IntroductionFlow diversion is a new approach to the endovascular treatment of intracranial aneurysms which uses a high density mesh stent to induce sac thrombosis. These devices...Full Text Available
Purpose: To evaluate the success rates of the implantation of stent grafts in the treatment of peripheral aneurysms. Materials and methods: in 13 patients with 15 aneurysms at the common iliac artery (n = 6), external iliac artery (n = 1), hypogastric artery (n = 2), femoral artery (n = 2) or popliteal artery (n = 4), implantation of dacron-covered nitinol stents was performed. The patients were followed up for three to 20 months (mean, 8.8 months) with intravenous digital subtraction angiography, CT or colour-coded Doppler sonography. Results: In all cases, the aneurysm was successfully occluded after stent implantation. In one case with a popliteal aneurysm, kinking of the vessel caused thrombosis of the stent. The stent was successfully reopened. The aneurysm however, had to be surgically treated 9 months later. The primary and secondary patency rates at 6 months were 93% and ...
As an alternative to surgery, endovascular therapy with stent grafts has become the second main treatment option for infrarenal abdominal aortic aneurysms. Unlike surgery, endovascular treatment with stent grafts is also applicable in patients unfit for open repair. Despite current improvements in endovascular repair devices, significant anatomic barriers still exclude this technique for a large number of patients. Computed tomography, magnetic resonance imaging, and ultrasound are essential for diagnostics, preintervention planning, and postintervention follow-up of abdominal aneurysms treated with stent grafts. This review covers etiology, pathology, and diagnostic aspects. Materials and methods for endovascular treatment of abdominal aortic aneurysms are presented in detail, and clinical results and complications are discussed. (orig.) [German] Die endovaskulaere Therapie des ...
Nineteen of 69 patients undergoing coronary angioplasty required immediate coronary surgery after the procedure. Six of these operations were planned as a result of angioplasty that failed without producing...Full Text Available
Computerized Tomography has gained an important role in the diagnosis of the complications of prosthetic surgery of the abdominal aorta: the importance of such complications come from their frequency, which is proportional to the increasing number of interventions, and their severity. The authors investigated the CT patterns of the most frequent complications. 24 patients referred for strongly suspected postoperative complications were examined in 2 years: fever and leukocytosis (20 cases) and progressive anemia (4 cases) were the most frequent findings. The operation had been performed 7#+-# 12 weeks before (2 patients were excluded because surgery dated less than 3 weeks. 14 patients had infective complications: thickening (57%) and inhomogeneity (43%) of the periprosthetic wrap and ectopic gas bubble (78%) were the most frequent Computerized Tomography findings. The authors also observed 2 periprosthetic hematomas, 1 ...
A rare, true aneurysm of a branch of the right subclavian artery is described. Transcatheter coil embolization of the feeder artery was successful in obliterating blood flow into the aneurysm and the mass reduced in size. However, the aneurysm reenlarged over the next week of follow-up due to development and enlargement of the collateral vascular network. Extirpation of the aneurysm was performed. Histopathological examination revealed a true aneurysm. PMID:11833847
This is a report of surgical treatment of thoracoabdominal aortic aneurysms and aneurysms of the abdominal aorta from which the visceral vessels arise during the 18 year period from April 5, 1960,...Full Text Available
Unruptured cerebral aneurysms often present with neuro-ophthalmological symptoms but ocular autonomic involvement from an aneurysm of the posterior circulation has not previously been reported. A patient...Full Text Available
BackgroundVisceral artery aneurysms (VAA), although uncommon, are increasingly being detected. We describe a case of spontaneous retroperitoneal hemorrhage from a ruptured IMA aneurysm...Full Text Available
NSCLC (non-small cell lung cancer) comprises about 80% of all lung cancer cases worldwide. Surgery is most effective treatment for patients with early-stage disease. However, 30%–55% of these...Full Text Available
Background and PurposeHemodynamic insults at arterial bifurcations are hypothesized to play a key role in intracranial aneurysm formation. This study investigates...Full Text Available
Background. The coexistence of neoplasm and abdominal aortic aneurysm (AAA) presents a real management challenge. This paper reviews the literature on the prevalence, diagnosis,...Full Text Available
We report the results of a prospective clinical study using a new self-expanding nitinol stent (Enterprise) designed for the treatment of wide-necked intracranial aneurysms. We treated 31 saccular, wide-necked intracranial aneurysms in 30 patients. Ten aneurysms had recanalized after prior endovascular treatment without a stent, and 21 aneurysms had not been treated before. Stent deployment was successful in all procedures. Additional coil embolization was performed in all aneurysms. Initial complete angiographic occlusion was achieved in 6 aneurysms, a neck remnant was left in 18 aneurysms and there were 7 residual aneurysms. Angiographic follow-up examinations of 30 lesions after 6 months demonstrated 15 complete occlusions, 8 neck remnants and 7 residual aneurysms. One patient refused the 6-month ...
Eleven patients who had undergone cardiac surgery were studied by means of high-field MR imaging (1.5 T). Six patients had aortic root and valve replaced with a Bjork-Shiley (BS) composite tubular aortic graft prosthesis for acute dissection of ascending aorta. In the other 5 patients with rheumatic calcific aortic disease, the valve had been replaced with a BS prosthesis. As a whole, MR studies were 14. Previous evaluations of magnetic field effects had seem carried out ex vivo on both BS valves and BS composite prostheses, on surgical ligation clips (Tantalium and Stainless) and on stainless wires for sternal closure. In 4 patients (2 BS composite grafts, and 2 BS valves) MRI diagnosed chronic dissection of both arch and descending aorta. In 1 of them, with a bs valve, associated localized acute dissection of ascending aorta was observed. In 3 patients with BS composite grafts, MRI revealed pseudo-aneurysms (including a thrombosed one) at the ...
Coiling or infusion of embolic materials into a wide necked aneurysm can be performed with stenting. The purpose of our study is to assess the technical feasibility of aneurysm treatment with glue embolization after stenting. We used four Wallstents for surgically repairing eight canine carotid aneurysms. After confirmation of the aneurysms on the angiogram, we introduced a 6-7 F guiding catheter in order to deploy the stents. After stenting, we passed a microcatheter into the aneurysm lumen through the stent mesh. 28% glue was slowly injected until the glue cast completely filled the lumen. We evaluated the passage of a microcatheter through the stent meshwork, formation of the glue cast and the stents' ability to protection for any leakage of glue. The follow-up angiogram was obtained for two dogs, one to three times until 8 weeks, and then we sacrificed the dogs and performed ...
Femoral head replacement was performed for femoral neck fracture or femoral head necrosis on 36 hips of 34 patients on whom Tc-99m MDP scintigraphy was done for analysis of radioisotope uptake around the prosthesis. In the cases with satisfactory clinical course after replacement surgery the uptake was high in the area between the prosthesis and the trochanter, in the area of the stem tip of the prosthesis and in the acetabular area. The high uptake decreased gradually and reached a normal level by 8 months after surgery. The cases with no decrease of high uptake by 8 months after surgery were considered to have had an eventful postoperative course associated with some complication such as infection, fracture, loosening etc. Tc-99m MDP scintigraphy was useful for early detection of complications and to evaluate progress of the operated patients. (author)
Purpose. To compare erectile function (EF) recovery of patients treated by early penile rehabilitation therapy (PRT) with sildenafil and with control group. Method. Forty men treated by bilateral nerve sparing radical prostatectomy (NSRP) and with a normal pre-operative EF were enrolled. Fourteen days after surgery, they were randomised to a flexible-dose sildenafil group and to a control group. The International Index of Erectile Function (IIEF) questionnaire was completed before surgery and at 3, 6, 12 and 24 weeks after NSRP. Results. In the group treated, the mean IIEF score before surgery was 26.2 and 14.1, 16.2, 22.5 and 25.2 at 3, 6, 12 and 24 weeks after NSRP, respectively. In the control group, the respective scores were 26.5 and 12.4, 15.8, 15.3 and 17.4. There was a significant ...
