The Experts below are selected from a list of 321 Experts worldwide ranked by ideXlab platform
Jongcheol Park - One of the best experts on this subject based on the ideXlab platform.
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video assisted thoracoscopic Decortication for management of postpneumonic pleural empyema
American Journal of Surgery, 2004Co-Authors: Bongsuk Oh, Wonchae Jang, Youngkyu Park, Jongcheol ParkAbstract:Abstract Background Video-assisted thoracoscopic surgery (VATS) for Decortication or debridement in the management of empyema thoracis has increased the available treatment options but requires validation. We present and evaluate our technique and experience with thoracoscopic management of pleural empyema, irrespective of chronicity. Methods From May 1, 2000, to April 30, 2002, VATS debridement and Decortication in 70 consecutive patients presenting with pleural space infections was performed with endoscopic shaver system. A retrospective review was performed and the effect of this technique on perioperative outcome was assessed. Results The VATS evacuation of infected pleural fluid and Decortication was successfully performed in 65 of 70 patients. The mean duration of preoperative symptoms before referral was 23 ± 1.8 days. The mean duration of hospitalization before transfer was 13.5 ± 1.5 days. Blood loss was 330 ± 200 mL. Intercostal drainage was required for 5 ± 3 days. The postoperative hospital stay was 5 ± 0.7 days. There were no operative mortalities. Conclusions Video-assisted thoracoscopic Decortication with endoshaver system is a simple and effective method in the management of the fibropurulent or organic pleural empyema.
David A Waller - One of the best experts on this subject based on the ideXlab platform.
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the role of video assisted thoracoscopic pleurectomy Decortication in the therapeutic management of malignant pleural mesothelioma
European Journal of Cardio-Thoracic Surgery, 2008Co-Authors: Apostolos Nakas, Antonio Martin Ucar, John G Edwards, David A WallerAbstract:OBJECTIVE: Extrapleural pneumonectomy (EPP) has high mortality and morbidity; radical pleurectomy Decortication (P/D) carries less mortality but still significant morbidity. This surgery is not suitable for many patients with malignant pleural mesothelioma (MPM) for whom video assisted thoracic surgery (VATS) offers a minimally invasive alternative. We aimed to assess the role of VATS Decortication for MPM. METHODS: Over a 9-year period 208 patients underwent therapeutic surgery for MPM in our unit. One hundred and twelve of the patients underwent EPP, 29 had a P/D and 67 had VATS Decortication. Sixty-three of the 208 patients (EPP n=13, P/D n=8 and VATS Decortication n=42) were 65 years of age or older at the time of the operation (57 males and 6 females, age 70 (65-80) years). In this group we analyzed perioperative morbidity and mortality and long-term survival data using the Kaplan-Meier method. RESULTS: Postoperative stay and 30-day mortality was significantly lower for VATS P/D than for EPP (14.3 days vs 36.6 days, p<0.05 and mortality 7.1% vs 23%, respectively). There was no significant difference in the overall mean survival between the two groups (11.5 months for EPP and 14 months for VATS P/D, p=0.6). CONCLUSION: VATS Decortication should be considered in the therapeutic strategy for MPM.
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thoracoscopic Decortication a role for video assisted surgery in chronic postpneumonic pleural empyema
The Annals of Thoracic Surgery, 2001Co-Authors: David A Waller, Arvind RengarajanAbstract:Abstract Background . We evaluated a technique of video-assisted thoracoscopic (VAT) Decortication of the visceral cortex to reexpand entrapped lung in cases of chronic postpneumonic pleural empyema. Methods . A prospective cohort study of 48 consecutive patients with multiloculated postpneumonic pleural empyema in whom visceral pleural Decortication was required was studied. The effect of VAT Decortication on perioperative outcome and factors affecting its success were assessed. Results . Before the introduction of VAT Decortication 12 patients were treated by thoracotomy (group T). In the subsequent 36 patients VAT Decortication was attempted with success in 21 (group VS) but lung expansion was not observed in 15 patients (group VF) who required thoracotomy. There was no difference in the age or sex distribution of the 3 groups. Operating time was significantly longer in group T than group VS, mean difference 30.3 minutes ( p = 0.001) and postoperative hospital stay was longer in group T than group VS, mean difference 2.9 days ( p = 0.004). The success of VAT Decortication was not related to either the delay between onset of symptoms or hospital admission and surgery; indeed the operating time decreased with increasing preoperative delay. However, success was related to increasing operative experience ( p = 0.001). Conclusions . VAT Decortication is a feasible new technique to achieve lung reexpansion in chronic postpneumonic pleural empyema and has perioperative benefits over thoracotomy.
