Paired Organs Research Articles

A multicentric study of practice of surgical site marking

Objective: The objective of this study was to evaluate the process of surgical site marking (SSM) and compare the actual practice with the recommended practices. Methodology: This was a prospective study involving 768 patients from 19 accredited hospitals located in different regions of India and are members of the Consortium of Accredited Healthcare Organizations. The study was performed over a period of 45 days. While performing the study, proportionate to size sampling methodology was used. The total number of surgeries performed per month in the top six specialties (in terms of volume) of the participating hospitals were considered. Further, in a particular specialty out of the six top specialties of the hospital, the auditors randomly selected the top three most frequently performed surgeries and studied the SSM process as per the predefined Pro forma. The observations of the study were then compared (and analyzed) with the recommended practices as per the guide to SSM, High 5 S by Haute Autorite d e Sante and CEPPRAL, October 2012. Results: In this study, the actual side marking was done in 85% of the surgeries that required side marking and 81% had site marking done. Surgical site in majority of the patients was marked in preoperative bay (43.8%). Moreover, surgical sites in 57.9% of the patients were marked by operating surgeons themselves, while others were delegated to nurses or technicians. Surgical side marking was done on 88.3% of the surgeries performed on paired organs. In surgeries with laterality such as hernia repair, the marking was done in 90% when the open surgery was performed and 70% for laparoscopic surgeries. Surgical site markings were visible before and after the site preparation in 63.2% and 46.5% of patients, respectively. It was pertinent to note that the SSM markings were not visible in 17.8% and 34.5% of the cases before and after skin preparation and 19% did not have the site marking. This percentage is quite high and thus an important area of concern. In addition, only in 36.1% of the patients, the SSM was visible within 6 inches from the incision. Crosses (27.7%) were the most common markings used. It is crucial that the nurses checked the patient's SSM only in 42.7% of cases in the wards and 74.1% of cases preoperatively in operation theater (OT), thereby a strong need to strengthening, streamlining, and standardization of the process of SSM to avoid missing out of cases. The surgical site marks were verbally and physically checked in 6.8% and 67.3% of the patients and not checked for 25.9% of the cases. Similarly, the surgical team inside the OT checked the surgical site marks verbally and physically in 17.6% and 77.7% of the patients, respectively. Conclusions: The findings of this study demonstrate that SSM procedure is practiced in majority of the hospital audited, but operating surgeons involved in this procedure were far from desired. Surgeons should be sensitized and educated and specialty-based protocols are to be framed so that they are strictly followed. There is a need to bring about national guidelines on the safe practice of SSM. Once protocols are in place and implemented, further studies will be required in future to assess their practice.

Анализ показателей микроциркуляции симметричных органов человека в условиях изменения артериального давления

It is known that a key link in a pathogenesis of many diseases, including arterial hypertension, is disturbances of microcirculation (MCR). Despite a considerable quantity of the publications on characteristics of MCR at patients with arterial hypertension, questions of functional asymmetry these characteristics and their interrelation with blood pressure till now are a little studied. Therefore the purpose of the present research was studying of features of left-right asymmetry in regulation of a vascular tonus of symmetric areas of paired organs under changes in blood pressure. Measurements of characteristics of microcirculation spent at 5 healthy volunteers from 50 till 70 years by means of a LDF method (device LAKK-02 NPP LASMA - two channels). The sensors LDF signal recorded on the symmetric parties of the bottom parts of the right and left shoulder in the points located on 3 cm above an elbow bend. Characteristics of MCR (perfusion) and amplitudes of frequency spectrum: neurogenic, myogenetic, respiratory and cardiac, and correlations between them was estimated. Correlation relationships between various components of a vascular tonus showed left-right asymmetry that has been not associated with blood pressure value. Low values of the correlation coefficients between the MCR and AD obtained in this study indicate the absence of linear regression dependencies between these values, but do not exclude the presence of nonlinear relationships between them.