In recent years, Obesity (defined as Body Mass Index > 30 kg/m2) has increased its prevalence reaching epidemic levels in countries such as The United States where it has became a national health issue. In Colombia the Obesity prevalence is figured around 14%. Treatment options for Obesity include life style modifications, pharmacologist management and surgical approach (Bariatric Surgery). This article describes a patient with previous bariatric surgery, who presents abdominal pain and melena owed to isquemic process of the alimentary limb caused by an internal hernia which is a potentially lethal condition if it is not highly suspected allowing its early diagnosis and treatment
ObjectiveWe describe our clinical experiences and outcomes in patients who had thromboembolic complications occurring during endovascular treatment of intracerebral aneurysms with...Full Text Available
Thoracic aortic aneurysms (TAAs) are potentially devastating, and due to their asymptomatic behavior, pose a serious health risk characterized by the lack of medical treatment options and high...Full Text Available
Purpose: To assess the prevalence, significance and practical value of two recently described CT signs of instable aneurysm: the crescent sign and the periluminal halo (a low-attenuating internal layer of the thrombus around the patent lumen). Material and methods: Among the CT examination performed in the last 5 years, they retrospectively selected the nonruptured aneurysms with a diameter exceeding 4 cm (no. = 93 average diameter 5.1 cm, unenhanced images in 28 cases and enhanced in 84) and the ruptured aneurysms (no. = 16, average diameter 6.7 cm, unenhanced images in 9 cases and enhanced in 9). They studied the prevalence of the crescent and halo sing, their relationship with the aneurysm diameter, and the effect of contrast enhancement. Results: The crescent sign was identified with a statistically significant prevalence in ruptured ( 37.5 % or cases) over asymptomatic ...
The subtemporal approach with division of the posterior communicating artery (PcomA) is described for treating aneurysms of the basilar tip. When the ipsilateral posterior cerebral artery (PCA) interferes...Full Text Available
BackgroundAn abdominal aortic aneurysm (AAA) that is identified when the abdomen is imaged for some other reason is known as an incidental AAA. No population-based studies have...Full Text Available
Aneurysms of saphenous vein grafts are rare but can result in complications such as myocardial infarction or death. Percutaneous treatment has included a variety of approaches, including covered stents....Full Text Available
Left ventricular aneurysm (LVA) is one of the most important complications of myocardial infarction LVA is strictly defined as a distinct area of abnormal left ventricular diastolic contour with systolic...Full Text Available
Two cases of left ventricular aneurysm, a 16-year-old black boy and a 23-year-old white girl, from Bahia, Brazil, are presented. In both patients there was enlargement of the cardiac silhouette and...Full Text Available
Six patients with diskitis following lumbar disk surgery were investigated by Computed Tomography (CT). Four patients underwent CT in a rather early phase of the disease (5-37 days after the onset of the symptoms): a posterior paravertebral fluid collection was always recognized, while the plain film was normal. Later on (2-4 months), the classical signs of diskitis were evident, with both CT and the plain film. The collection was always present at CT. A reintervention, performed on 3 patients, revealed the purulent content of the collections. It seems reasonable to suggest a relationship between the collection and the subsequent diskitis; the collection is probably an early sign of the disease. Its detection is of grat value, because it could allow an immediate and adequate therapy. The authors stress the usefulness of performing CT in an early phase on this kind of symptomatic patients.
Premature fusion of multiple cranial sutures has been associated with increased intracranial pressure and the potential for mental impairment. Isolated craniosynostosis, however, is considered a benign condition primarily reconstructed for aesthetic purposes. A comparative analysis, to assess the differences between pre- and post operatory cerebral perfusion of patients who underwent surgery for simple cranisynostosis, was performed using single positron emission computed tomography ''SPECT'' Images. Cerebral blood flow studies were performed using "9"9"mTc-HMPAO SPECT in children with simple cranisynotoses. The subjects were 8 children with craniosynostosis (age, 2 months-9 years). Preoperative revealed regional hypovascularity in the cerebral hemisphere in 5 cases (62%). In 6 patients the cerebral blood flow normalized or increased after craniofacial reconstruction. We demonstrated the presence of regional hypovascularity in the cerebral hemisphere of simple ...
Full text: Tumour ablation with radiofrequency (RF) energy is a relatively new procedure for the treatment of focal malignant disease. At our institution this is currently being used in the treatment of certain liver and lung lesions with the patients involved being enrolled in clinical trials. The poster describes the technique used at our institution for the placement of the radiofrequency ablation electrode using CT fluoroscopy. Criteria for patient selection are included. Complications from the procedure are described, as well as follow up appearances and results. Our results from the treatment of primary and secondary lesions in the liver correlate well with published literature. Treatment is still not as successful as surgical resection but there is significantly less morbidity. Where this method may be appropriate is when the patient is not a candidate for surgical resection. The treatment of colorectal metastases in the lung shows early promise as a ...
The parathyroid endocrine glands, usually four in number and about the size of a split pea, lie on either side of the posterior aspect of the thyroid gland. Occasionally one or more of these structures are found in an aberrant position in the neck or even in the superior mediastinum. The parathyroid secretion, parathormone, regulates the level of serum calcium within sharply defined limits. Lack of parathormone, with lowering of the serum calcium, results in hyper-irritability of skeletal muscle, the clinical condition known as tetany. This is encountered following inadvertent removal or bruising of the parathyroid glands at thyroidectomy. PMID:21488463
Ventricular septal defects can occur as part of other congenital cardiac malformations or as an isolated finding. Aneurysms of the sinus of Valsalva are rare, most commonly involving the right or noncoronary sinuses. They can be congenital or acquired through infection, trauma, or degenerative diseases. They frequently co-exist with ventricular septal defects, aortic valve dysfunction, or other cardiac abnormalities. More commonly, sinus of Valsalva aneurysms are diagnosed after the clinical sequelae of rupture. Several etiologic factors may lead to the development of pathologic pericardial effusion and the detection of pericardial effusion was one of the first applications of echocardiography to gain widespread acceptance. We present a case of a chance finding of an aneurysm of the right ...
Purpose: To assess the prevalence, significance and practical value of two recently described CT signs of instable aneurysm: the crescent sign and the periluminal halo (a low-attenuating internal layer of the thrombus around the patent lumen). Material and methods: Among the CT examination performed in the last 5 years, they retrospectively selected the nonruptured aneurysms with a diameter exceeding 4 cm (no. = 93 average diameter 5.1 cm, unenhanced images in 28 cases and enhanced in 84) and the ruptured aneurysms (no. = 16, average diameter 6.7 cm, unenhanced images in 9 cases and enhanced in 9). They studied the prevalence of the crescent and halo sing, their relationship with the aneurysm diameter, and the effect of contrast enhancement. Results: The crescent sign was identified with a statistically significant prevalence in ruptured ( 37.5 % or cases) over asymptomatic ...
Purpose: To describe CT appearances in patients with unilateral cleft lip and palate (CLP) 20 years after bone graft surgery. Material and Methods: Eighteen consecutive patients with unilateral CLP were examined. All patients had been treated with primary closure, both in infancy and early childhood, supplemented with bone grafting at the age of around 10 years. The CT examination of the upper jaw included a dental CT program. The CT appearances of the cleft side were compared with those of the untreated non-cleft side. Results: Abnormal CT appearances included skew nasal aperture (n=17), nasal septal deviation (n=17), low floor of nasal aperture (n=15) at or towards the cleft side, and deviation of anterior nasal spine towards the non-cleft side (n=18). The posterior part of the bone cleft was visible in all patients, and the dental arch was V-shaped in 8. Conclusion: Although adherence to the present treatment protocol is considered to give ...
Purpose: To describe CT appearances in patients with unilateral cleft lip and palate (CLP) 20 years after bone graft surgery. Material and Methods: Eighteen consecutive patients with unilateral CLP were examined. All patients had been treated with primary closure, both in infancy and early childhood, supplemented with bone grafting at the age of around 10 years. The CT examination of the upper jaw included a dental CT program. The CT appearances of the cleft side were compared with those of the untreated non-cleft side. Results: Abnormal CT appearances included skew nasal aperture (n=17), nasal septal deviation (n=17), low floor of nasal aperture (n=15) at or towards the cleft side, and deviation of anterior nasal spine towards the non-cleft side (n=18). The posterior part of the bone cleft was visible in all patients, and the dental arch was V-shaped in 8. Conclusion: Although adherence to the present treatment protocol is considered to give ...
We evaluated robotically assisted laparoscopic adrenalectomy (RLA) in a prospective study of 100 consecutive patients (60 women and 40 men) undergoing unilateral adrenalectomy at the University Hospital. The median age was 59 (24?82) years and BMI 27.6 (17.1?40.9) kg/m2. Preoperative diagnoses were Conn?s syndrome 30%, pheochromocytoma 23%, Cushing syndrome 27% and non-functional tumor 20%. The median tumor size was 53 (10?106) mm. The majority of the 7% of the patients who were converted to open surgery were in the early phase after the introduction of the technique. The BMI of the patients who were converted to open surgery was significantly higher, 31.5 (range 25.3?37.8) compared to, 27.5 (range 17.1?40.9) in patients without conversion (P?=?0.047). The median weight of the tumor was 51...
