This is the first tomography-presentation of the optical properties of a normal canine prostate,in vivo,in its native intact environment in the pelvic canal.The imaging was performed by trans-rectal near-infrared(NIR)...This is the first tomography-presentation of the optical properties of a normal canine prostate,in vivo,in its native intact environment in the pelvic canal.The imaging was performed by trans-rectal near-infrared(NIR)optical tomography in steady-state measurement at 840 nm on three sagittal planes across the right lobe,middle-line,and left lobe,respectively,of the prostate gland.The NIR imaging planes were position-correlated with concurrently applied trans-rectal ultrasound,albeit there was no spatial prior employed in the NIR tomography reconstruction.The reconstructed peak absorption coefficients of the prostate on the three planes were 0.014,0.012,and 0.014mm^(−1).The peak reduced scattering coefficients were 5.28,5.56,and 6.53 mm^(−1).The peak effective attenuation coefficients were 0.45,0.43,and 0.50 mm^(−1).The absorption and effective attenuation coefficients were within the ranges predictable at 840 nm by literature values which clustered sparsely from 355 nm to 1064 nm,none of which were performed on a canine prostate with similar conditions.The effective attenuation coefficients of the gland were shown to be generally higher in the internal aspects than in the peripheral aspects,which is consistent with the previous findings that the urethral regions were statistically more attenuating than the capsular regions.展开更多
BACKGROUND Cholecystectomy is the preferred treatment option for symptomatic gallstones.However,another option is gallbladder-preserving cholecystolithotomy which preserves the normal physiological functions of the ga...BACKGROUND Cholecystectomy is the preferred treatment option for symptomatic gallstones.However,another option is gallbladder-preserving cholecystolithotomy which preserves the normal physiological functions of the gallbladder in patients desiring to avoid surgical resection.AIM To compare the feasibility,safety and effectiveness of pure natural orifice transluminal endoscopic surgery(NOTES)gallbladder-preserving cholecystolithotomy vs laparoscopic cholecystectomy(LC)for symptomatic gallstones.METHODS We adopted propensity score matching(1:1)to compare trans-rectal NOTES cholecystolithotomy and LC patients with symptomatic gallstones.We reviewed 2511 patients with symptomatic gallstones from December 2017 to December 2020;517 patients met the matching criteria(NOTES,110;LC,407),yielding 86 pairs.RESULTS The technical success rate for the NOTES group was 98.9%vs 100%for the LC group.The median procedure time was 119 min[interquartile ranges(IQRs),95-175]with NOTES vs 60 min(IQRs,48-90)with LC(P<0.001).The frequency of post-operative pain was similar between NOTES and LC:4.7%(4/85)vs 5.8%(5/95)(P=0.740).The median duration of post-procedure fasting with NOTES was 1 d(IQRs,1-2)vs 2 d with LC(IQRs,1-3)(P<0.001).The median post-operative hospital stay for NOTES was 4 d(IQRs,3-6)vs 4 d for LC(IQRs,3-5),(P=0.092).During follow-up,diarrhea was significantly less with NOTES(5.8%)compared to LC(18.6%)(P=0.011).Gallstones and cholecystitis recurrence within a median of 12 mo(range:6-40 mo)following NOTES was 10.5%and 3.5%,respectively.Concerns regarding the presence of abdominal wall scars were present in 17.4%(n=15/86)of patients following LC(mainly women).CONCLUSION NOTES provides a feasible new alternative scar-free treatment for patients who are unwilling or unable to undergo cholecystectomy.This minimally invasive organ-sparing procedure both removes the gallstones and preserves the physiological function of the gallbladder.Reducing gallstone recurrence is essential to achieving widespread clinical adoption of NOTES.展开更多
Chordomas are rare tumors which originate from the remnants of the notochord. These tumors are locally aggressive and have a predilection for the ends of the axial skeleton. An important prerequisite for optimal manag...Chordomas are rare tumors which originate from the remnants of the notochord. These tumors are locally aggressive and have a predilection for the ends of the axial skeleton. An important prerequisite for optimal management of these tumors is a correct preoperative diagnosis. The present case is the first report of the use of endoscopic ultrasound to obtain transrectal fine needle aspiration biopsy of a presacral chordoma. A review of the prior computer tomography (CT) scans allowed us to calculate the tumor volume doubling time (18.3 mo). Transrectal biopsy of chordomas is controversial, however we believe that such concerns are not justified.展开更多
基金the Prostate Cancer Research Program of the US Army Medical Research Acquisition Activity(USAMRAA),820 Chandler Street,Fort Detrick,MD,21702-5014,through a Grant#W81XWH-07-1-0247.