Specificity of manifestation of functional asymmetry microcirculation parameters at physical loads on the upper limbs

Purpose – the study the functional asymmetry of oscillatory processes of microcirculatory bed at physical loads on the upper limbs.Material and methods. Microcirculation parameters were measured in 5 healthy volunteers (men aged 50–55 years) by laser Doppler flowmetry (LDF). LDF signal sensors were fixed symmetrically on the lower parts of the right and left shoulders (3 cm above the elbow bend). Physical exercise consisted of machs left or right hand in the standing position for 1 min. Measurements were performed in 3 conditions: 1 – initial state, 2 – immediately after exercise, 3 – 5 min after load termination The changes in the mean perfusion value and the components of the amplitude-frequency spectrum of blood flow fluctuations (myogenic, neurogenic, respiratory and cardiac), as well as the correlation between the changes in all parameters of the right and left sides of the observation were evaluated.Results. Asymmetry of changes in microcirculation parameters and correlations between them under the physical loads on the upper limbs was revealed. It is shown that both left and right machs change the microcirculation parameters of both the left and right sides, and the changes on the left are more pronounced than on the right. It is shown that after the left machs the blood flow on the left and right increases, and after the right machs – reduced. After loads the right side is recovering more slowly than the left.Conclusions. Our results illustrate the specific regulation of blood flow in micro vessels of paired organs, which is associated with functional asymmetry. The physiological mechanisms for this asymmetry require further experimental and clinical studies.

Inference about binocular sensitivity and specificity of screening tests for paired organs.

Recently Perera etal. introduced two new binocular accuracy measures to evaluate diagnostic tests for paired organs. They adopted the Gaussian copula model to account for correlation between fellow eyes. As the measures are functions of several joint probabilities and due to the nature of the joint models, variations of the estimates for the two new measures were assessed via bootstrapping. We provide a different approach to inference about the two interesting and innovative measures. In our opinion, when patients are independent, the binomial models suffice for inference about the parameters of interest. Inference becomes simple and straightforward. We perform numerical studies and analyse the data set as of Perera etal. for illustration. Also, we investigate thru simulations the issue of robustness of the Gaussian copula and the binomial models under model misspecification.

An update on anatomy and function of the teleost olfactory system.

About half of all extant vertebrates are teleost fishes. Although our knowledge about anatomy and function of their olfactory systems still lags behind that of mammals, recent advances in cellular and molecular biology have provided us with a wealth of novel information about the sense of smell in this important animal group. Its paired olfactory organs contain up to five types of olfactory receptor neurons expressing OR, TAAR, VR1- and VR2-class odorant receptors associated with individual transduction machineries. The different types of receptor neurons are preferentially tuned towards particular classes of odorants, that are associated with specific behaviors, such as feeding, mating or migration. We discuss the connections of the receptor neurons in the olfactory bulb, the differences in bulbar circuitry compared to mammals, and the characteristics of second order projections to telencephalic olfactory areas, considering the everted ontogeny of the teleost telencephalon. The review concludes with a brief overview of current theories about odor coding and the prominent neural oscillations observed in the teleost olfactory system.

РАЗВИТИЕ И ФУНКЦИОНАЛЬНАЯ ОРГАНИЗАЦИЯ ЦЕНТРАЛЬНЫХ ОРГАНОВ ГЕМОПОЭЗА ЛИЧИНОК ЛЕЩА ОБЫКНОВЕННОГО (ABRAMIS BRAMA (L.))

The article dwells upon physiological and morphological studies of fish carried out on a large scale, due to the need to control their reproduction and assess the impact of living conditions on the body of fish. Currently, a large amount of data on hematopoietic organs and the formation of blood cells in fish have been accumulated, but the facts are quite contradictory. At the same time, the state of the hematopoietic system can be justified only according to histogenesis of hematopoietic organs. From the results of examining reticular intercanal tissue of the head kidney (pronephros) of bream, a typical representative of bony fish, it can be inferred that pronephros is one of the main hemopoietic organs, in which the process of developing red blood cells and leukocytes takes place, with the majority of cells accounted for blood cells of erythropoietic series. Pronephros loses its excretory function in the early stages of ontogenesis. Throughout its development pronephros is presented as a dense formation, in the intercanal tissue of which there is reticular tissue with numerous hematopoietic elements. Active hematopoiesis occurs in mesonephros (trunk kidney) of bream larvae. The study of the morphophysiology of mesonephros in ontogenesis showed that this organ forms blood elements of all series, with more than half of the hematopoietic elements accounted for erythropoietic cells. The excretory function of the trunk kidney is maintained throughout the whole period of the organ developing. Thus, mesonephros of bream is also one of the main organs of hematopoiesis represented by a paired organ which stretches along the spine.

