Abdominal Shape Research Articles

Abdominoplasty Combined with the Anterior Component Separation Technique for Reconstruction of Midline Large Ventral Hernias: Functional and Aesthetic Outcome Clinical Study

Abstract Background Large midline ventral hernias, diastasis of recti and the associated laxity and abdominal shape deformity, represent aesthetic and functional problems for the patients. So, the surgical treatment of both pathologies at the same time is highly recommended if the patient’s general condition permits. This can be achieved by a comprehensive technique incorporating abdominoplasty performed by a transverse lower abdominal incision into any of the hernia repair techniques. Objective The aim of this study is to evaluate the functional and aesthetic outcome of the combined abdominoplasty and anterior component separation technique in the management of midline ventral abdominal hernias. Patients and Methods This study is a prospective case control study that evaluates both functional and aesthetic outcome of performing abdominoplasty on patients with large midline ventral hernias. This study was conducted between December 2020 to March 2022 at the Plastic Surgery Department, Demerdash University Hospital, Cairo, Egypt. Study consisted of fifteen patients with different presentations of abdominal wall laxity and ventral hernias. Patients were evaluated regarding their age, BMI, degree of rectus diastasis, Pre-operative radiological findings, post Operative complication and hernia reoccurrence, patients’ satisfaction, and the pre-operative and post-operative umbilical measurements were compared. Results and Conclusion The current study showed that Abdomioplasty can be combined with complex hernia repair by anterior component separation technique within the same setting in high-risk patients safely with an excellent functional outcome and acceptable satisfactory aesthetic results. Although, this can be associated with an increased risk of postoperative surgical site complications such as; skin necrosis and wound infection. Patient characteristics associated with the development of complications following anterior component separation combined with abdominoplasty include obesity, previous abdominal procedures and previous pregnancies.

Autonomous scanning motion generation adapted to individual differences in abdominal shape for robotic fetal ultrasound

The shortage of obstetricians and gynecologists is increasing in developed countries; therefore, there is a need to improve prenatal care procedures. To automate fetal ultrasound (US) imaging, this paper presents a deep neural network (DNN) model that generates US scan motions for a robot. Additionally, the robot can adapt to the abdominal surface even if the abdominal shape is not precisely known. The latent space of the DNN model is designed to represent the abdominal-shape information. The DNN model can predict the proper trajectory by mapping the height and width of the abdomen to the latent space. Moreover, the robot can detect any deviations from the correct trajectory and return to the right position. For validation, we performed a US scan using the proposed model on tissue-mimicked phantoms that were not used for training. Subsequently, we evaluated the number of dots that were wiped off by the robot from the phantom surface. Overall, the number of dots removed accounted for 91.7% of the total dots. The results demonstrated the feasibility of using the DNN model for motion generation. Hence, the proposed system has the potential to automate fetal US scans according to the individual differences in the abdominal shape.

Aesthetic Outcomes and Patient Satisfaction in Laparoscopic vs. Open Incisional Hernia Repair: Have We Asked the Patients?

Background: Incisional hernias are predominantly treated through open or laparoscopic surgery, with each method influencing recovery and patient-reported outcomes. This underscores the need for reliable assessment tools such as the EuraHS-QoL questionnaire to evaluate quality of life after surgery. Methods: This prospective single-center study was aimed at evaluating aestethic outcomes and patient satisfaction following laparoscopic versus open hernia repair. It involved 222 patients categorized by type of approach. The EuraHS-QoL questionnaire was used preoperatively and at 1- and 3-months post-surgery, with data analysis performed using Origin Pro 2018 and SPSS software version 28.0. Results: Among the participants, 152 were females and 70 males, with 78% undergoing open surgery and 22% laparoscopic. Findings revealed superior patient outcomes with laparoscopic repair in terms of pain management, daily activities, and aesthetic satisfaction. Patients reported significantly lower pain levels and fewer restrictions in daily activities post-laparoscopic surgery. While initial postoperative cosmetic results favored laparoscopic methods, the perceived differences in abdominal shape diminished over time. Conclusions: Laparoscopic repair significantly improves quality of life compared to open surgery, as shown by EuraHS-QoL scores. These results support the use of laparoscopic techniques in appropriate cases due to their benefits in pain reduction and faster functional recovery.