Chung Yiu Jack Cheng - One of the best experts on this subject based on the ideXlab platform.
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recombinant human bone morphogenetic protein 4 rhbmp 4 enhanced posterior spinal fusion without Decortication
Journal of Orthopaedic Research, 2002Co-Authors: Hung Kay Daniel Chow, Randy N Rosier, Chung Yiu Jack ChengAbstract:Abstract In posterior spinal fusion, insufficient Decortication may decrease the number of bone marrow derived ostoprogenitor stem cells and affect the success of bony fusion. The finding of bone formation through interaction between rhBMP-4 and non-marrow derived mesenchymal cells constituted the basis of the current study. The aim is to investigate the possibility of molecular enhancement of posterior spinal fusion by site-specific application of rhBMP-4 with or without surgical Decortication. Eighteen adult rabbits underwent single level bilateral posterior intertransverse process spinal fusion at L5–L6, one side with Decortication, and the other side without Decortication. Two animals underwent sham operation without bone grafts, the other 16 animals were randomly allocated into three groups, using hydroxyapatite-tricalcium phosphate (HA-TCP) ceramic blocks augmented with 0, 0.125 and 0.5 mg of rhBMP-4 respectively. Spinal fusion morphology was evaluated with sequential X-ray, microradiography and histomorphology. At week 7, complete bony fusion was achieved in none of the groups without rhBMP-4 irrespective of whether the bony contact surface was decorticated or not. In the groups with low dose rhBMP-4, complete fusion occurred in two of six un-decorticated sites (33%) and in three of six (50%) decorticated sites. 100% complete fusion was found in the high dose rhBMP-4 group independent of surgical Decortication. The dorsal cortices of the un-decorticated transverse processes were replaced by newly formed trabecular bone through biological remodeling. This study suggested that rhBMP-4 can induce non-marrow derived mesenchymal cells to differentiate into osteogenic cells and thus enhance the high success rate of posterior spinal fusion in both the decorticated and un-decorticated model.
William R Burfeind - One of the best experts on this subject based on the ideXlab platform.
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outcomes of video assisted thoracoscopic Decortication
The Annals of Thoracic Surgery, 2010Co-Authors: Betty C Tong, Jennifer M Hanna, Eric M Toloza, Mark W Onaitis, Thomas A Damico, David H Harpole, William R BurfeindAbstract:BACKGROUND: Video-assisted thoracoscopic surgical Decortication (VATSD) is widely used for treatment of early empyema and hemothorax, but conversion to open thoracotomy for Decortication (OD) is more frequent in the setting of complex, chronic empyema. This study compared indications for and outcomes associated with VATSD and OD. METHODS: The outcomes of 420 consecutive patients undergoing VATSD or OD for benign conditions from 1996 to 2006 were reviewed and compared with respect to baseline characteristics, preoperative management, and operative and postoperative course. Patients were analyzed on an intention-to-treat basis. RESULTS: The cohort consisted of 326 VATSD and 94 OD patients. The conversion rate from VATSD to OD was 11.4%. The operative time and median in-hospital length of stay were shorter for the VATSD group: 97 vs 155 minutes (p < 0.001), and 15 vs 21 days (p = 0.03), respectively. The median postoperative length of stay was 7 days for the VATSD group vs 10 days for the OD group (p < 0.001). Significantly fewer postoperative complications occurred in the VATSD group in the following categories: atelectasis, prolonged air leak, reintubation, ventilator dependence, need for tracheostomy, blood transfusion, sepsis, and 30-day mortality. CONCLUSIONS: Thoracoscopic Decortication for empyema, complex pleural effusion, and hemothorax yields results that are at least equivalent to open Decortication. Patients undergoing VATSD have fewer postoperative complications. The conversion and reoperation rates are low, suggesting that a thoracoscopic approach is an effective and reasonable first option for most patients with complex pleural effusions and empyema.