Confirming the Brain Death and the Nurse’s Tasks in the Care of Potential Organ Donors and Their Families

Introduction. Transplantology is the youngest area of medicine dealing with organ transplantation that is considered to be the most difficult.Aim. The aim of the work is to analyse the nurse’s tasks in the care of the organ donor after confirming brain death and propagate the idea of transplantology.Case Report. A 52-year-old patient admitted to the hospital at the neurological department after a craniocerebral trauma. Computed tomography of the head showed brain contusion, fractures of the bones of the skull cover, the presence of a small amount of air in the cranial cavity. Immediately after admission, the patient was tangled, conscious, reluctant to answer questions, without paresis and a short-term seizure. Anti-oedema and anti-epileptic treatment was implemented in the neurosurgery department. After starting treatment, there was a temporary improvement, followed by a secondary worsening of brain and brain stem failure with deep cerebral coma. The patient was referred for further treatment in the Intensive Care Unit.Discussion. Organ transplantation involves collecting them from the donor and implanting them into the recipient. The donor can be either a living person (when it comes to paired organs or fragment of the liver as well as the tissues and cells) or the deceased person, who during their life did not express objection to organ donation after their death. The major principle in this case is the pronouncement of brain death, i.e. confirmation of patient’s death resulting in changing the therapeutic goals.Conclusions. Transplantology is an interdisciplinary field of medicine, the success of which relies on the cooperation of many professionals. The nurse takes an active part in the team’s work starting from the donor’s organs eligibility, through transplantation, to the care of the patient after the transplantation. The nurse also participates in building up an atmosphere favourable for good relations with the potential donor’s family. (JNNN 2019;8(3):124–132)

Response misclassification in studies on bilateral diseases.

Misclassification in binary outcomes can severely bias effect estimates of regression models when the models are naively applied to error-prone data. Here, we discuss response misclassification in studies on the special class of bilateral diseases. Such diseases can affect neither, one, or both entities of a paired organ, for example, the eyes or ears. If measurements are available on both organ entities, disease occurrence in a person is often defined as disease occurrence in at least one entity. In this setting, there are two reasons for response misclassification: (a)ignorance of missing disease assessment in one of the two entities and (b)error-prone disease assessment in the single entities. We investigate the consequences of ignoring both types of response misclassification and present an approach to adjust the bias from misclassification by optimizing an adequate likelihood function. The inherent modelling assumptions and problems in case of entity-specific misclassification are discussed. This work was motivated by studies on age-related macular degeneration(AMD), a disease that can occur separately in each eye of a person. We illustrate and discuss the proposed analysis approach based on real-world data of a study on AMD and simulateddata.

Tests for homogeneity of risk differences in stratified design with correlated bilateral data

ABSTRACTCorrelated bilateral data arise from stratified studies involving paired body organs in a subject. When it is desirable to conduct inference on the scale of risk difference, one needs first to assess the assumption of homogeneity in risk differences across strata. For testing homogeneity of risk differences, we herein propose eight methods derived respectively from weighted-least-squares (WLS), the Mantel-Haenszel (MH) estimator, the WLS method in combination with inverse hyperbolic tangent transformation, and the test statistics based on their log-transformation, the modified Score test statistic and Likelihood ratio test statistic. Simulation results showed that four of the tests perform well in general, with the tests based on the WLS method and inverse hyperbolic tangent transformation always performing satisfactorily even under small sample size designs. The methods are illustrated with a dataset.