Abdominal function and appearance of patients after repairing the extensive skin and soft tissue defects in the limbs with two types of lower abdominal tissue flaps

Objective: To study the abdominal function and appearance of patients after repairing the extensive skin and soft tissue defects in the limbs with two types of lower abdominal tissue flaps. Methods: A retrospective clinical controlled study was conducted. From June 2016 to October 2022, 17 patients with extensive skin and soft tissue defects in the limbs who met the inclusion criteria were admitted to the Department of Bone Hand Microsurgery of Shandong Wendeng Orthopedic Hospital, including 2 males and 15 females, aged 21-60 years, with a defect ranging from 15.0 cm×10.0 cm to 23.0 cm×15.0 cm. According to the applied repair method, the patients were divided into deep inferior epigastric perforator (DIEP) flap group (9 cases) with the defect wound being repaired by the DIEP flap and muscle sparing transverse rectus abdominis myocutaneous (MS-TRAM) flap group (8 cases) with the defect wound being repaired by the MS-TRAM flap. On post surgery day (PSD) 1, 3, 5, 7, and 14, the blood supply of the tissue flaps was evaluated using a self-made tissue flap blood supply evaluation scale. At 12 months after surgery, the patients' satisfaction with the efficacy of tissue flap repair was evaluated using the satisfaction score standard for flap efficacy. Before surgery and at 3 and 12 months after surgery, a self-made abdominal wall strength evaluation scale was used to evaluate the strength of abdominal wall. At 12 months after surgery, a self-made abdominal appearance evaluation scale was used to evaluate the condition of abdominal scars, degree of abdominal symmetry, the appearance and restoration of umbilicus, abdominal protrusion during dressing, and formation of folds on both sides of the abdomen. Data were statistically analyzed with analysis of variance for repeated measurement, independent sample t test, paired sample t test, and Fisher's exact probability test. Results: On PSD 1, 3, 5, 7, and 14, there was no significant change in the blood supply score of tissue flaps of patients in the two groups, and there was no statistically significant difference between the two groups (P>0.05). At 12 months after surgery, the satisfaction ratio of patients in DIEP flap group with tissue flap repair efficacy was 8/9, which was close to 7/8 in MS-TRAM flap group (P>0.05). The preoperative abdominal wall strength of patients between the two groups was similar (P>0.05), while the abdominal wall strength of patients in DIEP flap group was significantly stronger than that in MS-TRAM flap group at 3 and 12 months after surgery (with t values of 3.09 and 3.02, respectively, P<0.05). Compared with the preoperative strength within each group, the abdominal wall strength of patients in DIEP flap group at 3 months after surgery and in MS-TRAM flap group at 3 and 12 months after surgery decreased significantly (with t values of 6.04, 9.71, and 2.91, respectively, P<0.05), which did not change significantly in DIEP flap group at 12 months after surgery (P>0.05). At 12 months after surgery, the scores of abdominal scars, degree of abdominal symmetry, the appearance and restoration of umbilicus, abdominal protrusion during dressing, and formation of folds on both sides of the abdomen of patients were similar between the two groups (P>0.05). Conclusions: Free transplantation of DIEP flap and MS-TRAM flap to repair the extensive skin and soft tissue defects in the limbs can achieve good repair results, including good blood supply of tissue flap and abdominal shape, and the patients' high degree of satisfaction with the efficacy of tissue flap repair. However, DIEP flap is superior to MS-TRAM flap in terms of long-term postoperative abdominal wall strength recovery, showing a broader prospect of application.

Crustacean Female Sex Hormone (CFSH) Transcript and Protein Profiles and Its Functions in Gradually Developing Adult-Specific-Features during the Prepuberty Molt Cycle of the Blue Crab, Callinectes sapidus