Abstract Background:- Surgical dislocation of the hip has been developed to deal with the problems causing femoroacetabular impingement (FAI). This is a relatively recent procedure that was historically reserved for larger areas specializing in hip surgery. Methods:- We hypothesized that surgical dislocation can be used for symptomatic FAI in a typical Australasian tertiary orthopaedic centre with acceptable results. This prospective study reviews the results of 53 surgical dislocations in this setting, looking particularly at functional outcomes and early complications. Results:- There were significant improvements in the Western Ontario and McMaster University Osteoarthritis Index score at 1, 2, 3 and 4 years post-operatively. Western Ontario and McMaster University Osteoarthritis Index ...
Ninety-four patients with peripheral arterial injuries were subjected to acute repair, negative exploration, or late repair of the complications of the arterial injury (false aneurysm, A-V fistula,...Full Text Available
A 65-year-old man suffering from ascending aorta aneurysm and atherosclerotic three vessel disease without left main involvement underwent aortic root replacement with coronary ostia reimplantation...Full Text Available
Anesthetic techniques vary widely in the endovascular repair of abdominal aortic aneurysms (EVAR). Previous studies have demonstrated the feasibility of using local anesthesia. However, the ideal anesthetic technique has not been determined. This study examines whether anesthesic technique influences the outcomes of EVAR. Data regarding demographics, risk factors, procedural characteristics, recovery characteristics, treatment complications, acute ( 0.05, ANOVA). From these results we concluded that EVAR with local anesthesia is a safe and efficacious method that may reduce recovery times and postoperative medical morbidity compared to use of genera1 or spinal/epidural anesthesia.
The aim of this study was to determine sensitivity and specificity of magnetic resonance angiography (MRA) for the assessment of durable occlusion of intracranial aneurysms with Guglielmi detachable coils (GDC) and to point out the influence of MRA results in re-intervention strategies. Forty-five patients with 54 aneurysms that were previously treated by endovascular occlusion with GDC were selected for this study. All patients underwent digital subtraction angiography (DSA) and MRA examinations on the same day. The time-of-flight MRA studies were performed on a 1-T scanner. The MRA images were first read by radiologists who were not aware of the DSA results. In a second consensus reading by the neuroradiologists who had performed all interventional procedures of this series, the decision was made as to whether re-treatment was necessary. The distribution of aneurysm sizes, configurations and treatment results were ...
ContextMusic and surgery.ObjectiveTo determine the effect of live classical piano music on vital signs of patients undergoing ophthalmic surgery.DesignRetrospective...Full Text Available
Arthroscopy, a minimally invasive alternative to standard open surgical techniques and now the most commonly performed orthopedic surgical procedure, was one of the greatest advances in orthopedic surgery...Full Text Available
Background: Contamination of autologous grafts unfortunately occurs in plastic surgery, but the literature provides no guidance for management of such incidents. Methods: American...Full Text Available
Objective:To evaluate the effect of urethral reconstructive surgery on sexual drive, erectile function and ejaculation.Materials and Methods:The...Full Text Available
PurposeTo evaluate the clinical characteristics and outcomes of cataract surgery in highly myopic Korean subjects.MethodsWe retrospectively reviewed...Full Text Available
The authors reviewed the literature on psychological and psychosocial outcomes for individuals undergoing cosmetic surgery, to address whether elective cosmetic procedures improve psychological...Full Text Available
Haemangiomas usually develop within the first few weeks of life, most regressing spontaneously before the age of 7 years. Some may ulcerate or compromise a vital function, in which case systemic corticosteroids, surgery or radiotherapy may be helpful. All of these treatment modalities are associated with significant morbidity. Treatment with the 585 nm flashlamp pulsed dye laser is safe and effective in the management of superficial vascular malformations. We report seven patients, under 12 months of age, who presented with proliferative haemangiomas, causing functional impairment. Ulcerated lesions were present in four patients. The patients were treated with the 585 nm pulsed dye laser (fluences 7.0-9.25 J/cm2), at intervals of 4-8 weeks. All of the lesions showed a significant reduction in size, together with improvement in the colour and integrity of the overlying skin. Treatment with the 585 nm pulsed dye laser should be considered in the management of infants ...
Diffusion magnetic resonance imaging (MRI) has become an important tool in the radiologic diagnosis of diseases of the brain as it measures molecular motion of water that characterizes the microstructure of tissues. Its most important clinical use to date is the early detection of cerebral ischemia by revealing the ischemic injury shortly after vessel occlusion and simultaneously providing therapy-relevant information on the tissue at risk. Furthermore, diffusion MRI is diagnostically promising in other diseases of the brain and is thus increasingly becoming part of routine clinical protocols in the diagnosis of tumors, inflammation, trauma, demyelination, dysmyelination and neurodegeneration. Although abnormalities of diffusion are generally not pathognomonic, diffusion MRI affords information about tissue changes for specific disorders that complements information obtained with standard MR techniques and frequently shows pathology earlier. In addition, diffusion ...
Gallstone is a common disease with a 10% prevalence in the United States and Western Europe. However, it is only symptomatic in 20-30% of patients, with biliary pain "colic" being the most common symptom. Complications of asymptomatic gallstone disease are generally rare, with an incidence of <1 %/yr. The most common complications of gallstone disease are acute cholecystitis, acute pancreatitis, ascending cholangitis, and gangrenous gallbladder. Less frequent complications include Mirizzi syndrome, cholecystocholedochal fistula, and gallstone ileus. Mirizzi syndrome and cholecystocholedochal fistula are two manifestations of the same process that starts with impaction of a gallstone in the gallbladder neck that results in obstruction of the bile duct, causing jaundice. The gallstone may erode into the bile duct, causing cholecystocholedochal fistula. Gallstone ileus refers to small bowel obstruction resulting from the impaction of one or more gallstones after they have migrated ...
Gastrointestinal lymphomas are almost exclusively of a non Hodgkin's type. The Western form is characterized by a higher incidence of stomach location (50 %), a MALT type (mucosa associated lymphoid tissue) (40 %), a B-cell type (90 %), and a high grade (55 %). Chronic infection with Helicobacter pylori is an important risk factor. Mediterranean lymphomas form a particular clinical and pathological entity with diffuse involvement of the small bowel and are frequently being associated with a chronic malabsorption disorder. Eradication of Helicobacter pylori in early lymphomas, and the use of tetracyclines in early Mediterranean lymphomas, have been shown to induce durable remissions. For more advanced gastric lymphomas, treatment usually consists of anthracycline-based chemotherapy followed by involved field radiotherapy. Surgery is usually reserved for complications such as perforation or bleeding, or in some selected cases ...
Background and purpose: Local treatment for non-metastatic Ewing's sarcoma family tumors (ESFTs) is controversial. Results achieved in a single institution in patients with ESFT of the humerus are presented. Materials and methods: Patients treated between 1983 and 2000 for ESFT of the humerus were included. The impact of local treatment (surgery, radiotherapy or both) on outcome was assessed. Results: 55 patients: 34 males (62%); 21 females (38%); mean age: 17.9 (range: 3-40). Local treatment: surgery in 27 patients (49%), radiotherapy in 17 (31%) and surgery followed by radiotherapy in 11 (20%). After a mean follow-up of 15 years (range: 7-25 years), 27 patients (49%) remained continuously disease free, 27 (49%) relapsed and one died of chemotherapy toxicity. The local recurrence rate was 13% overall: 18% (3/17) after radiotherapy, 7% (2/27) after surgery and 19% (2/11) after ...
Robotic surgery will give surgeons the ability to perform essentially tremorless microsurgery in tiny spaces with delicate precision and may enable procedures never before possible on children, neonates, and fetuses. Collaboration with radiologists, engineers, and other scientists will permit refinement of image-guided technologies and allow the realization of truly remarkable concepts in minimally invasive surgery. While robotic surgery is now in clinical use in several surgical specialties (heart bypass, prostate removal, and various gastrointestinal procedures), the greatest promise of robotics lies in pediatric surgery. We will briefly review the history and background of robotic technology in surgery, discuss its present benefits and uses and those being explored, and speculate on the future, with attention to the current and potential involvement of imaging modalities and the ...