Glow-Worms, Railroad-Worms (Insecta: Coleoptera: Phengodidae)

The family Phengodidae are uncommonly encountered beetles that have bioluminescent females that appear to be larvaiform (or larger versions of the immature stage.) These adult females are able to produce light from paired photic organs located on each body segment (one glowing spot on each side) and sometimes also from luminous bands that extend across the dorsal surface of the body between each body segment. Females appear to be more commonly encountered than larvae. Because these glowing spots along the females body resemble the windows of train cars internally illuminated in the night, they are often referred to as "railroad-worms." Males of these species are not larviform, but instead resemble other beetles, though their first pair of wings (elytra) are less then half as long as their hind wings and the males of most species have very elaborate, feather-like antennae. These fancy antennae are used to detect and follow pheromones produced by the female. This document is EENY-332 , one of a series of Featured Creatures from the Entomology and Nematology Department, Florida Cooperative Extension Service, Institute of Food and Agricultural Sciences, University of Florida. Published: December 2004. Revised: February 2005.
 EENY332/IN609: Glow-Worms, Railroad-Worms (Insecta: Coleoptera: Phengodidae) (ufl.edu)

Measuring thermal conductivity of ultra-small materials exampled by the reaction chambers of bombardier beetles

Bombardier beetles, as their name implies, defend themselves against the potential predators by spraying boiling-hot and corrosive chemicals which are products of an explosive biochemical reaction taking place in the paired organs called reaction chambers (RCs). Why these beetles can withstand the explosive reaction that takes place in their bodies? Knowledge of thermal properties of the RCs will help to shed light on this puzzle. However, the submillimeter dimension and irregular shape of the RCs discourage the traditional methods for thermal characterization. To overcome this challenge, in this paper a method is developed particularly for measuring the thermal conductivity of a material with dimension as small as submillimeter. The measurement results by this method are demonstrated reliable especially for polymeric or organic materials including the RCs of bombardier beetles. The results in this paper not only help to understand the superior thermal insulation of the RC wall but also offer a facile approach to measuring the thermal conductivity of materials in submillimeter scale.

Influence of laterality on testis anatomy and histology in Ghezel rams.

Whether paired organs are equivalent has to be analyzed by assessing both structural and functional aspects. The present study compared the paired left and right testis from Ghezel sheep originating from Northwestern Iran (Azerbaijan) and Northeastern Turkey. Twenty‐five pairs of testes were collected from mature Ghezel rams from Tabriz slaughterhouse. The two glands were compared for their size, weight and activity rate. Weight, length, width and thickness were measured. Then, paraffinized blocks were prepared by routine histological techniques and sections were stained by the haematoxylin‐eosin method. Five 6 μm sections were prepared from each paraffinized block and 50 seminiferous tubules (STs) were analysed in each section for tubular differential index (TDI) and spermiogenesis index (SPI). TDI and SPI were compared between the paired left and right testes. Weight, length and thickness of left testes were significantly higher than in right testes (P < 0.05). Moreover, TDI and SPI were found to be higher in left testes than the right (P < 0.05).

Nonlinear analysis of fluctuations of microcirculation parameters in symmetrical organs of humans by laser doppler flowmetry

Purpose– the study the nonlinear dynamics of microcirculation parameters in human symmetrical organs.Material and Methods. Parameters of microcirculation were measured in healthy volunteers (aged between 50 and 70 years) by means of laser Doppler flowmetry (LDF). LDF signal transducers were fixed symmetrically on the lower parts of the right and left shoulders (3 cm above the elbow bend). The degree of chaoticity of microcirculation parameters as a nonlinear dynamic process was estimated using Hausdorff’s index, relative entropy and characteristics of phase portraits. Along with components of the amplitude-and-frequency range for blood flow fluctuations (myogenic, neurogenic, respiratory, and cardiac) was estimated and correlations between all characteristics of microcirculation in both sides of the body were done.Results.Asymmetry of correlation relationships of nonlinear dynamics parameters and components of the amplitude-andfrequency range for blood flow fluctuations of right and left sides of the body was revealed. Hausdorff index in the left side correlated not only with the average value of perfusion and with the coefficient of variation in the same side (r1 = –0,68; r2 =–0,51), but also with correlation dimension of chaos in the opposite side (r=0,49). Similarly, entropy in the left side correlated not only with the average value of perfusion and coefficient of variation in the left (r1 =0,43; r2 =0,60), but also with the entropy and correlation dimension of chaos in the right side (r1 =0,48; r2 =–0,41). The neurogenic component in the left side positively correlated with the myogenic component in the same side (r=0,71). A positive correlation was observed between the neurogenic component in right side and myogenic component in the opposite side (r=0,57). Asymmetry of correlation relationships was also revealed for the respiratory and cardiac components.Conclusions. Our results illustrate the specific regulation of blood flow in micro vessels of paired organs, which is associated with functional asymmetry. The physiological mechanisms for this asymmetry require further experimental and clinical studies.

