced intraabdominal tumors died during the treatment with the intestinal tube; 13 patients died postoperatively. There was no tube-related mortality, but tube-related complications occurred in 6.9%. We conclude that intraluminal intestinal tube decompression after endoscopic placement provides a therapeutic tool with a concomitant low complication and high success rate in paralytic and early postoperative ileus.

Adolescent↗

[Endosonography control of percutaneous paracoccygeal drainage of deep pelvic abscesses after rectum resection].

Pelvic abscesses are severe complications after rectal surgery. In recent years, surgical drainage has been edged out by percutaneous drainage techniques. We report our experience with the drainage of postoperative pelvic abscesses via the paracoccygeal route controlled by endosonography. In eight patients the diagnosis of a retrorectal pelvic abscess was established by endosonography and confirmed by endosonographically controlled exploratory puncture. Drainage of the abscesses was performed via the paracoccygeal access route by trocar or Seldinger technique under permanent visual control by endoluminal sonography. Irrigation of the abscess cavity was than performed daily. In all cases drainage was successful without complications. Duration of drainage was 9-14 days with a mean of 10.8 days. In one patient there was a recurrence of the abscess because of early removal of the drainage catheter. Because of its overall availability and its good results, paracoccygeal percutaneous endosonographically controlled drainage seems to be a suitable uncomplicated method for drainage of postoperative pelvic abscesses.

Abdominal Abscess↗

Endoscopic therapy of benign anastomotic strictures of the colorectum by electroincision and balloon dilatation.

BACKGROUND AND STUDY AIMS: Endoscopic dilatation is the standard therapy for postoperative colorectal anastomotic strictures, although it carries the risk of perforation at the weakest part of the anastomosis. In order to minimize this risk we have developed a combined technique of endoscopic electroincision and hydraulic balloon dilatation. PATIENTS AND METHODS: Thirty-six symptomatic patients with benign colorectal anastomotic strictures were referred for endoscopic electroincision with consecutive balloon dilatation, if the diameter of the anastomosis was less than 12 mm (n = 15) or if the diameter was less than 20 mm and the patient complained of repeated obstructive symptoms under conservative therapy (n = 21). Under direct endoscopic control the scar tissue at the anastomotic line was incised radially with the tip of the polypectomy snare or with a papillotome. Endoscopic hydraulic balloon dilatation was then performed, using a pressure of 35 PSI for three minutes. An endoscopic or radiological control was carried out on the second day, and balloon dilatation was repeated if necessary. RESULTS: The combined technique of electroincision and consecutive balloon dilatation was performed successfully in 35 patients. In only one patient this therapy could not be performed, because of a long stenotic segment, and surgery was necessary. In 24 patients one single dilatation was sufficient after electroincision, whereas six patients required two, and five patients required three consecutive balloon dilatations. There were no severe complications such as bleeding or perforation. Complete follow-up evaluation was possible in 25 patients. In five cases recurrences appeared within the first year; all could be treated successfully by further balloon dilatation. CONCLUSIONS: The combination of endoscopic electroincision and hydraulic balloon dilatation leads to a high long-term clinical success with a minimum of complications. Therefore, in our opinion it is a useful method in the treatment of benign colorectal anastomotic strictures.

Anastomosis, Surgical↗

[Preoperative spiral CT cholangiography with 3-dimensional surface reconstruction: the anatomical imaging potentials, limits and application strategies].

PURPOSE: Evaluation of CT cholangiography compared to i.v. cholangiography concerning its diagnostic value before laparoscopic cholecystectomy and optimisation of CT cholangiography. METHOD: I.v. and CT cholangiographies of 54 patients were retrospectively evaluated by two radiologists. The time interval between contrast infusion and CT was correlated with the assessment of CT cholangiographies to detect the optimal timing for CT scanning. RESULTS: CT cholangiography was judged to be generally better than i.v. cholangiography. The optimal time interval for CT scanning is between 30 min and 60 min post contrast infusion. CONCLUSION: CT cholangiography should replace the conventional tomograms if i.v. cholangiography does not yield sufficient depiction of the biliary tree. It should be performed within 60 min post contrast infusion. Complete abolishment of i.v. cholangiography is not warranted. This is due to the fact that conventional cholangiography can sufficiently delineate the biliary tree and thereby reduce x-ray exposure and cost compared to initial performance of CT cholangiography.

Adult↗