Crustacean female sex hormone (CFSH) plays a pivotal role in developing adult-specific female characteristics, specifically the mating and parental care system of the female blue crab, Callinectes sapidus, manifested after the puberty-terminal molt. Therefore, this study aimed to determine if there is a relationship between CFSH and the development of phenotypes specific to the female C. sapidus during its life cycle and if the continued presence of CFSH is required for developing adult-specific features during the prepuberty molt cycle. First, CasCFSH transcripts in females steadily increase, starting from crab stages 3-4 to prepuberty, except for a decrease at crab stages 15-16. The prepuberty females have the highest CasCFSH transcripts, with ∼5.6-fold higher than adults. CFSH protein levels at prepuberty are the highest but similar to adults. The first and visible secondary female characteristics include a pair of gonopores or a triangular abdomen and four pairs of pleopods seen as early as crab stages at ∼3 (carapace width, CW, 5-7 mm) - 5 (CW 8-10 mm), respectively. The adult-specific female morphological features that are developed gradually throughout the prepuberty molt cycle are manifested only after the puberty-terminal molt. A CasCFSH knockdown study by injecting CasCFSH-dsRNA into prepuberty females at specific molt stages provides further evidence: the continued presence of CasCFSH is required for gradually developing adult-specific morphological features during the prepuberty molt cycle. Overall, the abdomen size is first determined at the intermolt stage. Then, the abdominal shape, gonopores, sternal tubercles, spermathecae, and ovigerous setae and hairs are formed at the intermolt and early premolt stages. Finally, the plumose hairs are developed during intermolt, early, and late premolt stages.

Ecological conditions and phenotypic characteristics of Austropotamobius torrentium (Schrank, 1803) in the Subotica and Toplik Rivers

Austropotamobius torrentium (Schrank, 1803) lives in two watercourses, namely Subotica (Sana) and Toplik (Tilava). The influence of the ecological conditions of these rivers on individuals of this species is analyzed based on 22 morphometric parameters. The assessment of abiotic conditions was done through the measurement of physical and chemical water parameters and the analysis of the composition of phytobenthos and macrozoobenthos. Sampling was carried out in June, September, and October 2021. Water quality at the investigated localities (on the basis of abiotic and biotic parameters) is oligo to betamesosaprobic. A total of 37 crayfish were analyzed (20 from Subotica and 17 from Toplik). Female crayfish have shown significant differences in the head width (HEW) and abdominal thickness (ABH). Males differed significantly in a number of parameters, including the weight (W), head shape (HEL and HEW), rostrum length (ROL), carapace width (CPW), and abdominal shape (ABH and ABL). Higher values of the indicated parameters have been found in the males from the Subotica River. The obtained results are influenced by different ecological conditions of their habitats. The Subotica River is a larger watercourse in the lowland belt with a large number of microhabitats, and the Toplik is a small river in the mountain belt, with uniform sediment and a small number of ecological niches of the analyzed species. The general ecological conditions in the water of both watercourses are also affected by aquaculture facilities, where wastewater has a direct influence on the distribution of Austropotamobius torrentium individuals in the watercourses of the Subotica and Toplik Rivers. For more detailed and complete data, it is necessary to analyze a larger number of individuals in both populations, and to include additional morphometric-meristic parameters and molecular-genetic analyses.

Development and Initial Validation of a Novel Professional Aesthetic Scale for the Female Abdomen.

A growing body of literature describes abdominal aesthetic goals to tailor surgical and nonsurgical treatment options to meet patient goals. The authors aimed to integrate layperson perceptions into the design of a novel professional aesthetic scale for the abdomen. An iterative process of expert consensus was used to choose five domains: abdominal muscle lines, abdominal shape, scar, skin, and umbilicus. A survey was developed to measure global and domain-specific aesthetic preferences on five abdomens. This was distributed through Amazon Mechanical Turk to 340 respondents. Principal component analysis was used to integrate survey data into weights for each of the scale's subquestions. Attending plastic surgeons then rated abdomens using the final scale, and reliability and validity were calculated. The final scale included 11 subquestions-hourglass shape, bulges, hernia, infraumbilical skin, supraumbilical skin, umbilicus shape, umbilicus medialization position, umbilicus height position, semilunar lines, central midline depression, and scar-within the five domains. Central midline depression held the highest weight (16.1 percent) when correlated with global aesthetic rating, followed by semilunar lines (15.8 percent) and infraumbilical skin (11.8 percent). The final scale demonstrated strong validity (Pearson r = 0.99) and was rated as easy to use by seven attending plastic surgeons. The final scale is the first published professional aesthetic scale for the abdomen that aims to integrate layperson opinion. This analysis and survey data provide insights into the importance of 11 components in overall aesthetic appeal of the abdomen.

Revision of the new Australasian orb-weaving spider genus Salsa (Araneae, Araneidae).