PurposeWe evaluated the effects of surgery for rectal cancer on postoperative voiding and sexual function over the course of time.Materials and MethodsData...Full Text Available
The study design includes a systematic literature review. The objective of the study was to evaluate the effectiveness of transforaminal endoscopic surgery and to compare this with open microdiscectomy...Full Text Available
Accompanying rapid developments in hepatic surgery, the number of surgeries and identifications of histological types of primary hepatic space-occupying lesions (PHSOLs) have increased dramatically....Full Text Available
Hip fractures are associated with a high rate of mortality and profound temporary and sometimes permanent impairment of quality of life. Current guidelines indicate that surgeons should perform surgery...Full Text Available
ObjectivesPericardial tamponade after cardiac surgery is difficult to diagnose, thereby rendering timing of rethoracotomy hard. We aimed at identifying factors predicting the outcome...Full Text Available
Ovarian carcinoma is now the leading cause of death among women. Surgery has reached its limits, and further aggressive surgery will result in an inordinate morbidity and mortality. Ovarian carcinoma...Full Text Available
Laparoscopic colon surgery for select cancers is slowly evolving as the standard of care but minimally invasive approaches for rectal cancer have been viewed with significant skepticism. This procedure...Full Text Available
Sudden unexpected postoperative hemodynamic collapse with a high mortality develops in 1–3% of patients undergoing coronary artery bypass surgery (CABG). The contribution of surgical graft complications...Full Text Available
IntroductionIn lung cancer surgery, large tidal volume and elevated inspiratory pressure are known risk factors of acute lung (ALI). Mechanical ventilation with low tidal volume...Full Text Available
Endovascular surgery is a new multidisciplinary field that applies the recently innovated techniques of angioscopy, intraluminal ultrasound, balloon angioplasty, laser, mechanical atherectomy, and stents....Full Text Available
Background:During transurethral resection surgery (TUR), accidental stimulation of the obturator nerve can cause violent adductor contraction, leading to serious intraoperative...Full Text Available
PurposeTo develop a generic instrument for measuring short-term health status in the recovery period among patients undergoing abdominal and pelvic surgery.Full Text Available
ObjectiveTo evaluate the impact of breast carcinoma (T1–2N0) surgery without axillary dissection on axillary and distant relapses, and to evaluate the usefulness of a panel...Full Text Available
BACKGROUNDOff-pump coronary artery bypass (OPCAB) surgery is associated with a hypercoagulable state in which the platelet thrombin receptor, protease-activated receptor-1...Full Text Available
This is a review of recently published literature on surgery in tropical Africa. It presents the current state of surgical need and surgical practice on the continent. We discuss the enormous burden of surgical pathology (as far as it is known) and the access to and acceptability of surgery. We also describe the available facilities in terms of equipment and manpower. The study looked at the effects of the human immunodeficiency virus, the role of traditional healers, anesthesia, and the economics of surgery. Medical training and research are discussed, as are medical migration out of Africa and the concept of task shifting, where surgical procedures are performed by others when surgeons are not available. It closes with recommendations for involvement and action in this area of great glob...
In interventional radiology (IVR) of cerebral aneurysms, it is important to understand the form and physical relationships between the cerebral aneurysm and the surrounding vessels. However, because the vessels in the head area are highly complex, it can be difficult to comprehend the structure using conventional angiography. Therefore, three-dimensional rotational angiography (3D-RA) has been used in recent years. This article discusses studies of the spatial resolution of 3D-RA. We reconstructed 3D-RA of an acrylic slit phantom (slit widths: 0.5, 0.75, 1.0, 1.5 mm) and examined spatial resolution by visual evaluation and profile curves. When the slit phantom was arranged to avoid the effect of beam hardening, the spatial resolution of 3D-RA was found to be as high as 0.75 mm. When the slit phantom was placed orthogonal to the rotational axis of the C-arm, the spatial resolution of 3D-RA was decreased because of the cone angle effect of ...
The objective of this study was to develop a method for 3D subtraction CT angiography and to optimize the visualization after semiautomatic segmentation. Ten patients with aneurysms of the abdominal aorta were examined using spiral CT. To reconstruct the vessels, as well as adjacent organs such as the liver and kidneys, one image data volume was acquired before and after injection of the contrast agent. The CT scans were obtained with a Siemens Somatom Plus 4. To improve the results of automatic segmentation, as well as visualization by maximum intensity projection (i.e. removal of bony structures), subtraction of both image volumes is necessary. However, small translation shifts disturb the subtraction process and produce artificial contours. To calculate the disparities along the three coordinate axes of two corresponding image volumes, a cepstrum filter is applied to a pair of image volumes. After detection of the disparities, which manifest as bright spots, the ...
IntroductionMost clinical studies on the outcome of apical surgery concentrate on periapical healing based on radiographic and clinical characteristics (signs and symptoms). This study focuses on long-term changes in periodontal parameters after apical surgery. MethodsPeriodontal parameters (ie, probing depth [PD], level of gingival margin [GM], and calculated clinical attachment level [CAL]) were collected at baseline and at 1 and 5 years after apical surgery. Changes in PD, GM, and CAL were calculated over time and were also evaluated in relation to patient-, tooth-, and treatment-related covariables. ResultsOne hundred eighty-six of 242 initially identified teeth could be evaluated. Significant changes in GM and CAL were observed at facial sites during the first year after surgery (mean...
The objective of this study was to compare contrast-enhanced magnetic resonance angiography (CE MRA) and multislice computed tomographic angiography (MS CTA) in the follow-up of thoracic stent-graft placement. The CE MRA and MS CTA were performed following nitinol stent-graft treatment due to thoracic aneurysm (n=4), intramural bleeding (n=2) and type-B aortic dissection (n=5). Corresponding evaluation of arterial-phase imaging characteristics focused on the stent-graft morphology and leakage assessment. Stent-graft and aneurysm extensions were comparable between both techniques. Complete exclusion (aneurysm, n=4; dissection, n=2) was assessed with high confidence with CE MRA and MS CTA. Incomplete exclusion (intramural bleeding, n=2; dissection, n=3) was assigned to lower confidence scores on CE MRA compared with MS CTA. On CE MRA the stent-graft lumen demonstrated an inhomogeneous signal, the stent struts could not be ...
Some studies suggest that giving radiation therapy after surgery for hilar cholangiocarcinoma improves the survival rate; however, many of these studies did not specify numbers of subjects or provide an impartial analysis. Thus, we evaluated the effectiveness of radiation therapy as adjuvant treatment after surgery and attempted to establish appropriate adaptation standards. We reviewed the records of 69 patients who underwent surgery for hilar cholangiocarcinoma between June 1980 and April 1998. Thirty-nine patients were treated with surgery followed by radiation therapy and 30 were treated with surgery alone. The clinicopathologic features that might have influenced prognosis were similar in the patients who received radiation therapy and those who did not. Radiation as adjuvant therapy did not have a beneficial effect on overall survival (P=0.554, log-rank test); however, it ...
Transcription for a hybrid SV40 promoter-beta globin coding sequence recombinant initiates from both early-early (EE) and late-early (LE) SV40 start sites (EES and LES) in the absence of DNA replication....Full Text Available
Russian field surgery with its long history and distinctive characteristics has accumulated great experience in the long-time practice of warfare. Chinese field surgery was established and developed on the basis of studying from the Russian model, which opened up new areas of traffic medicine, molecular traumatology and assessment of biological effects on weapon destruction and carried out in-depth research on wound ballistics, blast injury, burns and combined injury etc. through decades of construction with continuous development and innovation, and a series of major achievements have been made in these fields. By making comparative study on the historical evolution, structure system, characteristics of campaigns and development of society between Chinese and Russian field surgery, it can be found that there are great gaps between them and we should strengthen the research for more rapid development. PMID:20510098
BackgroundBlindness due to trachoma is avoidable through Surgery, Antibiotics, Facial hygiene and Environmental improvements (SAFE). Recent surveys have shown trachoma to be a serious...Full Text Available
... flex to LCCK components, to even a rotating hinge knee arthroplasty, and finally, to the segmental system. ... it also allows you to convert to the hinge immediately too, you know, especially in these bigger ...
Background/Aim:To assess the prognostic indicators preoperatively presenting and influencing the mortality rate following esophagectomy for esophageal cancer.Full Text Available
Corneal laser refractive surgery is increasingly being performed on patients with the aim of improving unaided vision. Most candidates for surgery have excellent spectacle- or contact lens-corrected vision. Although microbial keratitis following refractive surgery is a rare complication, and usually has a good visual outcome, it can be sight-threatening. The spectrum of pathogens differs to other causes of microbial keratitis, such as contact lens-associated keratitis, and a different management approach is required. Postoperatively, patients are prescribed topical steroids and broad-spectrum topical antibiotics, typically fluoroquinolones. These do not cover unusual organisms, such as fungi, Nocardia, Acanthamoeba and some atypical mycobacteria. In post-laser-assisted in situ keratomileus...
The MRI's of 16 patients with either primary or secondary lymphatic disorders are evluated and the findings are compared to those from lymphangioscintigraphy or surgery. (author).