University Students’ vs. Lay People’s Perspectives on Organ Donation and Improving Health Communication in Poland

Given that organ transplant is a standard medical technology admitted in medical practice, and taking into consideration that Polish transplantology is regarded among the most advanced in the world one should expect to find similarly high levels of acceptance in interviewees asked for their opinion on vital organ transplantation and their willingness to donate a paired organ ex vivo, or a vital organ ex mortuo in order to rescue the life of a recipient with a missing vital organ. The paper presents research build on the societal assessment of vital organ donation and transplant policies in Poland with the focus on students. Data have been collected at three different universities (Boratyński et al., Questionnaire on the Bases of Transplantation Medicine 2016/7). Various assessments concerning a vital organ donation have been observed. The authors discuss educational factors contributing to these variety including factual knowledge and ethical issues.

Correlation-and-Spectral Analysis of Time Series for Microcirculatory Parameters in Vessels of Symmetrical Organs.

The correlation relationships between microcirculatory parameters were studied in vessels of symmetrical organs in humans. Parameters of microcirculation in healthy volunteers were measured by the method of laser Doppler flowmetry (LDF). LDF-signal transducers were placed symmetrically on the lower parts of the right and left shoulders (3 cm above the elbow bend). Correlations between various components of the amplitude-frequency spectrum for blood flow fluctuations (myogenic, neurogenic, respiratory, and cardiac) were evaluated on symmetrical sides. A significant correlation was found for the mean value of vascular perfusion on the right side with the neurogenic, myogenic, respiratory, and cardiac components on the same side. However, the mean value of vascular perfusion on the light side was interrelated only with the cardiac component. A positive correlation was revealed between the neurogenic and myogenic components on the left side. However, the neurogenic component on the right side was positively related to the myogenic component on the opposite side. Asymmetry of correlation relationships was also observed for the respiratory and cardiac components of study spectrum. Our results illustrate the specific regulation of microcirculatory blood flow in paired organs, which is associated with the existence of functional asymmetry. The physiological mechanisms for this asymmetry require further experimental and clinical studies.

Directional and frequency characteristics of auditory neurons in Culex male mosquitoes.

The paired auditory organ of the mosquito, the Johnston's organ (JO), being the receiver of the particle velocity component of sound, is directional by its structure. However, to date almost no physiological measurements of its directionality have been made. In addition, the recent finding on the grouping of the JO auditory neurons into antiphase pairs demands confirmation by different methods. Using the vector superposition of the signals produced by two orthogonally oriented speakers, we measured the directional characteristics of individual units as well as their relationships in physiologically distinguishable groups - pairs or triplets. The feedback stimulation method allowed us to discriminate responses of the two simultaneously recorded units, and to show that they indeed responded in antiphase. Units of different frequency tuning as well as highly sensitive units (thresholds of 27 dB SPVL and below) were found in every angular sector of the JO, providing the mosquito with the ability to produce complex auditory behaviors.

Histological characterization of the olfactory organ in schilbid catfish, Clupisoma garua (Hamilton, 1822)

Fishes have a good sense of smell and are able to ascertain odour with the help of a pair of olfactory organs connected to the olfactory lobes of the forebrain by means of olfactory tracts. The functional anatomy and structural characterization of olfactory organ in the freshwater Indian Catfish Clupisoma garua (Hamilton, 1822) was investigated by light microscopy. The paired well-developed olfactory organs were located in nasal cavity having two exterior apertures: incurrent and excurrent nares. The olfactory rosettes were elongated structure, possessed 40±02 lamellae on each side of the narrow median raphe. Histologically, each lamella consisted of two principal layers: an epithelium consisted of sensory and non-sensory cells and a central core, which was composed of connective tissues, nerve fibers and blood vessels. The sensory epithelium was composed of three types of receptor cells: two described as classical bearing cilia or microvilli and third bearing rod like dendritic terminal. Synapses between primary and secondary neurons were formed. The indifferent epithelium comprised the greater surface area of the olfactory lamella, was typified with ciliated non-sensory cells, secretory mucous cells, mast cells and supporting cells. Undifferentiated basal cells were scattered in the deeper part of the epithelium above the basement membrane. Organization of various cells on the olfactory epithelium was correlated with essential life process of the fish concerned.

