scholarly journals Clinical Evaluation of a Newly Developed Guidewire for Pancreatobiliary Endoscopy

2020 ◽  
Vol 9 (12) ◽  
pp. 4059
Author(s):  
Shigeto Ishii ◽  
Toshio Fujisawa ◽  
Hiroyuki Isayama ◽  
Shingo Asahara ◽  
Shingo Ogiwara ◽  
...  

Background: The guidewire (GW) plays an important role in pancreatobiliary endoscopy. GW quality is a critical factor in the effectiveness and efficiency of pancreatobiliary endoscopy. In this study, we evaluate a new 0.025 inch multipurpose endoscopic GW: the M-Through. Methods: Our study was a multicenter retrospective analysis. We enrolled patients who underwent endoscopic procedures using the M-Through between May 2018 and April 2020. Patients receiving the following endoscopic treatments were enrolled: common bile duct (CBD) stone extraction, endoscopic drainage for distal and hilar malignant biliary obstruction (MBO), and endoscopic drainage for acute cholecystitis. For each procedure, we examined the rate of success without GW exchange. Results: A total of 170 patients (80 with CBD stones, 60 with MBO, and 30 with cholecystitis) were enrolled. The rate of completion without GW exchange was 100% for CBD stone extraction, 83.3% for endoscopic drainage for MBO, and 43.3% for endoscopic drainage for cholecystitis. In unsuccessful cholecystitis cases with the original GW manipulator, 1 of 8 cases succeeded in the manipulator exchange. Including 6 cases who changed GW after the manipulator exchange, 11 of 16 cases succeeded in changing GW. There was significant difference in the success rate between the manipulator exchange and GW exchange (p = 0.03). The insertion of devices and stent placement after biliary cannulation (regardless of type) were almost completed with M-through. We observed no intraoperative GW-related adverse events such as perforation and bleeding due to manipulation. Conclusion: The 0.025 inch M-Through can be used for endoscopic retrograde cholangiopancreatography-related procedures efficiently and safely. Our study found high rates of success without GW exchange in all procedures except for endoscopic drainage for cholecystitis. This GW is considered (1) excellent for supportability of device insertion to remove CBD stones; (2) good for seeking the biliary malignant stricture but sometimes need the help of a hydrophilic GW; (3) suboptimal for gallbladder drainage that require a high level of seeking ability.

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Emmanuel Christoforidis ◽  
Konstantinos Vasiliadis ◽  
Konstantinos Tsalis ◽  
Dimitrios Patridas ◽  
Konstantinos Blouhos ◽  
...  

The objective of this study is to retrospectively evaluate factors significantly contributing to a failed stone extraction (SE) in patients with difficult to extract bile duct stones (BDS). Patients and Methods. During a 10-year period 1390 patients with BDS underwent successfully endoscopic sphincterotomy. Endoscopic SE was graded as easy; relatively easy; difficult; and failed. Difficult SE was encountered in 221 patients while failed SE was encountered in 205. A retrospective analysis of the criteria governing the difficulty of endoscopic SE following the index endoscopic intervention was performed to evaluate their significance in determining failure of complete SE among patients with difficult to extract bile duct stones. Results. Age ≥ 85 years, periampullary diverticula, multiple CBD stones (>4), and diameter of CBD stones (≥15 mm) were all significant contributing factors to a failed SE in univariate statistical tests. In the definitive multivariate analysis age, multiple stones and diameter of stones were found to be the significant, independent contributors. Conclusion. Failed conventional endoscopic stone clearance in patients with difficult to extract BDS is more likely to occur in overage patients, in patients with multiple CBD stones >4, and in patients with CBD stone(s) diameter ≥15 mm.


Author(s):  
Marcela Moreira Salles ◽  
Viviane de Cássia Oliveira ◽  
Ana Paula Macedo ◽  
Claudia Helena Silva-Lovato ◽  
Helena de Freitas Oliveira Paranhos

Implant-supported prostheses hygiene and peri-implant tissues health are considered to be predictive factors for successful prosthetic rehabilitation. Therefore, the purpose of this study was to evaluate the effectiveness of brushing associated with oral irrigation measured as biofilm-removing capacity, maintenance of healthy oral tissues, and patient satisfaction. A randomized, crossover clinical trial was conducted with 38 patients who wore conventional maxillary complete dentures and mandibular overdentures retained by the O-ring system. The patients were instructed to use the following hygiene methods for 14 days: mechanical brushing [MB (brush and dentifrice - Control)]; and MB with oral irrigation [WP (Waterpik - Experimental)]. Biofilm-removing capacity and maintenance of healthy oral tissues were evaluated by the Modified Plaque Index (PI), Gingival Index (GI), Probing Depth (PD), and Bleeding on Probing Index (BP) recorded at baseline and after each method. In parallel, patients answered a specific questionnaire using a Visual Analogue Scale after each hygiene method. Data were analyzed by Friedman and Wilcoxon tests (α=0.05). The results showed significantly lower PI, GI, PD, and BP indices after application of the hygiene methods (P<0.001) than those observed at baseline. However, no significant difference was found between MB and WP. The satisfaction questionnaire responses to both methods showed high mean values for all questions, with no statistically significant difference found between the answers given after the use of MB and WP (P>0.05). The findings suggest that WP was effective in reducing PI, GI, PD, and BP indices and provided a high level of patient satisfaction.


