The Experts below are selected from a list of 267 Experts worldwide ranked by ideXlab platform
Andrew G. Hill - One of the best experts on this subject based on the ideXlab platform.
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Peritoneal Damage: The Inflammatory Response and Clinical Implications of the Neuro-Immuno-Humoral Axis
World Journal of Surgery, 2010Co-Authors: Tarik Sammour, Arman Kahokehr, Mattias Soop, Andrew G. HillAbstract:Background The peritoneum is a bilayer Serous Membrane that lines the abdominal cavity. We present a review of peritoneal structure and physiology, with a focus on the peritoneal inflammatory response to surgical injury and its clinical implications. Methods We conducted a nonsystematic clinical review. A search of the Ovid MEDLINE database from 1950 through January 2009 was performed using the following search terms: peritoneum, adhesions, cytokine, inflammation, and surgery. Results The peritoneum is a metabolically active organ, responding to insult through a complex array of immunologic and inflammatory cascades. This response increases with the duration and extent of injury and is central to the concept of surgical stress, manifesting via a combination of systemic effects, and local neural pathways via the neuro-immuno-humoral axis. There may be a decreased systemic inflammatory response after minimally invasive surgery; however, it is unclear whether this is due to a reduced local peritoneal reaction. Conclusions Interventions that dampen the peritoneal response and/or block the neuro-immuno-humoral pathway should be further investigated as possible avenues of enhancing recovery after surgery, and reducing postoperative complications.
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Peritoneal Damage: The Inflammatory Response and Clinical Implications of the Neuro-Immuno-Humoral Axis
World Journal of Surgery, 2010Co-Authors: Tarik Sammour, Arman Kahokehr, Mattias Soop, Andrew G. HillAbstract:Background The peritoneum is a bilayer Serous Membrane that lines the abdominal cavity. We present a review of peritoneal structure and physiology, with a focus on the peritoneal inflammatory response to surgical injury and its clinical implications.
J Jeekel - One of the best experts on this subject based on the ideXlab platform.
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biology of the peritoneum in normal homeostasis and after surgical trauma
Colorectal Disease, 2007Co-Authors: J JeekelAbstract:The peritoneum is a Serous Membrane, which has a protective function for the contents of the abdominal cavity. It maintains homeostasis by allowing exchange of molecules and production of peritoneal fluid, thus providing an environment in which intra-abdominal organs can function properly. When traumatized, whether by surgery or due to inflammatory processes, a series of responses come into action to regenerate the injured part of the peritoneum. The inflammatory reaction causes influx of inflammatory cells but also activates resident mesothelial cells, ultimately leading to a fibrinous exudate. Depending on the severity of the trauma this exudate is transient due to fibrinolysis, or becomes more dense as a result of fibroblasts persisting, leading to fibrinous adhesions. A pivotal role is taken by the enzyme plasmin and its promotors and inhibitors; it is mainly the tissue-type plasminogen activator/plasminogen activator inhibitor ratio which determines the rate of fibrinolysis and therefore the rate of adhesion formation. The rate of injury determines the rate and extent of the inflammatory response to that injury; in its turn the inflammatory reaction determines the extent of adhesion formation. One should realize this when performing intra-abdominal surgery, which is in fact operating inside the peritoneal organ.
Wenli Cai - One of the best experts on this subject based on the ideXlab platform.
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diagnostic value of multidetector ct and its multiplanar reformation volume rendering and virtual bronchoscopy postprocessing techniques for primary trachea and main bronchus tumors
PLOS ONE, 2015Co-Authors: Mingyue Luo, Chaijie Duan, Jianping Qiu, Dongyun Zhu, Wenli CaiAbstract:Purpose To evaluate the diagnostic value of multidetector CT (MDCT) and its multiplanar reformation (MPR), volume rendering (VR) and virtual bronchoscopy (VB) postprocessing techniques for primary trachea and main bronchus tumors. Methods Detection results of 31 primary trachea and main bronchus tumors with MDCT and its MPR, VR and VB postprocessing techniques, were analyzed retrospectively with regard to tumor locations, tumor morphologies, extramural invasions of tumors, longitudinal involvements of tumors, morphologies and extents of luminal stenoses, distances between main bronchus tumors and trachea carinae, and internal features of tumors. The detection results were compared with that of surgery and pathology. Results Detection results with MDCT and its MPR, VR and VB were consistent with that of surgery and pathology, included tumor locations (tracheae, n = 19; right main bronchi, n = 6; left main bronchi, n = 6), tumor morphologies (endoluminal nodes with narrow bases, n = 2; endoluminal nodes with wide bases, n = 13; both intraluminal and extraluminal masses, n = 16), extramural invasions of tumors (brokethrough only Serous Membrane, n = 1; 4.0 mm—56.0 mm, n = 14; no clear border with right atelectasis, n = 1), longitudinal involvements of tumors (3.0 mm, n = 1; 5.0 mm—68.0 mm, n = 29; whole right main bronchus wall and trachea carina, n = 1), morphologies of luminal stenoses (irregular, n = 26; circular, n = 3; eccentric, n = 1; conical, n = 1) and extents (mild, n = 5; moderate, n = 7; severe, n = 19), distances between main bronchus tumors and trachea carinae (16.0 mm, n = 1; invaded trachea carina, n = 1; >20.0 mm, n = 10), and internal features of tumors (fairly homogeneous densities with rather obvious enhancements, n = 26; homogeneous density with obvious enhancement, n = 1; homogeneous density without obvious enhancement, n = 1; not enough homogeneous density with obvious enhancement, n = 1; punctate calcification with obvious enhancement, n = 1; low density without obvious enhancement, n = 1). Conclusion MDCT and its MPR, VR and VB images have respective advantages and disadvantages. Their combination could complement to each other to accurately detect locations, natures (benignancy, malignancy or low malignancy), and quantities (extramural invasions, longitudinal involvements, extents of luminal stenoses, distances between main bronchus tumors and trachea carinae) of primary trachea and main bronchus tumors with crucial information for surgical treatment, are highly useful diagnostic methods for primary trachea and main bronchus tumors.
