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Search Results: 1 - 10 of 640062 matches for " Francisco M. Sánchez-Margallo "
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Herramienta de autoría de contenidos didácticos multimedia para entorno de formación colaborativo en Cirugía de Mínima Invasión
Patricia Sánchez-González,álvaro Fernández,Francisco M. Sánchez-Margallo,Ignacio Oropesa
RED : Revista de Educación a Distancia , 2011,
Abstract: TELMA es un entorno de formación y aprendizaje online basado en la edición de vídeo laparoscópico, la gestión del conocimiento y el trabajo colaborativo, cuyo fin es mejorar la efectividad y eficacia de los procesos de formación (inicial y continuada) de los cirujanos de Cirugía de Mínima Invasión (CMI). TELMA proporciona un aprendizaje personalizado a los usuarios del sistema, permitiendo crear, compartir y reutilizar los contenidos didácticos así como adaptarlos a sus necesidades individuales. Para ello, incorpora una herramienta de autoría de contenidos, que posibilita la creación y edición de los contenidos didácticos presentes en el entorno de formación. La herramienta de autoría incorpora un editor multimedia de vídeo laparoscópico, capaz de a adir a los vídeos originales información didáctica útil para los periodos de formación de los nuevos cirujanos.
Evaluation of Wedged Arterial Injection as a New Technique for Delivery of Experimental Therapeutic Sustances into the Porcine Pancreas
Rafael Latorre,Wendy Hernández,Fei Sun,Francisco Sánchez-Margallo,Francisco Gil,Octavio López-Albors,Jose M. Vázquez,Jesús Usón
Experimental Diabetes Research , 2011, DOI: 10.1155/2011/976910
Abstract: Objectives. To prospectively evaluate the technical feasibility and efficacy of wedged arterial injection (WAI) as a potential route for experimental selective therapy to the pancreas of healthy pigs. Materials and Methods. Selective angiographies were completed in ten pigs under general anaesthesia. By superselective angiography, the catheter was inserted and wedged into the major pancreatic artery, blocking the blood flow. In order to evaluate the efficacy of the WAI method, a DNA-specific fluorescent dye (Hoechst 33258) was used. Results. Histological study revealed a uniform distribution of the fluorescent dye within the nuclei of the endocrine and exocrine pancreatic cells. Pancreatic and liver enzymes as well as histopathology of the pancreas were normal. Conclusion. WAI is a highly effective minimally invasive methodology to target the porcine pancreas. The findings suggest that WAI may contribute to developing preclinical assays of pancreas gene or cell-transfer therapies in swine model.
Evaluation of Wedged Arterial Injection as a New Technique for Delivery of Experimental Therapeutic Sustances into the Porcine Pancreas
Rafael Latorre,Wendy Hernández,Fei Sun,Francisco Sánchez-Margallo,Francisco Gil,Octavio López-Albors,Jose M. Vázquez,Jesús Usón
Journal of Diabetes Research , 2011, DOI: 10.1155/2011/976910
Abstract: Objectives. To prospectively evaluate the technical feasibility and efficacy of wedged arterial injection (WAI) as a potential route for experimental selective therapy to the pancreas of healthy pigs. Materials and Methods. Selective angiographies were completed in ten pigs under general anaesthesia. By superselective angiography, the catheter was inserted and wedged into the major pancreatic artery, blocking the blood flow. In order to evaluate the efficacy of the WAI method, a DNA-specific fluorescent dye (Hoechst 33258) was used. Results. Histological study revealed a uniform distribution of the fluorescent dye within the nuclei of the endocrine and exocrine pancreatic cells. Pancreatic and liver enzymes as well as histopathology of the pancreas were normal. Conclusion. WAI is a highly effective minimally invasive methodology to target the porcine pancreas. The findings suggest that WAI may contribute to developing preclinical assays of pancreas gene or cell-transfer therapies in swine model. 1. Introduction Animal models are essential tools for investigating the aetiology and pathogenesis of diabetes as well as for developing effective treatment methods, such as islet transplantation or genetic engineering [1, 2]. Although a range of well-characterized and widely used models of type 1 diabetes in rodents are currently available, they do not reliably predict therapeutic outcomes in larger mammals [2–4]. Large animal models are a valuable complement to rodents for both physiological and practical reasons. Anatomically, the porcine and human pancreases are quite similar. In both species, it is a retroperitoneal organ, and the pancreatic head wraps the portal vein [5]. In addition, the firmness of the pig pancreatic parenchyma is similar to the gland in humans [6]. Physiologically, pig islets offer a very competitive product for β-cell replacement because of their morphological characteristics, ability to respond to glucose challenge, and cell composition and also because of the fact that the pig and human insulin differ in only one amino acid [5, 7]. Among the new emerging technologies for diabetes therapy, gene and cellular injections are currently attractive and of great potential. However, there are persistent and severe obstacles to their applications mainly because of the topography and structure of the pancreas [3]. So far, there are no effective ways of approaching the pancreas without causing significant unwanted effects, such as infection of other organs [8] or toxicity and damage of the pancreas parenchyma [3, 9]. Arterial or venous injection