The complex trophic anatomy of silver carp, Hypophthalmichthys molitrix, highlighting a novel type of epibranchial organ

Hypophthalmichthys molitrix, silver carp, is an invasive Asian carp that has become increasingly widespread and ecologically destructive within the upper Mississippi River Basin. Its complex trophic anatomy may help explain the apparent efficiency with which they consume phytoplankton, outcompeting native filter feeders. This cypriniform species is characterized by trophic synapomorphies that include a palatal organ, loss of upper pharyngeal jaws, and a hypertrophied lower pharyngeal jaw. However, in silver carp these structures have become greatly modified and diverge from the more basal condition that characterizes species such as goldfish. The trophic apparatus of silver carp is composed of discrete structures that are functionally coupled: filtering plates, paired epibranchial organs (EBO), a modified palatal organ composed of large muscular folds that interdigitate with the filtering plates, and hypertrophied lower pharyngeal jaws and teeth. The filtering plates fill a significant portion of the buccal cavity, especially since the distal parts of these filtering plates make up a key component of the EBOs. EBOs, food aggregating structures found in many teleosts, are thought to have independently evolved at least six times. Ranging in complexity from small slits on the dorsal wall of the pharyngeal cavity to exceedingly intricate spiraling structures, EBOs are morphologically diverse among filter-feeding fishes. Despite this morphological diversity and broad taxonomic distribution, little is known regarding the functional anatomy of the EBO. Moreover, the EBO in silver carp is distinct from the organs previously described in other species, being created by four independent pharyngeal involutions (instead of the more typical one or two) that form spiral-shaped pharyngeal tubes surrounded by circumferential muscle. On each side of the head greatly hypertrophied hyomandibulae and opercles are connected to the anterior cartilaginous caps of the bilateral EBOs via enlarged muscles. Given that these fish are pump filter feeders we hypothesize that the opercula may compress and expand the EBOs during pumping causing food to be moved posteriorly toward the pharyngeal jaws.

Robust likelihood inference for diagnostic accuracy measures for paired organs.

Paired data arise naturally in Ophthalmology where pairs of eyes undergo diagnostic tests to predict the presence of certain diseases. The common correlation model is popular for modeling the joint probabilities of responses from fellow eyes for inference about accuracy measures. One of the assumptions underlying the model is exchangeability of fellow eyes that stipulates the accuracy measures such as sensitivities/specificities of fellow eyes be equal. We propose a parametric robust likelihood approach to testing the equality of accuracy measures of fellow eyes without modeling correlation. The robust likelihood procedure is applicable for inference about diagnostic accuracy measures in general paired designs. We provide simulations and analyses of a data set in Ophthalmology to demonstrate the effectiveness of the parametric robust procedure.

Common risk difference test and interval estimation of risk difference for stratified bilateral correlated data.

Bilateral correlated data are often encountered in medical researches such as ophthalmologic (or otolaryngologic) studies, in which each unit contributes information from paired organs to the data analysis, and the measurements from such paired organs are generally highly correlated. Various statistical methods have been developed to tackle intra-class correlation on bilateral correlated data analysis. In practice, it is very important to adjust the effect of confounder on statistical inferences, since either ignoring the intra-class correlation or confounding effect may lead to biased results. In this article, we propose three approaches for testing common risk difference for stratified bilateral correlated data under the assumption of equal correlation. Five confidence intervals of common difference of two proportions are derived. The performance of the proposed test methods and confidence interval estimations is evaluated by Monte Carlo simulations. The simulation results show that the score test statistic outperforms other statistics in the sense that the former has robust type error rates with high powers. The score confidence interval induced from the score test statistic performs satisfactorily in terms of coverage probabilities with reasonable interval widths. A real data set from an otolaryngologic study is used to illustrate the proposed methodologies.