N G Malleshi - One of the best experts on this subject based on the ideXlab platform.
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influence of hydrothermal processing on functional properties and grain morphology of finger millet
Journal of Food Science and Technology-mysore, 2015Co-Authors: Usha Dharmaraj, M S Meera, Yella S Reddy, N G MalleshiAbstract:Finger millet was hydrothermally processed followed by Decortication. Changes in color, diameter, density, sphericity, thermal and textural characteristics and also some of the functional properties of the millet along with the grain morphology of the kernels after hydrothermal processing and Decortication were studied. It was observed that, the millet turned dark after hydrothermal processing and color improved over native millet after Decortication. A slight decrease in grain diameter was observed but sphericity of the grains increased on Decortication. The soft and fragile endosperm turned into a hard texture and grain hardness increased by about 6 fold. Hydrothermal processing increased solubility and swelling power of the millet at ambient temperature. Pasting profile indicated that, peak viscosity decreased significantly on hydrothermal processing and both hydrothermally processed and decorticated millet exhibited zero breakdown viscosity. Enthalpy was negative for hydrothermally processed millet and positive for decorticated grains. Microscopic studies revealed that the orderly structure of endosperm changed to a coherent mass after hydrothermal processing and the different layers of seed coat get fused with the endosperm.
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changes in carbohydrates proteins and lipids of finger millet after hydrothermal processing
Lwt - Food Science and Technology, 2011Co-Authors: Usha Dharmaraj, N G MalleshiAbstract:Finger millet was soaked, steamed and dried to prepare hydrothermally processed millet, followed by Decortication to prepare decorticated millet. The physicochemical properties and carbohydrate, protein and lipid profiles of control and processed millet were determined. The carbohydrates were fractionated to amlypectin and amylose equivalent fractions using gel permeation chromatography. The non-starch polysaccharides were isolated and their alditol acetyl derivatives were characterized by gas chromatography (GC). The proteins were extracted using different solvents and the total proteins were fractionated using SDS-PAGE. The ether extractable lipids were esterified and fractionated through GC. Hydrothermal processing decreased the amylopectin fraction and increased the amylose equivalent portion of the starch. Decortication further lowered the first fraction and increased the second fraction. A decrease in cold, hot water soluble and hemicellulose-B fractions and an increase in pectic polysaccharides, hemicellulose-A and cellulosic fractions were observed as a result of hydrothermal processing. Decortication significantly reduced the total non-starch polysaccharides specifically the cellulose fraction. Hydrothermal processing decreased the overall extractability of proteins by 50% but Decortication increased it to 80%. It was observed that hydrothermal treatment did not change the gross nutrients composition of finger millet but for their profile. Decortication of hydrothermally processed millet caused significant changes in the nutrient contents and also in their profiles.
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preparation and functional properties of decorticated finger millet eleusine coracana
Journal of Food Engineering, 2007Co-Authors: S Shobana, N G MalleshiAbstract:The food uses of finger millet are confined to flour based products because, it has not been possible to decorticate the millet similar to other cereals. This is mainly due to the highly floury endosperm. But, it was observed that, the hydrothermal treatment to the millet hardens the endosperm texture and enables its Decortication. Accordingly, the optimal conditions for the hydrothermal treatment and also for Decortication of the millet were determined. Equilibrating the millet to 33 ± 2% moisture content and steaming the same for about 20 min at atmospheric pressure followed by drying to 12 ± 2% moisture content enhanced the hardness of the millet kernel from 1.1 ± 0.2 to 7.1 ± 0.5 kg/cm2 and enabled its Decortication. Among the various cereal pearlers and decorticators, horizontal carborundum disc mill was most suitable and incipient moist conditioning the millet improved the Decortication efficiency. The decorticated millet contained 6.3 ± 0.6 g protein, 0.9 ± 0.2% fat, 14.7 ± 1.8% dietary fibre, 0.180 ± 0.015% calcium and 0.109 ± 0.01% phosphorus. The polyphenols and phytate phosphorus content of the decorticated millets were lower by 74.7% and 39.8%, respectively, as compared to the native millet. The decorticated millet could be cooked as discrete grains similar to rice to soft edible texture within 5 min which was not possible hitherto. The pasting and the dough properties and also some of the functional characteristics of the product indicated its versatility for diversified food uses.