Development of a Closed Chest Model of Chronic Myocardial Infarction in Swine: Magnetic Resonance Imaging and Pathological Evaluation
Verónica Crisóstomo,Juan Maestre,Manuel Maynar,Fei Sun,Claudia Báez-Díaz,Jesús Usón,Francisco M. Sánchez-Margallo
ISRN Cardiology , 2013, DOI: 10.1155/2013/781762
Abstract: Our aim was to develop an easy-to-induce, reproducible, and low mortality clinically relevant closed-chest model of chronic myocardial infarction in swine using intracoronary ethanol and characterize its evolution using MRI and pathology. We injected 3-4?mL of 100% ethanol into the mid-LAD of anesthetized swine. Heart function and infarct size were assessed serially using MRI. Pigs were euthanized on days 7, 30, and 90 ( at each timepoint). Postoperative MRI revealed compromised contractility and decreased ejection fraction, from 53.8% ± 6.32% to 43.79% ± 7.72% ( ). These values remained lower than baseline thorough the followup (46.54% ± 11.12%, 44.48% ± 7.77%, and 40.48% ± 6.40%, resp., ). Progressive remodeling was seen in all animals. Infarcted myocardium decreased on the first 30 days (from 18.09% ± 7.26% to 9.9% ± 5.68%) and then stabilized (10.2% ± 4.21%). Pathology revealed increasing collagen content and fibrous organization over time, with a rim of preserved endocardial cells. In conclusion, intracoronary ethanol administration in swine consistently results in infarction. The sustained compromise in heart function and myocardial thinning over time indicate that the model may be useful for the preclinical evaluation of and training in therapeutic approaches to heart failure. 1. Introduction Cardiovascular diseases are a major cause of death and disability in developed countries. Myocardial infarction has an estimated annual incidence in the US of 525.000 new and 190.000 recurrent attacks. Approximately 15% of patients who suffer a coronary attack will die as a result of it [1]. Patients who survive a heart attack have an increased prevalence of heart failure (HF) [2]. Research in animal models is mandatory to assess safety and efficacy of any new therapy prior to clinical translation [3, 4]. Large animal models are essential to test new interventional, surgical, or electrophysiological procedures that cannot be performed in small animals, thus providing a platform for training specialists in optimal techniques involving new procedures, another highly important role of animal models of disease [5]. Current models for myocardial infarct creation are suboptimal for a variety of reasons, including a high mortality and inconsistent infarct creation [6–9]. Clinically, intracoronary ethanol has been used for the management of symptomatic hypertrophic obstructive cardiomyopathy (HOCM) [10, 11] and in the therapy of arrhythmias. Studies using intracoronary ethanol administration in animals are limited and generally focused on refining HOCM therapies
Physiologic Responses to Infrarenal Aortic Cross-Clamping during Laparoscopic or Conventional Vascular Surgery in Experimental Animal Model: Comparative Study
María F. Martín-Cancho,Verónica Crisóstomo,Federico Soria,Carmen Calles,Francisco M. Sánchez-Margallo,Idoia Díaz-Güemes,Jesús Usón-Gargallo
Anesthesiology Research and Practice , 2008, DOI: 10.1155/2008/581948
Abstract: The aim of this study was to compare the hemodynamic and ventilatory effects of prolonged infrarenal aortic cross-clamping in pigs undergoing either laparotomy or laparoscopy. 18 pigs were used for this study. Infrarenal aortic crossclamping was performed for 60 minutes in groups I (laparotomy, =6) and II (laparoscopy, =6). Group III (laparoscopy, =6) underwent a 120-minute long pneumoperitoneum in absence of aortic clamping (sham group). Ventilatory and hemodynamic parameters and renal function were serially determined in all groups. A significant decrease in pH and significant increase in PaCO2 were observed in group II, whereas no changes in these parameters were seen in group I and III. All variables returned to values similar to baseline in groups I and II 60 minutes after declamping. A significant increase in renal resistive index was evidenced during laparoscopy, with significantly higher values seen in Group II. Thus a synergic effect of pneumoperitoneum and aortic cross-clamping was seen in this study. These two factors together cause decreased renal perfusion and acidosis, thus negatively affecting the patient's general state during this type of surgery.