At present time, there is evidence from randomized controlled studies of the success of laparoscopic resection for the treatment of colon cancer with reported smaller incisions, lower morbidity rate...Full Text Available
Aims and objectives.- To investigate infant well-being as measured by feeding and sleeping and parental support following discharge from the NICU in infants following major cardiac surgery. Background.- Infant feeding and sleeping have been identified as two of the most important concerns reported by parents. These concerns have been reported anecdotally for infants who have undergone cardiac surgery in the neonatal period. Design.- A prospective study using questionnaires and phone interviews followed a cohort of parents of neonates who underwent surgery in the neonatal period for congenital heart disease. Methods.- The study was conducted using validated questionnaires and phone interviews with a semi-structured questionnaire. The questionnaires were administered prior to discharge from ...
Background:Since first reported in 1996, endoscopic minimally invasive surgery of the cervical region has been shown to be safe and effective in the treatment of benign thyroid and...Full Text Available
... very difficult to help get better and to rehabilitate and sometimes even need surgery. 00:04:21 ... step of treatment, from our standpoint, is to rehabilitate, to strengthen the shoulder. And the real key ...
Previous research with individuals undergoing surgery or diagnostic procedures provided a conceptual framework for analysis of radiation therapy, a common form of cancer treatment. The present...Full Text Available
Objective Infectious endophthalmitis is among the most serious complications of cataract surgery. Gram-negative bacteria, including Pseudomonas aeruginosa, are responsible for less than 30% of cases; however, their rapidity of infection and virulence often results in poor visual outcome despite prompt antibiotic treatment. The purpose of this study was to investigate an outbreak of post-cataract surgery P. aeruginosa endophthalmitis in India. Design Hospital-based case series. Participants Twenty patients with acute postoperative endophthalmitis who underwent cataract surgery at one of the peripheral centers of Joseph Eye Hospital, Tiruchirapalli, Tamil Nadu, India, from February 23 to April 2, 2008. Interventions Vitreous aspirates and environmental surveillance specimens were inoculated ...
BACKGROUNDOpen carpal tunnel release (OCTR) is the standard procedure for the surgical treatment of carpal tunnel syndrome. With the advent of minimally invasive surgery, endoscopic...Full Text Available
Acute thoracic aortic injuries account for up to 10-20% of fatalities in high-speed deceleration road accidents and have an estimated immediate fatality rate of 80-90%. Untreated survivors to acute trauma (10-20%) have a dismal prognosis: 30% of them die within 6 hours, 40-50% die within 24 hours, and 90% within 4 months. It was investigated the diagnostic accuracy of Helical Computed Tomography (Helical CT) in acute traumatic injuries of the thoracic aorta, and the role of this technique in the diagnostic management of trauma patients with a strong suspicion of aortic rupture. It was compared retrospectively the chest Helical CT findings of 256 trauma patients examined June 1995 through August 1999. Chest Helical CT examinations were performed according to trauma score, to associated traumatic lesions and to plain chest radiographic findings. All the examinations were performed with no intravenous contrast agent administration and the pitch 2 technique. After a previous baseline ...
Penetrating liver wounds are related to many causes and rank second after blunt abdominal and liver trauma. In this report are examined the clinical and radiological findings of personal series of patients with penetrating trauma, especially by firearms and stab and cut wounds. It will also tried to define the diagnostic workup of these traumas, which is especially based on CT signs of liver damage and associated changes and which is of basic importance for following treatment, both surgical or conservative. In the last seven years it was retrospectively reviewed 31 cases of penetrating liver trauma. The patients were 19 men and 12 women, ranging in age 18 to 73 (mean 42), with penetrating liver injuries from firearms (16 patients) and stab (9 cases) wounds; 6 patients had injuries from different cases. Abdominal CT was carried out in emergency with the CT Angiography (CTA) technique in all patients. In the patients with suspected chest and abdomen involvement CT was performed from the ...
The evaluate the signs of aortic intramural hematoma with helical CT and the diagnostic role of this technique in patients with this condition. It was reviewed the CT findings of 396 patients submitted to emergency examinations for suspected aortic dissection from 1995 to 1999. Only 18 patients (6 women and 12 men) had CT signs of aortic intramural hematoma. Helical CT studies were carried out with the following parameters: slice thickness 10 mm, reconstruction index 10, feed 1.5 mm, conventional algorithm with minimum values of 130 kV and 125mA. All patients were examined with dynamic contrast-enhanced CT, before and after a power injection of 130 mL ionic contrast material. It was studied: hematoma localization and longitudinal extension; thickness and density of aortic wall; presence and location of intimal calcifications; integrity of intimal wall; hemo mediastinum and/or hemo thorax. Aortic wall thickening appeared as a high density crescent-shaped area at baseline CT and had low ...
An assessment is made of the biological effects and physical hazards of static and time-varying fields associated with the NMR devices that are being used for clinical imaging and in vivo spectroscopy. A summary is given of the current state of knowledge concerning the mechanisms of interaction and the bioeffects of these fields. Additional topics that are discussed include: (1) physical effects on pacemakers and metallic implants such as aneurysm clips, (2) human health studies related to the effects of exposure to nonionizing electromagnetic radiation, and (3) extant guidelines for limiting exposure of patients and medical personnel to the fields produced by NMR devices. On the basis of information available at the present time, it is concluded that the fields associated with the current generation of NMR devices do not pose a significant health risk in themselves. However, rigorous guidelines must be followed to avoid the physical interaction of these fields ...
BackgroundDue to the high morbidity and mortality of fulminant hepatitis, early diagnosis followed by early effective treatment is the key for prognosis improvement. So far, little...Full Text Available
... orthopaedics, waiting times, NHS, private hospitals,health news, medical news, health services, medical treatments, health tips NHS ...be sent to private hospitals for surgery in a bid to bring orthopaedic waiting times under control. Plan to send NHS patients for ...
The authors report the personal techniques and the results of CT-guided percutaneous drainage of postoperative abdominal fluid collections. CT-guided percutaneous drainage offers many advantages over surgery: it is less invasive, can be repeated and requires no anesthesia, there are not surgery-related risks and lower morbidity and mortality rates. Moreover, subsequent hospitalization is shorter and costs are consequently reduced. The authors conclude that CT-guided percutaneous drainage is the method of choice in the treatment of postoperative abdominal fluid collections.
Platelet-rich plasma (PRP) is a platelet concentrate that has widely been used to accelerate the healing of soft and hard tissues. The preparation of PRP has been described by several authors. Preparation protocols vary from system to system, depending on the concentration of different integrating proteins. The objective of this article is to describe the principal use of PRP mixed with fat grafts in aesthetic plastic surgery.
Recessive mutations of the early phase change (epc) gene in maize affect several aspects of plant development. These mutations were identified initially because of...Full Text Available
PurposeTo evaluate the effect of vitrectomy timing on outcomes for patients with crystalline retained lens fragments receiving vitrectomy 3+ days after cataract surgery. DesignSystematic review and meta-analysis of retrospective interventional cases series. MethodsSearches of MEDLINE (English, 1/1/85 through 7/30/2010) and article reference lists. Articles were screened for patients with crystalline retained lens fragments after surgery for age-related cataracts, discussion of vitrectomy timing, and, for the meta-analysis, patient totals for at least 1 outcome and multiple time periods, 10+ patients, and mean follow-up ?3 months. Outcomes included visual acuity, retinal detachment, increased intraocular pressure, intraocular infection/inflammation, cystoid macular edema, and corneal...
Seventy-one patients with intestinal injury secondary to pelvic irradiation had predominantly large bowel lesions. Seventeen cases were treated conservatively and 54 came to surgery, 28 patients having more than one operation. Following this essentially salvage surgery there were more ileal than colonic anastomotic leaks. Thirty-four patients died during the follow-up period (2-12 years), 19 from recurrent malignancy, and nine as a result of continuing radiation effects. Seventy per cent of the patients who had a radiation fistula died as a result of malignancy. Of 42000 cases of pelvic malignancy treated by irradiation over the decade 1972-1982, surgical referrals for complications constituted 1.7%, with an overall radiation-related mortality of 0.2%. It is our opinion that colostomy alone has little part to play in this condition, and a policy based on excisional surgery is suggested.
Abstract Aim- Conventional outcomes such as survival, tumour recurrence and complication rates after surgery for rectal cancer have been rigorously assessed, but the importance of maintaining quality of life (QOL) after surgery for rectal cancer has received less attention. The aim of the current study was to analyse QOL and the occurrence of pelvic dysfunction after the surgical treatment of rectal cancer. Method- Between May 2005 and May 2008, 150 patients with rectal cancer underwent abdominoperineal resection (APR) or anterior resection (AR). Seventy-four answered two preoperative questionnaires. At a follow up of 1-year, 65 were alive without sign of recurrence and answered the same questionnaires: (a) validated RAND 36-item health survey QOL questionnaire; and (b) self-administered d...
