- The liver is the largest gland in the body and has a wide variety of functions
- Weight: 1/50 of body weight in adult & 1/20 of body weight in infant
- It is exocrine(bile) & endocrine organ(Albumin , prothrombin & fibrinogen)
Function of the liver :
- Secretion of bile & bile salt
- Metabolism of carbohydrate, fat and protein
- Formation of heparin & anticoagulant substances
- Detoxication
- Storage of glycogen and vitamins
- Activation of vita .D
describes about peritoneal cavity and clinical importance of it. it describes in deatils about lesser sac, greater sac, pouch of Morrison, pouch of Douglas.
describes about peritoneal cavity and clinical importance of it. it describes in deatils about lesser sac, greater sac, pouch of Morrison, pouch of Douglas.
Η Λαπαροσκοπική Χειρουργική στον Καρκίνο του Παχέος Εντέρου και του ΟρθούDimitris P. Korkolis
One of the most common cancers in the world
US: 4th most common cancer
(after lung, prostate, and breast cancers)
2nd most common cause of cancer death
(after lung cancer)
2007: 130,000 new cases of CRC
56,500 deaths caused by CRC
Laparoscopic Low Anterior Resection for Cancer : “Pursued or just Permitted?”...Dimitris P. Korkolis
Potential Advantages of Lap TME
- Less blood loss
- Faster recovery
- Earlier return of gut function
- Lower morbidity and mortality
- Magnified view allows precise dissection (pelvic autonomics)
- Earlier hospital discharge
Χαμηλή Πρόσθια Εκτομή : «Η Λαπαροσκοπική Προσπέλαση Πλεονεκτεί για τον Ασθενή...Dimitris P. Korkolis
Potential Advantages of Lap TME
- Less blood loss
- Faster recovery
- Earlier return of gut function
- Lower morbidity and mortality
- Magnified view allows precise dissection (pelvic autonomics)
- Earlier hospital discharge
Surgery of Rectal Cancer : Potentials and Limitations - Dimitris P. KorkolisDimitris P. Korkolis
EPIDEMOLOGY
2015 Estimates
New cases: 96,830 (colon); 40,000 (rectal)
Deaths: 50,310 (colon and rectal combined)
Death rate over last 20 years declining
Screening and improvements in treatment
H Χειρουργική Αντιμετώπιση του Καρκίνου στον Οισοφάγο - Δημήτρης Π. ΚορκολήςDimitris P. Korkolis
- 5% των καρκίνων του πεπτικού συστήματος
- Άνδρες > 60 ετών Άνδρες : Γυναίκες = 3:1
- Αδενοκαρκίνωμα (40%)!!!!!:
- ΓΟΠ – Barrett’s - Παχυσαρκία
- Πλακώδες Καρκίνωμα (60%):
- Κάπνισμα – Αλκοόλ
- 85% στο μέσο ή κάτω 3μόριο του οισοφάγου
- Ελλάς: 3 περιστατικά / 100000 κάτοικοι Χαμηλότερο ποσοστό στην EU
- 5% των ασθενών με εντοπισμένη νόσο κατά τη διάγνωση
- <50%>< 25%
- 5ετής επιβίωση ≤ 20% μετά από χειρουργική αντιμετώπιση
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
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Surgical Site Infections, pathophysiology, and prevention.pptx
Surgical Anatomy of the Liver : Ηepatectomies - Dimitris P. Korkolis
1. Surgical Anatomy of the Liver -Surgical Anatomy of the Liver -
ΗΗepatectomiesepatectomies
Dimitris P. Korkolis
Surgeon
Saint Savvas Anticancer - Oncological Hospital of Athens
2. Liver
• The liver is the largest gland in the body and has a wide variety of
functions
• Weight: 1/50 of body weight in adult & 1/20 of body weight in infant
• It is exocrine(bile) & endocrine organ(Albumin , prothrombin &
fibrinogen)
• Function of the liver
• Secretion of bile & bile salt
• Metabolism of carbohydrate, fat and protein
• Formation of heparin & anticoagulant substances
• Detoxication
• Storage of glycogen and vitamins
• Activation of vita .D
3. EmbryologyEmbryology
44thth
Week of DevelopmentWeek of Development
– Projection from ventral wall of MidgutProjection from ventral wall of Midgut
Cranial BudCranial Bud →→ LiverLiver
Caudal BudCaudal Bud →→ Gallbladder, extrahepaticGallbladder, extrahepatic
biliary treebiliary tree
Ventral PancreasVentral Pancreas
4. EmbryologyEmbryology
Bile ducts develop from hepatocytes,Bile ducts develop from hepatocytes,
originating at hilumoriginating at hilum
77thth
WeekWeek
– Biliary lumen recanalizeBiliary lumen recanalize
1212thth
WeekWeek
– Liver begins to secrete bileLiver begins to secrete bile
5. DevelopmentalDevelopmental
AnomaliesAnomalies
Agenesis rareAgenesis rare
– Left lobe agenesis reportedLeft lobe agenesis reported
Reidel’s LobeReidel’s Lobe
– Long tongue of liver extending inferiorlyLong tongue of liver extending inferiorly
from right lobefrom right lobe
– Usually asymptomatic, may beUsually asymptomatic, may be
associated with colonic or pyloricassociated with colonic or pyloric
obstructionobstruction
Heterotopic liver tissueHeterotopic liver tissue
– Gallbladder, pancreas, adrenals,Gallbladder, pancreas, adrenals,
6. AnatomyAnatomy
PositionPosition
– Between 4Between 4thth
intercostalintercostal
space and costal marginspace and costal margin
– extends across midlineextends across midline
7. AnatomyAnatomy
Glisson’s CapsuleGlisson’s Capsule
– Peritoneal MembranePeritoneal Membrane
PeritoneumPeritoneum
– Bare patch under diaphragm next to IVCBare patch under diaphragm next to IVC
8. LigamentsLigaments
FalciformFalciform