Empleo del modelo animal en la formación en endoscopia diagnóstica y terapéutica de la vía biliar Animal model training in diagnostic and therapeutic biliary tract endoscopy teaching
J. Usón-Gargallo,F.M. Sánchez-Margallo,F. Soria-Gálvez,J. Boix-Valverde
Educación Médica , 2010,
Abstract: Objetivo. Mostrar nuestra experiencia en la formación en endoscopia terapéutica de la vía biliar en modelo animal. Materiales y métodos. Esta actividad formativa tiene una duración de 13 horas y comienza iniciando al alumno en las diferencias anatómicas de las especies que se emplean, la porcina y la canina, con respecto a la anatomía humana. Las prácticas consisten en habituar al endoscopista a la visión lateral del duodenoscopio; se realizan en un modelo porcino debido a que es más sencillo atravesar el esfínter pilórico, aunque no suele ser muy adecuado para la canulación de la papila duodenal. Tras superar la primera fase se utiliza el modelo canino, que permite adquirir las habilidades y destrezas propias de esta técnica. La evaluación de los resultados se realiza mediante una encuesta anónima. Resultados. El 76% de los alumnos confirma que ha avanzado mucho con este entrenamiento, un 18% regular y un 6% poco. El 75% considera que, tras realizar esta actividad de formación, se encontraría capacitado para llevar a cabo la técnica en su hospital. El 94% de los alumnos recomendaría esta actividad a sus compa eros. Conclusiones. El empleo del modelo animal en la formación en colangiopancreatografía retrógada endoscópica (CPRE) permite la adquisición de habilidades básicas necesarias para la práctica, ya que posibilita la repetición de las maniobras y la tutela continuada. Consideramos que con esta metodología mixta se podría acortar la curva de aprendizaje de la CPRE y disminuiría la iatrogenia en las primeras fases. Aim. To show our experience in training in therapeutic endoscopy of the biliary tract in animal model. Materials and methods. This training activity has duration of 13 hours and starts initiating the trainee in anatomical differences with regard to human anatomy that occur between species that are used, the swine and canine. The practices consist of endoscopist to habituate the lateral view of duodenoscope, performing on pig model because it is easier to pass through the pyloric sphincter, although this is not very suitable for cannulation of the duodenal papilla. After passing the first stage, we used the canine model to acquire the skills and abilities specific to this technique. The performance evaluation is done through an anonymous survey. Results. 76% of students confirmed that they have made good progress with this training, 18% regular and 6% that shortly. 75% believed that after making this training would be found competent to carry out the technique in their hospitals. About 94% of students would recommend this activity. Conclusi
Empleo del modelo animal en la formación en endoscopia diagnóstica y terapéutica de la vía biliar
Usón-Gargallo,J.; Sánchez-Margallo,F.M.; Soria-Gálvez,F.; Boix-Valverde,J.; Fernández-Bermejo,M.; Latorre-Reviriego,R.; Climent-Peris,S.; Tejedo-Grafía,V.;
Educación Médica , 2010, DOI: 10.4321/S1575-18132010000300008
Abstract: aim. to show our experience in training in therapeutic endoscopy of the biliary tract in animal model. materials and methods. this training activity has duration of 13 hours and starts initiating the trainee in anatomical differences with regard to human anatomy that occur between species that are used, the swine and canine. the practices consist of endoscopist to habituate the lateral view of duodenoscope, performing on pig model because it is easier to pass through the pyloric sphincter, although this is not very suitable for cannulation of the duodenal papilla. after passing the first stage, we used the canine model to acquire the skills and abilities specific to this technique. the performance evaluation is done through an anonymous survey. results. 76% of students confirmed that they have made good progress with this training, 18% regular and 6% that shortly. 75% believed that after making this training would be found competent to carry out the technique in their hospitals. about 94% of students would recommend this activity. conclusions. the use of animal model in training in endoscopic retrograde cholangiopancreatography (ercp) permits the acquisition of basic skills needed for practice, as it enables the repetition of the maneuvers and continuing care. we believe that this mixed methodology could shorten the learning curve for ercp and reduce iatrogenic in the early stages.
