PubMed · 11829253
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
William T Pope. 2002-02-01. Finds article on enteroplication confusing.. https://pubmed.ncbi.nlm.nih.gov/11829253/
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
The proliferation of disease at the bed of the distal junction of an end-to-side anastomosis is attributed to abnormal wall shear stress (WSS) distribution. WSS is proportional to the viscosity and shear rate of the flowing fluid. Blood is characterised by a shear rate dependent viscosity. Various constitutive equations have been developed to represent the shear rate dependence of blood viscosity: Newtonian, Carreau, Power law, Carreau-Yasuda, Bi-exponential, Cross, Modified Cross, Herschel-Bulkley, etc. In the femoral artery, the instantaneous shear rate varies from 1-1200 s(-1) over a cardiac cycle. An idealised, 45 degrees rigid, 6mm diameter, end-to-side femoral anastomosis was modelled on a Computational Fluid Dynamic software package Fluent 6.0. A steady flow of 0.15 and 0.01 m/s was applied to the inlet to model high and low wall shear rate environments respectively. Blood was modelled using the various constitutive equations. The resulting WSS distribution on the bed of the artery was then obtained. At high shear rates there was no significant difference between WSS distribution. At low shear rates there were qualitative differences of up to 300%. In conclusion, the choice of blood constitutive equation has to be based on the particular situation under study e.g. flow rate, steady/unsteady flow, and geometry.
BACKGROUND: Previous formulations of cyanoacrylate, though very effective, proved to have too high a tissue reactivity to be used internally. A novel cyanoacrylate compound with less tissue reactivity was recently developed. The objective of this study was to assess this novel cyanoacrylate compound for the use as vascular suture line sealant. MATERIALS AND METHODS: Twelve adult female sheep received a 6 mm PTFE interposition graft in each iliac artery, for a total of 24 grafts. Using oxidized cellulose (Surgicel) as a control, two formulations of a new cyanoacrylate compound (named "compound A" and "compound B") were assessed during this trial. Hemostatic efficiency was measured at the time of operation by the assessment of bleeding time and amount of blood loss. Long-term graft patency was assessed angiographically at 4, 6, and 18 months. Tissue reaction at 2 weeks, 1, 6, and 18 months was assessed grossly by vascular surgeons and microscopically by a blinded pathologist. RESULTS: Average time to hemostasis was 37.6, 50.6, and 219 s in group A, group B, and oxidized cellulose control groups, respectively (P<or=0.001 for both compounds versus control). There were no significant differences between groups with regards to graft patency. Histopathology analysis demonstrated mild to moderate tissue reaction at 2 weeks and 1 month in the cyanoacrylate groups compared with controls at 1 month (ANOVA P=0.004). Mild tissue reaction was seen at 6 months and 18 months, with no significant differences between groups (ANOVA P=0.08, 0.62, respectively). CONCLUSIONS: The novel cyanoacrylate compound examined in this study is a highly effective suture line sealant with only mild tissue reactivity and no significant effects on graft patency when studied over an 18 month period.
BACKGROUND AND AIM: Central pancreatectomy (CP) is an operation that allows one to resect benign or low grade malignant tumours located in the pancreatic isthmus that are not suitable for enucleation. The main advantage of this operation compared with major resections is that it permits to spare normal pancreatic parenchyma. PATIENTS AND METHODS: The operation is carried out by exposition of the pancreatic neck involved by the lesion. Thereafter, the gland is dissected from the splenic artery and porto-mesenteric axis and divided with a 1 cm clear margin. The cephalic stump is sutured, and the distal stump is anastomosed end-to-end or end-to-side with a Roux-en-Y jejunal loop. We treated 20 patients with this technique. The indications for CP were: serous cystadenoma in seven patients, mucinous in three, solid cystic papillary tumour in one, metastasis from renal cancer in one and endocrine tumour in eight patients. RESULTS: Mortality rate was 0% and morbidity rate was 35%; pancreatic fistulas occurred in 25% of the cases and were treated conservatively. Results of postoperative endocrine and exocrine function tests were normal in all controlled patients. All the patients are alive without evidence of local recurrence. CONCLUSION: CP is a safe technique for benign or low-grade malignant tumours of the pancreatic neck that allows one to cure the tumour with evident functional results without increasing the risk to the patient.