A new Australasian genus in the orb-weaving spider family Araneidae Clerck, 1757 is described to include seven species: Salsafuliginata (L. Koch, 1871) comb. nov. (type species; = Epeirarubicundula Keyserling, 1887) syn. nov.) (Australia, introduced to New Zealand); S.brisbanae (L. Koch, 1867) comb. nov. (Australia); S.canalae (Berland, 1924) comb. nov. (New Caledonia); S.neneba sp. nov. (Papua New Guinea); S.recherchensis (Main, 1954) comb. nov. (Australia); S.rueda sp. nov. (Australia); and S.tartara sp. nov. (Australia; Lord Howe Island endemic). Salsa gen. nov. belongs to the Australasian informal backobourkiine clade and differs from other genera of this clade by a distinct abdominal shape (single posterior abdominal tubercle) and ventral colouration (pale lateral spindle-shaped bands), male pedipalp morphology (C-shaped median apophysis that has teeth-like tubercles inside the basal arch) and the shape of the female epigyne scape (partially translucent and generally shorter than the epigyne plate). Based mainly on male pedipalp morphology within the backobourkiines, Salsa gen. nov. has closest morphological affinities with Acroaspis Karsch, 1878 and Socca Framenau, Castanheira & Vink, 2022.

A Sensor-augmented Belt toward Abdominal Shape Measurement System

A Sensor-augmented Belt toward Abdominal Shape Measurement System

A Simple Predictive Index of the Abdominal Shape for Postoperative Complications After Laparoscopy-Assisted Distal Gastrectomy for Gastric Cancer.

Background: The purpose of this study was to explore the effect of abdominal shape on the short-term surgical outcomes.Methods: This was a retrospective study that included 425 patients undergoing laparoscopic distal gastrectomy plus D2 lymph node dissection (LADG) from January 2013 to January 2021. The abdominal parameters, including the shortest distance of the pancreas from the anterior abdominal skin (PAAD), the lower sternum angle (LSA), the thickness of the subcutaneous fat at the navel level (SFT), the anteroposterior diameters (APD) and the left-right diameters (LRD) at the navel level, the distance from the xiphoid process to the navel (XND) and the distance from the xiphoid process to the pubis (XBD), were calculated by preoperative abdominal computed tomography (CT) imaging. The parameters and short-term surgical outcomes were analyzed.Results: In males, the number of retrieved lymph nodes was significantly higher in patients with a lower APD group (p = 0.031). The operation time was significantly shorter in the lower body mass index (BMI) (p = 0.007), lower LSA (p = 0.035), lower PAAD (p = 0.000), lower SFT (p = 0.004), lower APD (p = 0.000) and lower LRD (p = 0.014) groups. The estimated blood loss was significantly less in the lower BMI (p = 0.035), lower LSA (p = 0.001), lower PAAD (p = 0.012), lower SFT (p = 0.003), lower APD (p = 0.000) and lower LRD (p = 0.005) groups. The complications were fewer in the lower LSA (p = 0.012), lower APD (p = 0.043) and lower LRD (p = 0.023) groups. In females, the postoperative hospital stay was shorter in the lower PAAD (p = 0.027) and lower SFT (p = 0.004) groups, and the lower SFT group had fewer complications (p = 0.020). Furthermore, in multivariate analysis, higher PAAD (p = 0.037, odds ratio = 1.030, 95% CI = 1.002–1.059) was an independent factor for predicting postoperative complications in males.Conclusion: Various abdominal shapes can affect the difficulty of LADG. Higher PAAD is a simple independent index for predicting postoperative complications in males.

A MANAGEMENT OF YAKRIT VRIDDHI (HEPATOMEGALY) BY SHODHANA CHIKITSA (VIRECHANA) FOLLOWED BY SHAMAN CHIKITSA (ARKA MAKOI): A CASE STUDY