Combination of genotypes of main types’ genetic markers causes milk productivity in cattle. The article studies correlation between kappa casein genotypes (C3N3), beta-lactoglobulin (LGB), their complexes and milk production indices in cows bred under equal conditions at a breeding farm. The calculation of parental milk yield and fat indices between the three breeds showed a significant difference (P>0,999) of PCI of Ayrshire and Holstein cattle breed milk yield - 3395 kg, PCI of fat - 0,22%; between Holstein and Yaroslavl cattle breeds - 3200 kg, PCI offat - 0,16%. A significant difference of realization indices of protein between all three breeds was not stated. The highest realization ofparental milk yield index was stated - between Ayrshire and Yaroslavl cattle breeds- 113%, Holstein cattle breed - 88%. As for the fat and protein indices, all three cattle breeds showed a high realization of PCI from 98% to 109%. However, Holstein cattle breed showed the highest percentage: protein - 101%, fat - 109%. A significant difference of PCI realization of milk productivity in CSN3 and LGB genotypes was not stated. It was also stated that there is a tendency of high level parental indices realization when there is a higher number of B-allele variants in genotypes of cows.


Total twenty different processed meat plant producing emulsion type sausage were histologically and chemically examined for detection of adulteration with unauthorized tissues. Results revealed that samples were adulterated with different types of animal tissues included; hyaline cartilage, tendon, spongy bone, peripheral nerve trunk, basophilic matrix, lymphatic tissue, fascia, fibrocartilage and vascular tissue. Moreover, these samples were adulterated Also, adulterated with plant tissue included; plant stem, leaves and root. Chemical analysis showed a significant difference in their chemical composition (moisture, fat, protein, ash and calcium) content. Moisture and fat content varied around the permissible limit of E.S.S. while low protein, high ash and calcium content was detected in the examined samples. Therefore, Histological and chemical examinations can be used as reliable methods to detect adultration using unauthorized addition of both animal and plant tissues in processed meat product samples which revealed a high level of falsification.


Author(s):  
Richard Stone ◽  
Minglu Wang ◽  
Thomas Schnieders ◽  
Esraa Abdelall

Human-robotic interaction system are increasingly becoming integrated into industrial, commercial and emergency service agencies. It is critical that human operators understand and trust automation when these systems support and even make important decisions. The following study focused on human-in-loop telerobotic system performing a reconnaissance operation. Twenty-four subjects were divided into groups based on level of automation (Low-Level Automation (LLA), and High-Level Automation (HLA)). Results indicated a significant difference between low and high word level of control in hit rate when permanent error occurred. In the LLA group, the type of error had a significant effect on the hit rate. In general, the high level of automation was better than the low level of automation, especially if it was more reliable, suggesting that subjects in the HLA group could rely on the automatic implementation to perform the task more effectively and more accurately.


2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Bingran Wang ◽  
Tiancheng Lou ◽  
Lingling Wei ◽  
Wenchan Chen ◽  
Longbing Huang ◽  
...  

AbstractAlternaria alternata, a causal agent of leaf blights and spots on a wide range of hosts, has a high risk of developing resistance to fungicides. Procymidone, a dicarboximide fungicide (DCF), has been widely used in controlling Alternaria leaf blights in China for decades. However, the resistance of A. alternata against DCFs has rarely been reported from crucifer plants. A total of 198 A. alternata isolates were collected from commercial fields of broccoli and cabbage during 2018–2019, and their sensitivities to procymidone were determined. Biochemical and molecular characteristics were subsequently compared between the high-level procymidone-resistant (ProHR) and procymidone-sensitive (ProS) isolates, and also between ProHR isolates from broccoli and cabbage. Compared with ProS isolates, the mycelial growth rate, sporulation capacity and virulence of most ProHR isolates were reduced; ProHR isolates displayed an increased sensitivity to osmotic stresses and a reduced sensitivity to sodium dodecyl sulfate (SDS); all ProHR isolates showed a reduced sensitivity to hydrogen peroxide (H2O2) except for the isolate B102. Correlation analysis revealed a positive cross-resistance between procymidone and iprodione, or fludioxonil. When treated with 10 μg/mL of procymidone, both mycelial intracellular glycerol accumulations (MIGAs) and relative expression of AaHK1 in ProS isolates were higher than those in ProHR isolates. Sequence alignment of AaHK1 from ten ProHR isolates demonstrated that five of them possessed a single-point mutation (P94A, V612L, E708K or Q924STOP), and four isolates had an insertion or a deletion in their coding regions. No significant difference in biochemical characteristics was observed among ProHR isolates from two different hosts, though mutations in AaHK1 of the cabbage-originated ProHR isolates were distinct from those of the broccoli-originated ProHR isolates.


