Hirschsprung's disease: the "Swiss roll" technique revisited.

PURPOSE: During pull-through for Hirschsprung's disease (HSCR), the assessment of innervation is mainly based on the presence of ganglion cells when conventional Hematoxylin and Eosin (HE) staining is used. In hypoganglionosis, the evaluation is difficult. We adapted a standardized methodology for the examination of resected bowel after HSCR surgery, using the technique described by Moolenbeek on rodent intestine and later by Meier-Ruge in children. We have analysed the entire innervation of surgically resected bowels and compared the results with the follow up of patients. METHODS: Three longitudinal strips of colon were harvested from the mesenteric, anti-mesenteric and intermediate part in the whole length of resected colon of six patients with HSCR. Each strip was divided into two parts. One of the contiguous strips was assessed with HE and Hematoxylin-Phloxin-Safran, and the other one with acetylcholinesterase (AChE) histochemistry. We analyzed the distribution of ganglion cells and nerve arrangement along the strips with both techniques and compared the results obtained in the three different regions of the bowel. RESULTS: There was no significant difference in the pattern of innervation circumferentially. There was a correlation between a progressive increase of AChE activity and nerve hypertrophy and a decrease of ganglion cells from the proximal to the distal part of the resected colon in the submucosa and the myenteric plexus. Nerve hypertrophy and AChE-positive reaction in the mucosa were found at the resection border in patients who presented postoperative complications. CONCLUSIONS: Simultaneous assessment of nerve cells, nerve fibers and AChE activity is important in the evaluation of the innervation of the bowel segment proximal to the aganglionic zone. The method described is feasible and can be adapted to older children and adults with larger bowels. These results point out the importance of assessing nerve fibers in intraoperative biopsies during pull-through procedures to prevent uncomplete surgical bowel resection.

Ús de Sensor Web Enablement per a gestió de dades marines i accés al servei d'observació de sensors a través de client Android

El present treball és un estudi de l'estat de Sensor Web Enablement (SWE) aplicat a l'àmbit marí d'investigació oceanogràfica. Per assolir aquest objectiu s'han avaluat les diferents solucions d'arquitectura de sistemes més adients a la problemàtica indicada i s'ha dissenyat un client de Sensor Observation Service (SOS) per plataforma mòbil Android que permeti consultar la descripció del sensor (SensorML) i conjunts d'observacions mitjançant estàndards oberts de SWE i peticions web (SOAP). Els dissenys anteriorment indicats han permès que quedés palès l'ampli ventall de possibilitats i avantatges que s'obtenen pel fet d'emprar SWE, ja que ens permet integrar fàcilment les dades proporcionades pels sensors i les pròpies descripcions dels sensors en diferents entorns, tal i com és el cas del disseny presentat en Android, a través d'estàndards oberts independents de les múltiples especificacions de cada fabricant, en un entorn, com és l'àmbit de la investigació marina on hi ha una gran heterogeneïtat de sensors i protocols.

L'hémisphérotomie péri-insulaire: technique chirurgicale, monitoring EEG intraopératoire et résultats sur le contrôle de l'épilepsie [Periinsular hemispherotomy: surgical technique, intraoperative EEG monitoring and results on seizure outcome]

Peri-insular hemispherotomy is a surgical technique used in the treatment of drug-resistant epilepsy of hemispheric origin. It is based on the exposure of insula and semi-circular sulci, providing access to the lateral ventricle through a supra- and infra-insular window. From inside the ventricle, a parasagittal callosotomy is performed. The basal and medial portion of the frontal lobe is isolated. Projections to the anterior commissure are interrupted at the time of amygdala resection. The hippocampal tail and fimbria-fornix are disrupted posteriorly. We report our experience of 18 cases treated with this approach. More than half of them presented with congenital epilepsy. Neuronavigation was useful in precisely determining the center and extent of the craniotomy, as well as the direction of tractotomies and callosotomy, allowing minimal exposure and blood loss. Intra-operative monitoring by scalp EEG on the contralateral hemisphere was used to follow the progression of the number of interictal spikes during the disconnection procedure. Approximately 90% of patients were in Engel's Class I. We observed one case who presented with transient postoperative neurological deterioration probably due to CSF overdrainage and documented one case of incomplete disconnection in a patient presenting with hemimegalencephaly who needed a second operation. We observed a good correlation between a significant decrease in the number of spikes at the end of the procedure and seizure outcome. Peri-insular hemispherotomy provides a functional disconnection of the hemisphere with minimal resection of cerebral tissue. It is an efficient technique with a low complication rate. Intra-operative EEG monitoring might be used as a predictive factor of completeness of the disconnection and consequently, seizure outcome.

Percutaneous extraction of retained biliary T-tubes: a new technique.

Retained T-tubes are rare complications after biliary surgery. The authors present three cases of retained T-tubes in patients with transplanted liver that could not be removed by a standard manual traction. The authors describe a new simple percutaneous method that allows removal of these T-tubes without complication.

Open partial nephrectomy in renal cancer: a feasible gold standard technique in all hospitals

Introduction. Partial nephrectomy (PN) is playing an increasingly important role in localized renal cell carcinoma (RCC) as a true alternative to radical nephrectomy. With the greater experience and expertise of surgical teams, it has become an alternative to radical nephrectomy in young patients when the tumor diameter is 4 cm or less in almost all hospitals since cancer-specific survival outcomes are similar to those obtained with radical nephrectomy. Materials and Methods. The authors comment on their own experience and review the literature, reporting current indications and outcomes including complications. The surgical technique of open partial nephrectomy is outlined. Conclusions. Nowadays, open PN is the gold standard technique to treat small renal masses, and all nonablative techniques must pass the test of time to be compared to PN. It is not ethical for patients to undergo radical surgery just because the urologists involved do not have adequate experience with PN. Patients should be involved in the final treatment decision and, when appropriate, referred to specialized centers with experience in open or laparoscopic partial nephrectomies

A review of sensor fusion techniques for underwater vehicle navigation

This work provides a general description of the multi sensor data fusion concept, along with a new classification of currently used sensor fusion techniques for unmanned underwater vehicles (UUV). Unlike previous proposals that focus the classification on the sensors involved in the fusion, we propose a synthetic approach that is focused on the techniques involved in the fusion and their applications in UUV navigation. We believe that our approach is better oriented towards the development of sensor fusion systems, since a sensor fusion architecture should be first of all focused on its goals and then on the fused sensors

Accuracy estimation of a new omnidirectional 3D vision sensor

We present a computer vision system that associates omnidirectional vision with structured light with the aim of obtaining depth information for a 360 degrees field of view. The approach proposed in this article combines an omnidirectional camera with a panoramic laser projector. The article shows how the sensor is modelled and its accuracy is proved by means of experimental results. The proposed sensor provides useful information for robot navigation applications, pipe inspection, 3D scene modelling etc