Background: Ecchymosis, oedema, haematoma and pain after SMAS-based facelift surgery are all the direct result of the physical trauma of surgery and subsequent inflammatory response. Hilotherapy is a novel form of cryotherapy that purports to minimise these events through single-use face masks circulating cooled, sterile water. This study was performed to assess the validity of Hilotherapy in this population of patients. Methods: Over 14 weeks fifty consecutive patients were randomised to post-operative facial cooling with Hilotherapy or management with standard dressings alone, while fifteen subsequent, consecutive patients were randomised to cooling of one side of the face but not the other. Assessment of ecchymosis, oedema, haematoma and pain was performed independently by clinical staf...
Roux-en-Y gastric bypass surgery (RYGB) remains to be the most effective long-term treatment for obesity and its associated comorbidities, but the specific mechanisms involved remain elusive. Because RYGB patients appear to no longer be preoccupied with thoughts about food and are satisfied with much smaller meals and calorically dilute foods, brain reward mechanisms could be involved. Just as obesity can produce maladaptive alterations in reward functions, reversal of obesity by RYGB could normalize these changes or even further reset the food reward system through changes in gut hormone secretion, aversive conditioning and/or secondary effects of weight loss. Future studies with longitudinal assessments of reward behaviors and their underlying neural circuits before and after surgery wil...
Background: While waiting for surgery, patients often exhibit fear and anxiety. Music is thought to be an alternative to medication to relieve anxiety. However, due to concerns about infection control, devices other than headphones may be considered for this purpose. Objectives: The purpose of this study was to determine the anxiety-relieving effect of broadcast versus headphone music playing for patients awaiting surgery. Design: A randomized controlled clinical study. Setting: The waiting area of an operating theater of a metropolitan teach hospital in Taiwan. Participants: Alert adult with age between 20 and 65 years old waiting for surgery without premedications. Methods: A total of 167 patients were randomly assigned to the headphone, broadcast and control groups. Both the headphone a...
Background Laparoscopic inguinal hernia repair has been around since the 1990s. A novel surgical approach known as laparoendoscopic single-site surgery (LESS) has been developed to reduce the port-related morbidities and improve the cosmetic outcomes of laparoscopic surgery, including totally extraperitoneal (TEP) inguinal hernia repair. The aim of the present study was to evaluate the safety and feasibility of the LESS TEP technique for inguinal hernia repair and compare the outcomes with the standard TEP approach. Methods Between January and May 2009, 54 consecutive healthy patients (48 men and 6 women) underwent LESS TEP inguinal hernia repair at our institute. All procedures were performed using our homemade single port for simultaneous passage of the laparoscope and instruments. The p...
A 65-year-old woman who was diagnosed as having psoitis by CT findings, which disclosed non-symmetrical dilation of the psoas muscle and gaseous image. Pus from the psoas muscle seen at surgery corresponded to CT findings. Preoperative CT examination was useful in the establishment of diagnosis. (Namekawa, K.).
Vitamin D deficiency is a well-known comorbidity of obesity that can be exacerbated after bariatric surgery and can predispose the patient for hypocalcemia. Vitamin D and calcium doses to prevent and...Full Text Available
Angiosarcoma (AS) is a rare and aggressive vascular neoplasm with very poor prognosis. Patients with extensive cutaneous AS who are not surgical candidates have very limited options since there is no...Full Text Available
Recurrent or primary carcinoma of the breast en cuirasse, which may involve the skin of the entire thorax and abdomen, cannot be controlled by means of surgery or conventional local irradiation. The...Full Text Available
BackgroundSymptomatic heterotopic ossification (HO) in multiple trauma patients may lead to follow up surgery, furthermore the long-term outcome can be restricted. Knowledge of the...Full Text Available
A 4.5-year-old Holstein-Friesian cow underwent surgery because of left abomasal displacement. Intra-operative palpation of the pyloric region revealed a phytobezoar. The abomasum containing the phytobezoar...Full Text Available
Study DesignA retrospective study.PurposeTo determine the feasibility and effectiveness of revisional percutaneous full endoscopic discectomy for...Full Text Available
BackgroundEfficient and safe transection of biological tissue in liver surgery is strongly dependent on the ability to address both parenchymal division and hemostasis simultaneously....Full Text Available
ObjectivesWe have developed an image-guided surgery system based on invisible near-infrared (NIR) fluorescent light. Presently, the only clinically-available NIR...Full Text Available
This is a report of 21 patients presenting with epigastric pain, bilious vomiting, upper gastrointestinal bleeding, iron-deficiency anemia, and weight loss, who had undergone Billroth II gastrectomy from 3 to 35 yr earlier. Eighteen of 21 patients were found to have significant enterogastric reflux indices varying from 60% to 95% demonstrated by /sup 99m/Tc HIDA scintigraphy. Thirteen patients had diversion antireflux surgery in the form of a Roux-en-Y procedure, and 1 patient had a Henley loop jejunal interposition. Postoperative /sup 99m/Tc HIDA scintigraphic studies showed the enterogastric reflux indices to have decreased significantly to a range of 2%-26% (p less than 0.00001). There was marked improvement of symptoms, including correction of anemia and weight gain in those patients who had been anemic or who had sustained earlier weight loss. The enterogastric reflux indices of 10 asymptomatic control patients after Billroth II gastrectomy ranged from 4% to ...
The purpose of this paper was to inform the reader that prolonged upper airway obstruction after posterior cervical spine surgery is a possible complication for patients with metastatic tumor of upper...Full Text Available
Nine infants (six boys, three girls) with anorectal anomalies were examined in the immediate newborn period, prior to corrective surgery, with MRI. Three high, one intermediate and five low anomalies were found at MRI - one patient with a `low` lesion was subsequently found at surgery 2 months later to have a high anorectal anomaly. This infant had passed meconium per urethram soon after the MRI study, prompting the need for a protective colostomy and stressing the importance of a thorough clinical examination of babies with anorectal malformations. The MRI results and findings at surgery were in agreement in all other patients (n=8). Hydronephrosis was evident in two and renal agenesis in one patient. Sacrococcygeal hypoplasia was found in two and two hemivertebrae in one infant. No spinal cord lesion was identified. One fistula was evident on MRI but four were later found at surgery. Uniformly ...
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...Full Text Available
Nowadays, percutaneous pulmonary valve implantation is a successful alternative to surgery for patients requiring treatment of pulmonary valve dysfunction. However, owing to the wide variety of implantation...Full Text Available
BackgroundThe successful use of zirconia ceramics in orthopedic surgery led to a demand for dental zirconium-based implant systems. Because of its excellent biomechanical characteristics,...Full Text Available
Sixty-six patients in whom the macula was detached before surgery were observed for at least 1 year after retinal reattachment. Macular abnormalities were recognised clinically in most patients with...Full Text Available
We performed a prospective study evaluating the 2-year success rate of extracapsular cataract surgery and posterior chamber IOL insertion performed in 610 eyes by an experienced surgeon in the Nepal...Full Text Available
The present study was undertaken in 27 children with localized Ewing's sarcoma treated at our hospital. In 9 cases the lesion was central and in 18 peripheral. Treatment consisted of: 1) Chemotherapy with 6 drugs (vincristine, cyclophosphamide, methotrexate, bleomycin, dactinomycin and doxorubicin) for one year in all patients; 2) Radiotherapy in 24 patients at a dose of 30-40 Gy in the entire bone with a booster dose of 10-15 Gy in the lesion. In 7 patients debulking surgery was performed followed by irradiation. Two cases with tumor in expendable bones and one with extensive destructive lesion in the tibia underwent radical surgery. One patient suffered local recurrence (femur) and 6 developed distant metastases. The remaining 20 (74%) patients were alive and tumor-free after follow-up periods of 17-80 months. Among the 12 patients with extremity lesions who were alive, 7 (58%) had minimal or mild treatment sequelae, 2 moderate, and 3 severe ...
The case of an unusual late metastasis of neuroblastoma to the calcaneum, appearing as a sole recurrence 9 years after surgery, is reported. The radiographic features of the osseous lesion were very suggestive of primary bone malignancy, Ewing's sarcoma as the first option, with extraosseous spread to the soft tissues. (orig.).