– Attaches to anterior abdominal wall fromAttaches to anterior abdominal wall from
diaphragm to umbilicusdiaphragm to umbilicus
– Includes Ligamentum Teres (roundIncludes Ligamentum Teres (round
ligament) at inferior borderligament) at inferior border
Former Umbilical VeinFormer Umbilical Vein
May recanalize in portal hypertension, orMay recanalize in portal hypertension, or
malignant hematologic disordersmalignant hematologic disorders
9. LigamentsLigaments
Right and Left CoronaryRight and Left Coronary
– Connect diaphragm to liverConnect diaphragm to liver
– Lateral aspects become TriangularLateral aspects become Triangular
LigamentsLigaments
10. LigamentsLigaments
GastrohepaticGastrohepatic
– Anterior layer of lesser omentumAnterior layer of lesser omentum
– Continuous with Left Triangular LigamentContinuous with Left Triangular Ligament
HepatoduodenalHepatoduodenal
– Anterior border of Foramen of WinslowAnterior border of Foramen of Winslow
– Contains Portal TriadContains Portal Triad
11. The Ligamentum
Venosum
-Fibrous band that is the
remains of the ductus
venosus
-Ligament of Aranthius
- It is attached to the left
branch of the portal vein
and ascends in a fissure on
the visceral surface of the
liver to be attached above
to the inferior vena cava
13. Lobar AnatomyLobar Anatomy
(American System)(American System)
Right and Left Lobe determined by Cantlie’sRight and Left Lobe determined by Cantlie’s
Line (portal fissure)Line (portal fissure)
– Gallbladder Fossa to IVCGallbladder Fossa to IVC
15. Segmental AnatomySegmental Anatomy
(Couinaud System)(Couinaud System)
Caudate LobeCaudate Lobe
– Segment ISegment I
Left LobeLeft Lobe
– Segments II – IVSegments II – IV
Right LobeRight Lobe
– Segments V-VIIISegments V-VIII
16. Segmental AnatomySegmental Anatomy
(Couinaud System)(Couinaud System)
Caudate LobeCaudate Lobe
– Segment ISegment I
Left LobeLeft Lobe
– Segments II – IVSegments II – IV
Right LobeRight Lobe
– Segments V-VIIISegments V-VIII
17. Blood supply of the liver
• Proper hepatic artery
The right and left hepatic
arteries enter the porta
hepatis.
• The right hepatic artery
usually gives off the cystic
artery, which runs to the
neck of the gallbladder.
20. Portal VeinPortal Vein
Laminar Blood flowLaminar Blood flow
– Affects distribution of amebic abscesses andAffects distribution of amebic abscesses and
tumor metastasestumor metastases
21. Portal-SystemicPortal-Systemic
communicationcommunication
Submucosal veins of distal esophagus andSubmucosal veins of distal esophagus and
proximal stomachproximal stomach
Umbilical and periumbilical veinsUmbilical and periumbilical veins
– Caput MedusaeCaput Medusae
– Cruveilhier-Baumgarten bruitCruveilhier-Baumgarten bruit
Tributaries of inferior mesenteric veinsTributaries of inferior mesenteric veins
– Superior hemmorhoidalsSuperior hemmorhoidals
Retroperitoneal communicationRetroperitoneal communication
– Adrenal veinsAdrenal veins
23. Hepatic ArteryHepatic Artery
CautionsCautions
– Only 55-65% of population has “normal”Only 55-65% of population has “normal”
hepatic arterial anatomyhepatic arterial anatomy
– Aberrant R hepatic artery may beAberrant R hepatic artery may be
mistaken for cystic arterymistaken for cystic artery
– Cystic artery may originate from theCystic artery may originate from the
gastroduodenal artery, the left hepaticgastroduodenal artery, the left hepatic
artery, or the common hepatic arteryartery, or the common hepatic artery
24. Biliary SystemBiliary System
Triangle of CalotTriangle of Calot
– Cystic Duct, Common Hepatic Duct, andCystic Duct, Common Hepatic Duct, and
hilum of liverhilum of liver
26. Hepatic VeinsHepatic Veins
Short extrahepaticShort extrahepatic
segmentsegment
– RightRight
– MiddleMiddle
Usually joins leftUsually joins left
– LeftLeft
Direct communication to IVC fromDirect communication to IVC from
Segment I (caudate)Segment I (caudate)
28. LIVER Histology
• lobules >> roughly
hexagonal structures
consisting of
hepatocytes. Radiate
outward from a central
vein.
• At each of the six
corners of a lobule is a
portal triad
( p.arteriole,p.venule &
bile duct)
•Between the
hepatocytes are the
liver sinusoids.
29. Where do the two blood supplies mix?
• Liver surrounded by a thin capsule at
portahepatic(it is thick)Glisson’s
capsule invests the liver and send septa
into liver subset subdivide the
parenchyma into lobules
30.
31. Segmental anatomy of the liver
• Rt .& Lt. lobes anatomically no
morphological significance.
Separation by ligaments
(Falciform, lig. Venoosum &
Lig.teres)
• True morphological and
physiological division by a line
extend from fossa of GD to fossa
of I.V.C each has its own arterial
blood supply, venous drainage
and biliary drainage
• No anastomosis between
divisions
• 3 major hepatic veins Rt, Lt &
central
• 8 segments based on hepatic and
portal venous segments
32. Segmental anatomy of the liver
– Liver segments are based on the portal and
hepatic venous segments
33.
34. •Source: HPB 2000; 2(3):333-39
•Terminology Committee of the International Hepato-Pancreato-Biliary Association