Is combined therapy more effective than growth hormone or hyperbaric oxygen alone in the healing of left ischemic and non-ischemic colonic anastomoses?
Abstract:OBJECTIVE:Our aim was to investigate the effects of growth hormone (GH), hyperbaric oxygen and combined therapy on normal and ischemic colonic anastomoses in rats.METHODS:Eighty male Wistar rats were divided into eight groups (n = 10). In the first four groups, non-ischemic colonic anastomosis was performed, whereas in the remaining four groups, ischemic colonic anastomosis was performed. In groups 5, 6, 7, and 8, colonic ischemia was established by ligating 2 cm of the mesocolon on either side of the anastomo… Show more
“…Other two studies corroborate our findings of no significant differences in ischemic necrosis and reepithelization 8,16 .…”
Section: ■ Discussionsupporting
confidence: 91%
“…Previous studies had different results with statistically significant increase in HBOT groups in neovascularization 16,27,30 , and in collagen deposition 8 .…”
Section: ■ Discussionmentioning
confidence: 90%
“…With an alpha = 0.05 and power = 0.85, able to detect a 20% statistical significant difference calculated by T-Test for two samples, the sample size estimated with this effect size was approximately N = 10 for each group. This size group was used in similar studies 4,7,16 .…”
Section: Discussionmentioning
confidence: 99%
“…A colon segment 2 cm cranial to the landmark was isolated and the venous-arterial branches that drained or irrigated this left colonic segment were electrocoagulated. The mesenteric vessels of the vasa recta were electrocoagulated with bipolar hemostatic forceps set to 10 W. Then, 1 cm of the middle third of this devascularized portion was resected, as described by Adas et al 16 . The colon was then repaired by a single-plane end-toend anastomosis with continuous 6-0 polypropylene sutures placed with a 1.3 cm cylindrical needle (Prolene ® , ETHICON), encompassing all layers of the intestinal wall.…”
Section: Anesthesia and Surgical Proceduresmentioning
Conception and design of the study, technical procedures, acquisition and interpretation of data, statistics analysis, manuscript preparation and writing, critical revision, final approval.
“…Other two studies corroborate our findings of no significant differences in ischemic necrosis and reepithelization 8,16 .…”
Section: ■ Discussionsupporting
confidence: 91%
“…Previous studies had different results with statistically significant increase in HBOT groups in neovascularization 16,27,30 , and in collagen deposition 8 .…”
Section: ■ Discussionmentioning
confidence: 90%
“…With an alpha = 0.05 and power = 0.85, able to detect a 20% statistical significant difference calculated by T-Test for two samples, the sample size estimated with this effect size was approximately N = 10 for each group. This size group was used in similar studies 4,7,16 .…”
Section: Discussionmentioning
confidence: 99%
“…A colon segment 2 cm cranial to the landmark was isolated and the venous-arterial branches that drained or irrigated this left colonic segment were electrocoagulated. The mesenteric vessels of the vasa recta were electrocoagulated with bipolar hemostatic forceps set to 10 W. Then, 1 cm of the middle third of this devascularized portion was resected, as described by Adas et al 16 . The colon was then repaired by a single-plane end-toend anastomosis with continuous 6-0 polypropylene sutures placed with a 1.3 cm cylindrical needle (Prolene ® , ETHICON), encompassing all layers of the intestinal wall.…”
Section: Anesthesia and Surgical Proceduresmentioning
Conception and design of the study, technical procedures, acquisition and interpretation of data, statistics analysis, manuscript preparation and writing, critical revision, final approval.
“…Bu tedavi, sadece iskeminin yan etkilerini önlemekle kalmaz, aynı zamanda farklı yara tiplerinin iyileşmesinde de etkili olur. Yapılan deneysel çalışmalarda, kolonik anastomozlarda gelişebilecek kaçak oranını azalttığı gösterilmiştir (9)(10)(11).…”
Deneysel Künt Duodenum Yaralanmalarında Hiperbarik Oksijen Tedavisi ve Timokinon'un Etkisi ÖZET Amaç: Duodenumun abdomenin iyi korunmuş bir alanında olmasına rağmen, duodenum arkasında lomber vertebralar bulunmasından ve iyi fikse olmasından dolayı özellikle künt travmalarda yaralanabilmektedir. Hiperbarik Oksijen (HBO 2) tedavisi, sekonder hasarın en önemli nedenlerinden biri olan iskemiyi azaltır. Travmadan sonra seri olarak verilen HBO 2 tedavileri klinik, histopatolojik ve biyokimyasal fayda sağlar. Timokinon'un (TQ) topikal veya sistemik kullanımda yara iyileşmesini hızlandırdığı gösterilmiştir. Çalışmamızda deneysel oluşturulmuş Grade 1-2 künt duodenal travmalarda HBO 2 ve oral TQ tedavisinin yararlı olabileceği yönünde sonuçlar elde edilmiştir. Gereç ve Yöntem: 32 adet Wistar Albino cinsi rat rastgele 4 gruba ayıldı. Birinci grup dışındaki ratlara cerrahi işlem uygulanmıştır. İlk grup sham olarak seçilirken 2. grup kontrol, 3. grup HBO 2 tedavisi, 4. grup ise HBO 2 +TQ tedavisi almıştır. Sonuçlar duodenum ve serumda histopatolojik ve biyokimyasal olarak incelenmiştir. Bulgular: Histopatolojik bulgularda HBO 2 tedavisi iyileşmeyi hızlandırırken tedaviye eklenen TQ tedavisi iyileşmedeki başarıyı artırmıştır. Duodenum dokusunda ve serumda çalışılan parametreler histopatolojik değişikliklere kısmen paralel olsa bile biyokimyasal değerler genel olarak istatistiksel olarak anlamlı bulunmamıştır. Sonuç: Bu çalışmada duodenumun 2. kısmına künt hasar taklit edilmiş ve HBO 2 ve TQ tedavisinin Grade 1-2 hasarlarda diğer gruplara göre iyileşme sağladığı gösterilmiştir. Grade 1 ve 2 duodenal hasarlarda, konservatif tedavinin yanında belirlenecek bir HBO 2 programı ve bu programa TQ eklenerek tedavide başarılı yanıtlar alınabileceğini düşünüyoruz.
Strategic management of populations of interacting biological species routinely requires interventions combining multiple treatments or therapies. This is important in key research areas such as ecology, epidemiology, wound healing and oncology.Despite the well developed theory and techniques for determining single optimal controls, there is limited practical guidance supporting implementation of combination therapies. In this work we use optimal control theory to calculate optimal strategies for applying combination therapies to a model of acute myeloid leukaemia.We consider various combinations of continuous and bang-bang (discrete) controls, and we investigate how the control dynamics interact and respond to changes in the weighting and form of the pay-off characterising optimality. We demonstrate that the optimal controls respond non-linearly to treatment strength and control parameters, due to the interactions between species. We discuss challenges in appropriately characterising optimality in a multiple control setting and provide practical guid-
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