BackgroundThe analgesic effect of perioperative low doses intravenous lidocaine has been demonstrated after abdominal surgery. This study aimed to evaluate whether...Full Text Available
Many otolaryngologists perform septoplasty with or without turbinate surgery and the surgical method relies largely on the surgeon's clinical judgment. This study used computed tomography (CT) of the sinuses of 20 patients to examine the correlation between a unilateral deviated nasal septum and compensatory hypertrophy of the contralateral inferior turbinate to suggest guidelines for septal and turbinate surgery. The thickness of the mucosa and conchal bone, the projection angle of the conchal bone, and the distances between the conchal bone, and lateral nasal line and median line were measured. The volume of the inferior turbinate was measured from the three-dimensional reconstruction. Each measurement was compared with those of the nasal cavity on the contralateral and of normal control subjects. The inferior turbinate on the concave side had a significantly greater volume, including the thickness of medial mucosa and the thickness and ...
Acoustic lenses are employed in a variety of applications, from biomedical imaging and surgery to defense systems and damage detection in materials. Focused acoustic signals, for example, enable ultrasonic...Full Text Available
Between 1978 and 1983, 13,890 cataract extractions were performed in Baltimore at JHH and the GBMC with 14 expulsive hemorrhages for an incidence of 0.10%. In the years 1963 through 1983, 180,690 cataract...Full Text Available
Hemoptysis in patients with lung cancer is not uncommon and sometimes have dangerous consequences. Hemoptysis has been managed with various treatment options other than surgery and medicine, such as...Full Text Available
AimsTo describe the pharmacokinetic–pharmacodynamic (PK–PD) characteristics of the direct thrombin inhibitor dabigatran in hip replacement patients by assessing coagulation...Full Text Available
BackgroundLung volume reduction surgery is effective at improving lung function, quality of life, and mortality in carefully selected individuals with advanced emphysema. Recently,...Full Text Available
The purpose of this study was to determine the clinical significance of nodal micrometastasis detected by immunohistochemistry in patients that had undergone curative surgery for pancreatic cancer....Full Text Available
We report a case of chylopericardium after ascending aorta and aortic valve replacement, which presented as late tamponade. We discuss the various treatment options in this rare condition which can...Full Text Available
The paper investigates the functional endoscopic sinus surgery with the Messer-linger's technique which treats benign or inflammatory diseases of paranasal sinuses resistant to medical therapy. The goal of this type of surgery is to open the obstructed sinus ostia and restore normal aeration and mucociliary clearance. The computerized tomography permits an accurate assessment of extension and results of functional endoscopic sinus surgery. [Italian] L'articolo discute l'uso della tecnica di Messerklinger nella chirurgia funzionale endoscopica dei seni paranasali per il trattamento delle malattie benigne e delle infiammazioni croniche. Essa disostruisce gli osti sinusali ripristinando la normale areazione e la pulizia mucociliare. La tomografia computerizzata consente di valutare l'estensione e i risultati del trattamento chirurgico funzionale, soprattutto nel caso di insuccesso ...
We report an unusual case of spontaneous haemopneumothorax associated with haemoptysis due to blood clots within emphysematous bulla in a 42-year-old man. Haemoptysis disappeared after surgery.
BackgroundThe effects of intervention programs on health-related quality of life (HRQOL) of patients with hip fracture have not been well studied. We hypothesized that older patients...Full Text Available
Alton Ochsner was a giant of American surgery. His career encompassed patient care, teaching, and research as symbolized on the original seal of the Ochsner Clinic. His ideas were innovative and groundbreaking...Full Text Available
OBJECTIVE: To increase cost-efficiency while maintaining the standard of medical care, an accelerated surgical stay program for patients having breast surgery was instituted. SUMMARY BACKGROUND DATA:...Full Text Available
Based on the assumption that an accelerated proliferation process prevails in tumour cell residues after surgery, the possibility that treatment acceleration would offer a therapeutic advantage in postoperative...Full Text Available
BackgroundDuring surgery, controlled haemostasis to prevent blood loss is vital for a successful outcome. It can be difficult to ligate vessels located deep in the abdomen. A device...Full Text Available
INTRODUCTIONCutiplast (absorbent perforated dressing with adhesive border; Smith & Nephew) is commonly used following orthopaedic operation, but complications of its use...Full Text Available
... York, 7/15/2008) Cancers Adrenal Gland Cancer Laparoscopic Adrenalectomy (Shawnee Mission Medical Center, Shawnee Mission, KS, ... MN, 1/24/2007) Colorectal Cancer Advances in Laparoscopic Colorectal Surgery (Charles E. Schmidt College of Biomedical ...
The main purpose of this work is to evaluate the role of CT in identifying other morphological signs of met static lymph node involvement from non small cell bronchogenic carcinoma. This is done to improve N staging, a critical step in this disease. In fact, since diameter is the only criterion used to distinguish normal form abnormal lymph nodes, mediastinal CT only has 80% diagnostic accuracy. 137 patients with known or suspected lung cancer were examined with Helical CT during early and late arterial phases (2 min. delay, 3 mm thickness, 5 mm inter slice gap) to depict node characteristics. Mediastinal lymph nodes, located according to the American Thoracic Society mapping, were considered normal when they were not visible or, if visible, less than 1 cm in diameter and of homogeneous density; lymph nodes over 1 cm in diameter and homogenous density were considered reactive. A lymph node was considered metastatic when, independent of size, the following signs ...
Computerized tomography of the adrenal glands was performed in 10 patients with Cushing's syndrome using a G.E. 8800 CT/T Body Scanner. The tomographic findings of unilateral adrenal masses in 4 patients were confirmed by surgery. In the remaining 6 patients, computerized tomography did not identify any masses, and both glands were well visualized and showed normal shape. In these patients, measurement of the adrenal glands revealed both normal (n=1) and enlarged glands (n=5). The findings of adrenalectomy (n=4) or transphenoidal surgery and follow-up (n=2) established the diagnosis of adrenal phyperplasia in all patients. (Author).
Lung transplantation has become an accepted option for many patients with end-stage pulmonary diseases. Anesthesia and surgery following lung transplantation may be required for various diseases that may affect both systemic organs and the transplanted graft. When a patient with a lung transplant undergoes surgery, there is the potential for interference with lung function, depending on the type of intervention and its anatomical site. Accurate preoperative evaluation, an understanding of the physiology of the transplanted lung, proper airway instrumentation, individualized management of intraoperative ventilation, and fluid balance are essential for a positive perioperative outcome.
The evaluation of radiotherapy and surgery as exclusive local treatment in comparably selected subgroups of patients with Ewing's sarcoma on the basis of the CESS 86-data. In the German multicenter Ewing's sarcoma study CESS 86, treatment consisted for four 9-week-courses of VACA- or VAIA-chemotherapy plus local therapy. VACA (vincristine, actinomycin D, cyclophosphamide, adriamycin) was given in low-risk extremity tumors with a tumor volume below 100 cm"3. Highrisk patients with central lesions or a tumor volume >100 m"3 received VAIA (ifosfamide instead of cyclophosphamide). Local therapy started after one complete chemotherapy course in week 10. Based on an individual decision in each patient, local therapy was either radical surgery or resection plus postoperative irradiation with 45 Gy or definitive radiotherapy with 60 Gy. Because of poor results with radiotherapy in a preceeding study, it was intended to restrict irradiation to ...
Endoluminal vascular prostheses that can be implanted by percutaneous routes represent the most recent development in vascular interventional radiology. Various commercially available types of prosthesis are presented and the construction principles and applications are described. At present secure indications for the implantation of endoluminal prostheses are limited to the elimination of aneurysms and arteriovenous fistulae of the large vessels near the trunk in sections that do not cross a joint. The wide use in peripheral occlusive diseases cannot yet be recommended because confirmed data are not available. (orig.) [German] Endoluminale Gefaessprothesen, die perkutan implantierbar sind, stellen die juengste Entwicklung in der vaskulaeren interventionellen Radiologie dar. Verschiedene kommerziell erhaeltliche Prothesentypen werden vorgestellt, ihr Konstruktionsprinzip und ihre Applikation erlaeutert. Die gesicherten Indikationen zur endoluminalen ...