Sensors ◽  
2021 ◽  
Vol 21 (12) ◽  
pp. 3956
Author(s):  
Youngsun Kong ◽  
Hugo F. Posada-Quintero ◽  
Ki H. Chon

The subjectiveness of pain can lead to inaccurate prescribing of pain medication, which can exacerbate drug addiction and overdose. Given that pain is often experienced in patients’ homes, there is an urgent need for ambulatory devices that can quantify pain in real-time. We implemented three time- and frequency-domain electrodermal activity (EDA) indices in our smartphone application that collects EDA signals using a wrist-worn device. We then evaluated our computational algorithms using thermal grill data from ten subjects. The thermal grill delivered a level of pain that was calibrated for each subject to be 8 out of 10 on a visual analog scale (VAS). Furthermore, we simulated the real-time processing of the smartphone application using a dataset pre-collected from another group of fifteen subjects who underwent pain stimulation using electrical pulses, which elicited a VAS pain score level 7 out of 10. All EDA features showed significant difference between painless and pain segments, termed for the 5-s segments before and after each pain stimulus. Random forest showed the highest accuracy in detecting pain, 81.5%, with 78.9% sensitivity and 84.2% specificity with leave-one-subject-out cross-validation approach. Our results show the potential of a smartphone application to provide near real-time objective pain detection.


2021 ◽  
Vol 10 (12) ◽  
pp. 2636
Author(s):  
Ka Wing Ma ◽  
Hoonsub So ◽  
Euisoo Shin ◽  
Janice Hoi Man Mok ◽  
Kim Ho Kam Yuen ◽  
...  

There is limited evidence on the standard care for painful obstructive chronic pancreatitis (CP), while comparisons of endoscopic and surgical modes for pain relief have yielded conflicting results from small sample sizes. We aimed to obtain a clear picture of the matter by a meta-analysis of these results. We searched the Pubmed, Embase, and Cochrane Library databases to identify studies comparing endoscopic and surgical treatments for painful obstructive CP. Pooled effects were calculated by the random effect model. Primary outcomes were overall pain relief (complete and partial), and secondary outcomes were complete and partial pain relief, complication rate, hospitalization duration, and endocrine insufficiency. Seven studies with 570 patients were included in the final analysis. Surgical drainage was associated with superior overall pain relief [OR 0.33, 95% CI 0.23–0.47, p < 0.001, I2 = 4%] and lesser incidence of endocrine insufficiency [OR 2.10, 95% CI 1.20–3.67, p = 0.01, I2 = 0%], but no significant difference in the subgroup of complete [OR 0.57, 95% CI 0.32–1.01, p = 0.054, I2 = 0%] or partial [OR 0.67, 95% CI 0.37–1.22, p = 0.19, I2 = 0%] pain relief, complication rates [OR 1.00, 95% CI 0.41–2.46, p = 0.99, I2 = 49%], and hospital stay [OR −0.54, 95% CI −1.23–0.15, p = 0.13, I2 = 87%] was found. Surgery is associated with significantly better overall pain relief and lesser endocrine insufficiency in patients with painful obstructive CP. However, considering the invasiveness of surgery, no significant differences in complete or partial pain relief, and heterogeneity of a few parameters between two groups, endoscopic drainage may be firstly performed and surgical drainage may be considered when endoscopic drainage fails.


2015 ◽  
Vol 114 (6) ◽  
pp. 3351-3358 ◽  
Author(s):  
Stefania de Vito ◽  
Marine Lunven ◽  
Clémence Bourlon ◽  
Christophe Duret ◽  
Patrick Cavanagh ◽  
...  

When we look at bars flashed against a moving background, we see them displaced in the direction of the upcoming motion (flash-grab illusion). It is still debated whether these motion-induced position shifts are low-level, reflexive consequences of stimulus motion or high-level compensation engaged only when the stimulus is tracked with attention. To investigate whether attention is a causal factor for this striking illusory position shift, we evaluated the flash-grab illusion in six patients with damaged attentional networks in the right hemisphere and signs of left visual neglect and six age-matched controls. With stimuli in the top, right, and bottom visual fields, neglect patients experienced the same amount of illusion as controls. However, patients showed no significant shift when the test was presented in their left hemifield, despite having equally precise judgments. Thus, paradoxically, neglect patients perceived the position of the flash more veridically in their neglected hemifield. These results suggest that impaired attentional processes can reduce the interaction between a moving background and a superimposed stationary flash, and indicate that attention is a critical factor in generating the illusory motion-induced shifts of location.


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