A 39-year-old man with clinical sign and symptoms of poor appetite, nausea, fatigue, distend abdomen, increased abdominal size and shape, abdominal pain, indigestion, vomiting sensation diagnosed as Yakrit Vriddhi or Yakrit-dalodar (Hepatomegaly). As per Ayurveda Samhita Shodhana Chikitsa is more effective in such type of patient. In this case after the routine examination i.e., History, Palpation, Blood Investigation (LFT), and Ultrasonography patient was treated by Panchakarma treatment. (Bio-purification therapy) In this Poorva Karma (Snehan- Bahya/Abhyantara) and Pradhana Karma (Abhayadimodak - Virechana Karma) in which vitiated doshas were expelled through Adhomarga (Anal route). After the Virechana Karma for restoration of the body Sansarjana Karma (Ayurvedic Dietary &amp; Behavior regimen) was also done. The patient was on purgation 26 times (Vegas). At the end of the virechana karma Kapha was presented in the stool (Kaphant-Virechana). After the complete procedure followed by palliative treatment with Arka Makoi (Solanum nigrum) patient felt remarkable relief from above cited symptoms i.e., poor appetite, nausea, fatigue, distend abdomen, increased abdominal size and shape, abdominal pain, indigestion, vomiting sensation. The therapeutic purgation is safe and effective Panchakarma protocol to eliminate the morbid Pitta Dosha in the body either by pathological condition or diet and behavioral mismanagement.

Measuring organ shift and deformation for port placement in robot-assisted minimally invasive surgery

ObjectivePort placement is a crucial pre-operative task in robot-assisted minimally invasive surgery. Due to the insufflation process, the abdominal shape is deformed while the internal organs are shifted in position. These changes need to be considered when determining the optimal port locations for the robotic manipulators. However, intra-operative medical image acquisition systems are not always available. In this study, we aim to estimate the shift extent of the abdominal organs in humans by measuring the changed volume and position of the abdominal organs before and after insufflation in three pigs. MethodsA 3D model of the abdomen and abdominal organs was reconstructed from 3D images of the pigs taken by an MRI scanner before and after insufflation. Position shift and shape changes of the abdominal organs after insufflation were determined. The corresponding shift in port location for the robotic manipulators was determined based on the abdominal model. ResultsOrgan movements as a result of insufflation ranged from 6.37 ± 0.10 cm for the spleen, to 1.64 ± 0.22 cm for the liver. Even a slight planar motion of the target organ (e.g., 1.33 ± 0.06 cm, 2.38 ± 0.21 cm in X-Y plane for the left kidney) can shift the access port for the robot manipulator by about 1.6 cm on the abdominal surface. ConclusionsThe target organs’ motion due to insufflation is a critical factor in determining port locations in robot-assisted minimally invasive surgery.

Population Growth of Fruit Flies (Drosophilla melanogaster) Using The Barangan Banana (Musa paradisiaca) was tested in the FKIP UISU Medan Laboratory

This study aims to: 1) recognize fruit flies (Drosophila melanogaster), 2) morphologically distinguish adult fruit fly sex, 3) study the growth of fruit fly populations. The practicum was held on August 20, 2019 in the Biology Education Laboratory FKIP UISU. The working principle of practicum is making food as a medium for fruit fly culture (a mixture of bananas, cassava tape, benzoate), etherization and observation, observing the growth of fruit fly populations. Observations were made by counting the number of live flies and dead flies, the sex ratio of flies. Observations were carried out every day, for 15 days (20 August 2019 - 3 September 2019). The results of the analysis show that: 1) population growth of Drosophila melanogaster includes logistic growth models with S-shaped curves, 2) sex of adult fruit flies can be morphologically distinguished through body size, abdominal shape, genital comb and external genital organs in the abdomen. Based on the results and discussion, the following conclusions are obtained: 1) fruit flies including insects undergoing perfect metamorphosis (egg phase, larvae, pupa, imago), 2) differences in adult fruit fly sex can be seen from body size, abdomen shape, presence of genital comb, external genital organs in the abdomen, 3) population growth of fruit flies including logistic growth models in the form of S curves, influenced by environmental factors

Abdominal Wall Reconstruction

The closure of the abdominal wall defects is a fascinating field within surgery. The combined strength of sutures and scar after simple approximation of tissues in many cases does not suffice to contain the abdominal viscera and an incisional hernia results. Surgical failure can be seen immediately in the dramatic form of a dehiscence or can emerge slowly over time with a change in the abdominal shape and contour. This chapter delves into the theory and practicum of how a surgeon can approximate two halves of an abdominal wall together to resist the inherent tensile forces that exist and create a durable closure. This review contains 19 figures and 35 references Key Words: bioprosthetic, bridging, component release, force distribution, foreign body reaction, gap formation, hernia, laparotomy, mesh, perforator preservation, rectus diastasis, suture pull-through, TAR release

Xipho-pubic angle (XPA) correlates with patient's reported outcomes in a population of adult spinal deformity: results from a multi-center cohort study.