Estudio ultrasonográfico e histológico de la evolución de un modelo canino de hiperplasia benigna de próstata inducida por hormonas
Crisóstomo Ayala,Verónica; Maynar Moliner,Manuel; Sun,Fei; Usón Gargallo,Jesús; Sánchez Margallo,Francisco M.;
Actas Urológicas Espa?olas , 2009, DOI: 10.4321/S0210-48062009000800011
Abstract: introduction: despite exhibiting histological differences from the human process, canine hormone-induced benign prostatic hyperplasia (bph) is still the most widely used animal model for evaluating treatment strategies. objectives: the aim of this study is to determine the optimal moment for starting a therapeutic trial in this animal model. material and methods: six male beagle dogs over one year of age were used in this study. all animals received a combination of steroid hormones, namely 17b-estradiol and 5a-androstene 3a 17b-diol, every other day during three (group 1, n=3) or five months (group 2, n=3). transrectal ultrasonographic examinations to measure prostate volume were performed monthly. animals were euthanized after five months for histological study of their prostates. results: all animals developed bph, with prostate volume increasing over time as hormones were administered (r=0,910). all ultrasonographic studies performed up to the third month evidenced a significant increase in prostate volume when compared to the prior ultrasound measurement. a significant decrease in prostate volume was seen in group 1 once hormone administration was interrupted, whereas group 2 animals showed a continuing increase in prostate size. histological examination showed almost no evidence of bph in group 1 animals, while group 2 animals clearly exhibited moderate epithelial hyperplasia. conclusions: the administration of a combination of steroid hormones is effective in inducing benign prostatic hyperplasia in canines, but this hyperplasia disappears when hormone treatment is interrupted. in order to be useful for experimental studies, hormones should be administered for at least three months before commencing any treatment, and they should be continued throughout the length of the study.
Clips metálicos de titanio: una técnica de sutura más rápida y fácil de utilizar que las suturas convencionales en autotrasplantes renales heterotópicos en cerdos en crecimiento
Calles Vázquez,Ma Carmen; Abellan Rubio,Elena; Crisóstomo Ayala,Verónica; Martín Cancho,Ma Fernanda; Sánchez Margallo,Francisco M.; Usón Gargallo,Jesús;
Actas Urológicas Espa?olas , 2009, DOI: 10.4321/S0210-48062009000100014
Abstract: introduction: when performing vascular reconstruction in growing elements, specifically in paediatric transplant surgery, where a short vascular occlusion time is mandatory, master and easily handled suturing methods are needed. thus the present study compares conventional continuous suturing with polypropylene and dexon versus easier and faster to apply titanium clips in heterotopic renal autotransplants. material and methods: 24 growing pigs were used for this study. heterotopic renal autotransplant was performed when the animals were 45 days old using vcs clips, continous polypropylene or dexon suturing when anastomosing the renal artery and vein to the aorta and cava in an end-to-side fashion results: vcs clips were easy to use for the surgeon, significantly (p ≤ 0.001) decreasing the time needed for end-to-side anastomosis of the renal artery to the aorta (clips, 5.31 ± 0.80 min/ polypropylene, 14.25 ± 2.25 min/dexon, 14.37 ± 2.97 min); and also the time needed for end-to-side anastomosis of the renal veins to the cava (clips, 8.25 ± 1.98 min/polypropylene, 16.25 ± 2.96 min/ dexon, 19.00 ± 4.50 min). conclusions: the use of vcs clips in heterotopic renal autotransplants significantly decreases the time needed for vascular reconstruction, compared to conventional suturing.
Modelos experimentales en la cirugía laparoscópica urológica
Usón Gargallo,J.; Sánchez Margallo,F.M.; Díaz-Güemes Martín-Portugués,I.; Loscertales Martín de Agar,B.; Soria Gálvez,F.; Pascual Sánchez-Gijón,S.;
Actas Urológicas Espa?olas , 2006, DOI: 10.4321/S0210-48062006000500005
Abstract: we present the experience of the minimally invasive surgery centre (misc) in the development of a modular training model in laparoscopic surgery. the experience analysis includes the description of the training objectives, the learning process of simple and advance laparoscopic urologic techniques, as well as some current and future considerations before applying the laparoscopic techniques. this learning program pretends to optimize the knowledge of the surgeon and the clinical practice of these surgical techniques. the phases of the learning process have been classified in four levels, which include different modules and models and whose application will depend on the experience and surgical skills. this pyramidal training system permits the student to advance step by step through each level depending on her surgical skills. we have presented our experience in twelve courses about laparoscopic urology and four courses of laparoscopic radical prostatectomy, in which more than 300 urologists have assisted. furthermore, some spanish urology units have been developing special experimental training programs on laparoscopic radical prostatectomy, partial nephrectomy or laparoscopic dismembered pyeloplasty with anderson-hynes technique. it has been previously described that laparoscopic modular learning constitutes a very useful concept to avoid problems related to an incomplete and incorrect learning process. also it seems clear that the laparoscopic training reduces the learning curve in laparoscopic urologic techniques.
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