文摘This is the first tomography-presentation of the optical properties of a normal canine prostate,in vivo,in its native intact environment in the pelvic canal.The imaging was performed by trans-rectal near-infrared(NIR)optical tomography in steady-state measurement at 840 nm on three sagittal planes across the right lobe,middle-line,and left lobe,respectively,of the prostate gland.The NIR imaging planes were position-correlated with concurrently applied trans-rectal ultrasound,albeit there was no spatial prior employed in the NIR tomography reconstruction.The reconstructed peak absorption coefficients of the prostate on the three planes were 0.014,0.012,and 0.014mm^(−1).The peak reduced scattering coefficients were 5.28,5.56,and 6.53 mm^(−1).The peak effective attenuation coefficients were 0.45,0.43,and 0.50 mm^(−1).The absorption and effective attenuation coefficients were within the ranges predictable at 840 nm by literature values which clustered sparsely from 355 nm to 1064 nm,none of which were performed on a canine prostate with similar conditions.The effective attenuation coefficients of the gland were shown to be generally higher in the internal aspects than in the peripheral aspects,which is consistent with the previous findings that the urethral regions were statistically more attenuating than the capsular regions.
基金Supported by Outstanding Foreign Scientist Studio Project of Henan Province,No.GZS2020006.
文摘BACKGROUND Cholecystectomy is the preferred treatment option for symptomatic gallstones.However,another option is gallbladder-preserving cholecystolithotomy which preserves the normal physiological functions of the gallbladder in patients desiring to avoid surgical resection.AIM To compare the feasibility,safety and effectiveness of pure natural orifice transluminal endoscopic surgery(NOTES)gallbladder-preserving cholecystolithotomy vs laparoscopic cholecystectomy(LC)for symptomatic gallstones.METHODS We adopted propensity score matching(1:1)to compare trans-rectal NOTES cholecystolithotomy and LC patients with symptomatic gallstones.We reviewed 2511 patients with symptomatic gallstones from December 2017 to December 2020;517 patients met the matching criteria(NOTES,110;LC,407),yielding 86 pairs.RESULTS The technical success rate for the NOTES group was 98.9%vs 100%for the LC group.The median procedure time was 119 min[interquartile ranges(IQRs),95-175]with NOTES vs 60 min(IQRs,48-90)with LC(P<0.001).The frequency of post-operative pain was similar between NOTES and LC:4.7%(4/85)vs 5.8%(5/95)(P=0.740).The median duration of post-procedure fasting with NOTES was 1 d(IQRs,1-2)vs 2 d with LC(IQRs,1-3)(P<0.001).The median post-operative hospital stay for NOTES was 4 d(IQRs,3-6)vs 4 d for LC(IQRs,3-5),(P=0.092).During follow-up,diarrhea was significantly less with NOTES(5.8%)compared to LC(18.6%)(P=0.011).Gallstones and cholecystitis recurrence within a median of 12 mo(range:6-40 mo)following NOTES was 10.5%and 3.5%,respectively.Concerns regarding the presence of abdominal wall scars were present in 17.4%(n=15/86)of patients following LC(mainly women).CONCLUSION NOTES provides a feasible new alternative scar-free treatment for patients who are unwilling or unable to undergo cholecystectomy.This minimally invasive organ-sparing procedure both removes the gallstones and preserves the physiological function of the gallbladder.Reducing gallstone recurrence is essential to achieving widespread clinical adoption of NOTES.
文摘Chordomas are rare tumors which originate from the remnants of the notochord. These tumors are locally aggressive and have a predilection for the ends of the axial skeleton. An important prerequisite for optimal management of these tumors is a correct preoperative diagnosis. The present case is the first report of the use of endoscopic ultrasound to obtain transrectal fine needle aspiration biopsy of a presacral chordoma. A review of the prior computer tomography (CT) scans allowed us to calculate the tumor volume doubling time (18.3 mo). Transrectal biopsy of chordomas is controversial, however we believe that such concerns are not justified.