Retrospective multi-center cohort study. Sagittal misalignment causes changes in the abdominal shape. Xipho-pubic angle (XPA) has been previously described to radiographically evaluate the shape of the abdominal cavity in patients with spine deformity. The aims of this study are to evaluate the correlation of XPA-to-spinopelvic sagittal parameters and to patients' health-related quality-of-life (HRQoL) scores. 278 patients from a multi-center database with diagnosis adult spinal deformity (ASD) (one or more of: coronal Cobb angle>20°, sagittal vertical axis (SVA)>50mm, pelvic tilt (PT)>25°, and thoracic kyphosis>60°) were included. Cut-off values for moderate and severe disability (ODI-Oswestry Disability Index-20 and 40%) were calculated. Pearson's correlation was tested between XPA and spinopelvic parameters and between XPA and HRQoL scores. The cut-off value of XPA to identify ODI severe disability (40/100) was identified with XPA smaller than 103°; minimal (20/100) disability was identified by XPA greater than 113°. XPA showed strong correlation to sagittal spinopelvic parameters-PT, SVA, lumbar lordosis (LL), pelvic incidence (PI) minus LL-and to HRQoL scores-ODI, SF-36 PCS and SRS-22 activity and pain. XPA was the parameter with the strongest correlation to HRQoL scores. Xipho-pubic angle reflects changes in spinal changes and has strong correlation to HRQoL and spinopelvic parameters. It can discriminate between patients with minimal, moderate, and severe disability as measured by ODI scores. These slides can be retrieved under Electronic Supplementary Material.

Bloating and Abdominal Distension: Old Misconceptions and Current Knowledge

Bloating, as a symptom and abdominal distension, as a sign, are both common functional-type complaints and challenging to manage effectively. Individual patients may weight differently the impact of bloating and distension on their well-being. Complaints may range from chronic highly distressing pain to simply annoying and unfashionable protrusion of the abdomen. To avoid mishaps, organic bloating, and distension should always be considered first and appropriated assessed. Functional bloating and distension often present in association with other manifestations of irritable bowel syndrome or functional dyspepsia and in that context patients tend to regard them as most troublesome. A mechanism-based management bloating and distension should be ideal but elucidating key operational mechanisms in individual patients is not always feasible. Some clues may be gathered through a detailed dietary history, by assessing bowel movement frequency and stool consistency and special imaging technique to measure abdominal shape during episodes of distension. In severe, protracted cases it may be appropriate to refer the patient to a specialized center where motility, visceral sensitivity, and abdominal muscle activity in response to intraluminal stimuli may be measured. Therapeutic resources focussed upon presumed or demonstrated pathogenetic mechanism include dietary modification, microbiome modulation, promoting gas evacuation, attenuating visceral perception, and controlling abdominal wall muscle activity via biofeedback.

Role of obesity and abdominal shape morphometric features to predict postoperative complications and quality of lymph node dissection of gastrectomy for gastric cancer.

Obesity and abdominal shape morphometric features have been thought to be independent risk factors for surgical outcomes after gastrectomy.A total of 113 patients undergoing surgery for primary gastric adenocarcinoma from June 2011 to January 2015 were retrospectively included. Body mass index, visceral fatty area, anterior-posterior abdominal and transverse diameters and depth ratio at levels of the umbilicus, the gastroesophageal junction and the root of the celiac artery were measured or calculated. Patients were grouped according to body mass index (<25.0 kg/m2or ≥25.0 kg/m2) or median value of these parameters. Surgical outcomes including postoperative complications, total and metastatic lymph node numbers and their ratio were compared.There was a significant association between body mass index and abdominal shape indexes. Body mass index and abdominal shape indexes showed no statistical significance on development of complications. But, lymph node numbers and their ratio were negatively affected by depth ratio at the root of the celiac artery.Our findings showed that gastrectomy with curative intent can be performed safely in patients with higher body mass index and abdominal shape indexes. Therefore, there is no need to perform any change in surgical strategy according to these measurements and calculations.

