Physiological substances pose a challenge for researchers since their optical properties change constantly according to their physiological state. Examination of those substances noninvasively can be achieved by different optical methods with high sensitivity. Our research suggests the application of a novel noninvasive nanophotonics technique, ie, iterative multi-plane optical property extraction (IMOPE) based on reflectance measurements, for tissue viability examination and gold nanorods (GNRs) and blood flow detection. The IMOPE model combines an experimental setup designed for recording light intensity images with the multi-plane iterative Gerchberg-Saxton algorithm for reconstructing the reemitted light phase and calculating its standard deviation (STD). Changes in tissue composition affect its optical properties which results in changes in the light phase that can be measured by its STD. We have demonstrated this new concept of correlating the light phase STD and the optical properties of a substance, using transmission measurements only. This paper presents, for the first time, reflectance based IMOPE tissue viability examination, producing a decrease in the computed STD for older tissues, as well as investigating their organic material absorption capability. Finally, differentiation of the femoral vein from adjacent tissues using GNRs and the detection of their presence within blood circulation and tissues are also presented with high sensitivity (better than computed tomography) to low quantities of GNRs (<3 mg).
The purpose of this study was to report our experience in elongating short distal necks of descending thoracic aortic aneurysms (DTAAs) by coil embolization of the celiac trunk prior to endovascular aneurysm repair (EVAR). During 6 years seven patients (five men and two women; mean age, 74) who had DTAAs with short distal necks unsuitable for conventional EVAR, and well patent superior and inferior mesenteric arteries based on CT, were treated in one session with EVAR after the celiac trunk was coil embolized to elongate the neck. All patients were followed by CT every 3 months in the first year and every 6 months thereafter. Technical success was achieved in all patients, and no early or late ischemic complications were noted. No procedural complications occurred and good aneurysm sealing was obtained in all patients. Three endoleaks were identified after 3 months (one patient) and 6 months (two patients); all were treated successfully with insertion of an additional stent-graft. In patients with DTAAs who are candidates for EVAR but have short aneurysm distal necks, celiac trunk embolization -- only if the superior and inferior mesenteric arteries are patent -- is a good and safe way to elongate the neck and enable EVAR.
A case of primary intraluminal leiomyosarcoma of the right common iliac artery that presented itself by intermittent claudication is described. The diagnosis was established only postoperatively, based on examination of the endarterectomy specimen. No other primary tumor was found in the postoperative investigation and the patient received no further treatment. A review of the literature attests to the rarity of the diagnosis and the uncertainty regarding the mode of treatment.
Ultrasonography has led to an increase in the incidence of acute acalculous cholecystitis (AAC). Fifty-three patients with AAC are compared to 521 patients with acute calculous cholecystitis (ACC), both out of a series of 2,800 patients operated on between 1970 and 1988. Patients with AAC are usually older males with a high incidence of diabetes mellitus. Over 10% report recent preoperative extrabiliary surgery or trauma, 5 % had undergone splenectomy for hematological indications. Gangrenous changes and obstructive jaundice are significantly more frequent among AAC patients. The bacterial flora, the antibiogram and the incidence of common bile duct stones do not differ between AAC and ACC patients. Early surgery, feasible today with early diagnosis by ultrasonography, gives excellent results in terms of morbidity and mortality. Our series demonstrates low mortality rates for AAC patients when compared to historical series and thus represents, in our opinion, the present trend of change in this group of patients.
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