Susumu Yamasaki - One of the best experts on this subject based on the ideXlab platform.
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Intrahepatic cholangiocarcinoma: macroscopic type and stage classification
Journal of Hepato-Biliary-Pancreatic Surgery, 2003Co-Authors: Susumu YamasakiAbstract:The Liver Cancer Study Group of Japan established a classification of macroscopic type and the TNM staging of intrahepatic cholangiocarcinoma (ICC). With the observation of more than 240 resected cases of ICC, three fundamental types were established. They were: (1) mass-forming (MF) type, (2) periductal-infiltrating (PI) type, and (3) intraductal growth (IG) type. The MF type forms a definite mass, located in the liver parenchyma. The PI type is defined as ICC which extends mainly longitudinally along the bile duct, often resulting in dilatation of the peripheral bile duct. The IG type proliferates toward the lumen of the bile duct papillarily or like a tumor thrombus. The TNM classification of ICC was then designed, using 136 cases of the MF type resected curatively between 1990 and 1996 at member institutes. Univariate and multivariate analyses showed: (1) tumor 2 cm or less, (2) single nodule, and (3) no vascular and Serous Membrane invasion as prognostic factors. T factors were defined as follows: T1 is an ICC that meets all requirements of factors (1), (2), and (3); T2 meets two of the three requirements, T3 meets one of the three requirements and T4 meets none of the three requirements. Our data did not support the idea that the hepatoduodenal lymph node is regional. The N factors were defined as N0 no lymph node metastasis; and N1, positive at any nodes. Thus, the stages of ICC were defined as stage I, T1N0M0; stage II, T2N0M0; stage III, T3N0M0; stage IVA, T4N0M0 or any TN1M0; and stage IVB, any T any NM1.
J C Healy - One of the best experts on this subject based on the ideXlab platform.
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Detection of peritoneal metastases
Cancer Imaging, 2001Co-Authors: J C HealyAbstract:The peritoneum is the largest and most complexly arranged Serous Membrane in the body. The potential peritoneal spaces, the peritoneal reflections forming peritoneal ligaments, mesenteries, omenta, and the natural flow of peritoneal fluid determine the route of spread of intraperitoneal fluid and consequently disease spread within the abdominal cavity. The peritoneal ligaments, mesenteries, and omenta also serve as boundaries and conduits for disease spread. Peritoneal metastases spread in four ways: Direct spread along peritoneal ligaments, mesenteries and omenta to non-contiguous organs Intraperitoneal seeding via ascitic fluid Lymphatic extension Embolic haematogenous spread. Before the introduction of cross-sectional imaging, the peritoneum and its reflections could only be imaged with difficulty, often requiring invasive techniques. Computed tomography and to a lesser extent sonography and MR imaging allow us to examine the complex anatomy of the peritoneal cavity accurately, which is the key to understanding the spread of peritoneal metastases. This article reviews the detection of peritoneal metastases.
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the peritoneum mesenteries and omenta normal anatomy and pathological processes
European Radiology, 1998Co-Authors: J C Healy, R H ReznekAbstract:The peritoneum is the largest and most complexly arranged Serous Membrane in the body. The potential peritoneal spaces, the peritoneal reflections forming peritoneal ligaments, mesenteries, omenta and the natural flow of peritoneal fluid determine the route of spread of intraperitoneal fluid and, consequently, disease processes within the abdominal cavity. The peritoneal ligaments, mesenteries and omenta also serve as boundaries for disease processes and conduits for disease spread. The peritoneal cavity and its reflections are frequently involved by infectious, inflammatory, neoplastic and traumatic processes. Before the introduction of cross-sectional imaging, the peritoneum and its reflections could only be imaged with difficulty, often requiring invasive techniques. Computed tomography and, to a lesser extent, sonography and MR imaging allow the accurate examination of the complex anatomy of the peritoneal cavity, which is the key to understanding the pathological processes affecting it. This article reviews the normal peritoneal anatomy and its disease processes.