Impact of Abdominal Shape on Short-Term Surgical Outcome of Laparoscopy-Assisted Distal Gastrectomy for Gastric Cancer

BackgroundLaparoscopy-assisted distal gastrectomy (LADG) has been widely accepted for the treatment for gastric cancer. The aim of the present study was to explore the impact of abdominal shape parameters on gastric antrum cancer patients’ short-term surgical outcomes of LADG with D2 lymph node dissection in both genders, including the number of lymph nodes retrieved and surgical safety index. MethodsThis was a retrospective analysis of 177 gastric antrum cancer patients, who underwent LADG between April 2009 and January 2016. The abdominal shape parameters, including abdominal anterior-posterior diameter (APD), transverse diameter (TD), xiphoid process of the sternum-navel distance (XND), and thickness of subcutaneous fat (SCF) at the umbilicus level, were calculated by preoperative abdominal computed tomography (CT) scans. The effects of abdominal shape parameters on the short-term surgical outcomes of LADG were analyzed. ResultsIn male patients undergoing LADG and D2 lymph node dissection, the number of retrieved lymph nodes was significantly lower in patients with APD ≥17.3 cm (P = 0.005), TD ≥27.4 cm (P = 0.029), SCF ≥1.2 cm (P = 0.014), and BMI ≥22.2 (P = 0.008), whereas in female patients, these were statistically insignificant (P > 0.05). APD, TD, SCF, and BMI were negatively correlated with the number of retrieved lymph nodes in male patients. There was no significant difference in the number of lymph nodes retrieved between high-XND group and low-XND group in either gender. Operation time was significantly shorter in male patients with XND < 17.0 cm (P = 0.044) and in female patients with SCF < 2.15 cm (P = 0.013). Intraoperative blood loss and postoperative complication rate were not significantly different between high- and low-APD groups, high- and low-TD groups, high- and low-XND groups, and high- and low-SCF groups in either gender. Compared with male patients, SCF and TD were significantly higher in female patients. In addition, a higher incidence rate of hypertension was observed in patients of both genders with large APD and SCF, although statistically significant only in male patients. ConclusionsLADG with D2 lymph node dissection can effectively achieve the lymph node dissection requirement of radical distal gastrectomy for patients with various abdominal shapes. It is worth noting that APD, TD, and SCF can impact on lymph node dissection of LADG in male patients. Nevertheless, in female patients, abdominal shape do not impact on lymph node dissection of LADG. Moreover, LADG with D2 lymph node dissection is proved to be safe for various abdominal shape in both genders, even for abdominal obese patients.

Descripción de cuatro especies nuevas del subgrupo Drosophila fasciola, gruporepleta (Diptera, Drosophilidae) en dos bosques nublados del Ecuador

RESUMEN En el presente trabajo se describen cuatro miembros nuevos del grupoDrosophila repleta capturados en dos bosques nublados del Ecuador. Las nuevas especies fueron agrupadas dentro del subgrupo D. fasciola basados en el patrón de pigmentación del tórax y la morfología de la genitalia masculina. Drosophila inti sp. nov.,D. nigua sp. nov. y D. yambe sp. nov. fueron capturadas con trampas de banano, mientras que D. carvalhoi sp. nov. fue recolectada en inflorescencias deAnthurium sp. La pigmentación del abdomen y la forma del edeago de D. nigua sp. nov., D. yambe sp. nov. y D. carvalhoi sp. nov. indicarían que están relacionadas entre ellas, mientras que D. inti sp. nov. sería más cercana aD. linearepleta Patterson &amp; Wheeler, 1942.

Computerized Liver Segmentation from CT Images using Probabilistic Level Set Approach

Accurate segmentation of patient’s liver from his/her computed tomography–angiography (CTA) images is the preliminary component for a reliable computerized liver evaluation system. Flawlessness in liver diagnosis relies upon the precision in the segmentation of liver region from all the slices/images in a given patient dataset. Nevertheless, with the challenges like intensity similarity, partial volume effect of liver with its adjacent abdominal organs and liver shape variability across patients, achieving automated optimal liver region segmentation from acquired CT scans is difficult. This paper proposes a semisupervised liver segmentation technique, which adjusts the segmentation parameters for each patient through continuous learning of patient’s CTA dataset properties in a Bayesian level set framework to address all the aforementioned challenges. In this framework, Bayesian probability model with spatial prior is utilized to initiate the level set and to derive an enhanced variable force and edge indication function that helps level set evolution to reach genuine liver boundaries in reduced time. The proposed model has been validated on standard MICCAI liver dataset, producing accuracy score of 79.