A series of deletion mutants extending from -250 toward the capsite has been constructed in the early promoter region of the adenovirus 2 EIIa gene and tested both in vitro, and in vivo after transfection...Full Text Available
Sunbed use is associated with increased risk of melanoma. Younger people might be more susceptible to the carcinogenic effects of ultraviolet radiation. We investigated the association between...Full Text Available
The changes in protein species synthesized during early Drosophila embryogenesis were characterized by two-dimensional electrophoresis. Of the 261 proteins scored, 68 (26%) show dramatic changes in...Full Text Available
AbstractStudies performed to identify early events of ovarian cancer and to establish molecular markers to support early detection and development of chemopreventive regimens have been...Full Text Available
Purpose.To estimate the prevalence of early and late age-related macular degeneration (AMD) in India.Methods.Of 7518 people aged 60 years and older...Full Text Available
Cognitive rehabilitation is an effective intervention for addressing cognitive impairments in patients with schizophrenia. Previous research has shown that the early application of Cognitive...Full Text Available
The origin of myofibroblasts or myofibroblastic cells in the desmoplastic stroma associated with carcinoma invasion has been controversial. In the early invasive area of a rectal adenocarcinoma reported...Full Text Available
BackgroundThe precise mechanisms involved in the initiation and progression of rheumatoid arthritis (RA) are not known. Early stages of RA often have non-specific symptoms, delaying...Full Text Available
Early detection of precancerous tissue has significantly improved survival of most cancers including colorectal cancer (CRC). Animal models designed to study the early stages of cancer are valuable...Full Text Available
Photodynamic therapy (PDT) is an established endoscopic technique for ablating Barrett’s esophagus with high-grade dysplasia or early-stage intraepithelial neoplasia. The most common clinically...Full Text Available
The long-term impact of early stress on behavior and emotions is well documented in humans, and can be modeled in experimental animals. In mice, maternal separation during early postnatal development...Full Text Available
BackgroundPeak bone mass, attained by early adulthood, is influenced by genetic and life-style factors. Early infant feeding and duration of breastfeeding in particular, associate...Full Text Available
SUMMARYDendritic cells (DCs) in mucosal surfaces are early targets for human immunodeficiency virus-1 (HIV-1). DCs mount rapid and robust immune responses upon pathogen encounter....Full Text Available
In both humans and songbirds, infants learn vocalizations by imitating the sounds of adult tutors with whom they interact during an early sensitive period. Vocal learning occurs in few animal taxa;...Full Text Available
BackgroundOne-stage implant placement has clinically acceptable treatment outcomes. Among other advantages, it may allow investigation of early wound healing. The...Full Text Available
Higher plants use photoperiodic cues to regulate many aspects of development, including the transition from vegetative to floral development. The EARLY FLOWERING3 (ELF3)...Full Text Available
Instantaneous cross sectional flow velocity profiles from early mitral flow in 10 healthy men were constructed by time interpolation of the velocity data from each point in sequentially delayed two...Full Text Available
Early simian virus 40-specific mRNA was isolated from lytically infected and stably transformed cells and analyzed with respect to the 5'-terminal cap content. An analogous diversity of capped structures...Full Text Available
Mission losses were incurred by an early warning satellite and a Milstar-2 communications satellite when their launch vehicles malfunctioned, the first, ...
Purpose of reviewTo summarize recent advances in the classification of preradiographic axial spondyloarthritis (SpA).Recent findingsFull Text Available
The relative sensitivity and combined value of myocardial technetium-99m stannous pyrophosphate imaging and determinations of serum MB creatine phosphokinase (the ''myocardial'' CPK isoenzyme) in detecting acute myocardial infarction were evaluated in 41 patients with suspected infarction and 23 patients recovering from cardiac surgery. In the patients with suspected infarction, myocardial infarction was confirmed in 25 and was consistently associated with increased serum MB CPK. Abnormal radionuclide images were obtained in 23 of 25 patients (92%)) with definite myocardial infarction and in 2 of 16 patients without confirmed infarction. Although the localization of infarction by imaging correlated well with the localization by electrocardiogram, infarct size estimated by imaging did not correlate well with estimates based on peak total serum CPK activity or serial changes in CPK activity. Serum MB CPK activity increased after cardiac surgery ...
From 1979 to 1986, 182 patients with biopsy proven diagnosis of Ewing's sarcoma of bone were observed. One hundred of the 182 patients (72 males, 28 females, median age 15.8 years) with localized disease and no previous treatment were treated with chemotherapy (VCR, ADM, CTX, D-ACT) for 15-18 months. Local treatment was radiotherapy (42 patients), surgery (31 patients), or a combination of both (27 pts). Radiation doses ranged from 45 to 64 Gy given with conventional fractionation. Median follow-up was 51.2 months (24-106). Overall and disease-free survival were, respectively, 58.7 and 42.6%. Resected patients tended to have a better local control (Surgery 93.6%, Surgery + Radiation therapy 92.6%, Radiation therapy 69.1%). Disease-free survival was significantly related to the volume of the primary tumor (bulky: 33.2%, not-bulky: 57.7%), to site (extremities 54.6%, central sites 16.6%, other sites 40.9%), and to local ...
The last decade has produced an explosion in neuroscience research examining young children's early processing of language that has implications for education. Noninvasive, safe functional brain measurements have now been proven feasible for use with children starting at birth. In the arena of language, the neural signatures of learning can be documented at a remarkably early point in development, and these early measures predict performance in children's language and pre-reading abilities in the second, third, and fifth year of life, a finding with theoretical and educational import. There is evidence that children's early mastery of language requires learning in a social context, and this finding also has important implications for education. Evidence relating socioeconomic status (SES) ...
Bladder perforation due to the obturator nerve reflex (ONR) is a serious complication during TUR of bladder tumor using the conventional TUR system; requiring monopolar electrocautery and non-conductive solution as perfusate. Recently, the TURis system, which employs bipolar electrocautery and physiological saline as perfusate, has been developed. Electrical resistance of physiological saline and human tissues are approximately 40 and 500 omega, respectively. Thus, theoretically, electrical current flows between the resection loop and the recovery electrode integrated in the outer sleeve of the endoscope, without forming electrical circuit in the patient's body; suggesting possible elimination of the ONR. Here we describe a case of bladder perforation during surgery using the TURis system; the ONR was exaggerated during the procedure to stop bleeding at the lateral wall using bipolar electrocautery. In addition to this case, there have been a few reports of the ONR ...
The waterjet technique enables precise tissue dissection without thermal damage and with preservation of vessels in general surgery. In neurosurgery, these qualities could help to avoid damage of intact brain parenchyma in tumour resections. The present study reports our first results with this technique in brain metastases. Ten patients with intracranial metastases underwent surgery with the aid of the waterjet. Resection was performed in combination with conventional neurosurgical methods. The follow-up consisted of neurological examination and MRI studies. Intraoperatively, the device was easy to handle. No complications due to the device were observed. Vessels were preserved at pressures below 20 bars. Six of the tumours consisted of soft tissue which was poorly demarcated from the surrounding brain. In these tumours, the waterjet was very helpful. It enabled tumour debulking by aspiration and - more important - precise separation of tumour ...
The choice of treatment in adult skeletal Class III occlusions often poses a particularly tricky problem for the orthodontist. Faced with the option of either orthodontic camouflage or orthognathic surgery, the clinician's clinical experience is of paramount importance, especially in borderline cases. The aim of our study was to uncover a guide model enabling the practitioner to distinguish between skeletal Class III cases which can be suitably treated with orthodontics and those requiring orthognathic surgery. The lateral headfilms of 47 adult patients exhibiting skeletal Class III occlusions were analyzed. The orthodontic group comprised 22 patients and the surgical group 25. Twenty-seven linear, proportional and angular measurements were scrutinized. Stepwise discriminant analysis was used to identify the dentoskeletal and esthetic variables which most distinguished the two groups. The Holdaway angle was chosen to differentiate between ...
Bone loss associated with estrogen depletion is well documented in cancellous bone but less well characterized in cortical bone. The effects of ovariectomy on the aged beagle skeleton were studied by histomorphometric analysis of the cortical bone in sequential rib biopsies. Biopsies were taken from each ovariectomized or sham-operated dog at the time of surgery and at 1, 4, and 8.5 months after surgery. Just prior to each postoperative biopsy, tetracycline, calcein, and xylenol orange, respectively, were administered by a fluorochrome labeling procedure (2d-10d-2d) to provide markers of bone formation. Analysis of sequential rib biopsies provided a means to follow the ovariectomy response over time and to compare each animal against its own baseline. Though ovariectomy did not influence histomorphometric indices at 1 month after surgery, a transient increase in cortical bone formation occurred thereafter, with a sixfold ...
When total mesorectal excision (TME) is accurately performed, dysfunction, theoretically, does not occur. However, there are differences among individuals in the running patterns and the volumes of nerve fibers, and if obesity or a narrow pelvis is present, nerve identification is difficult. Currently, the rate of urinary dysfunction after rectal surgery ranges from 33% to 70%. Many factors other than nerve preservation play a role in minor incontinence. Male sexual function shows impotence rates ranging from 20% to 46%, while 20%-60% of potent patients are unable to ejaculate. In women, information on sexual function is not easily obtained, and there are more unknown aspects than in men. As urinary, sexual, and defecation dysfunction due to adjuvant radiotherapy have been reported to occur at a high frequency, the creation of a protocol that enables analysis of long-term functional outcome will be essential for future clinical trials. In the treatment of rectal ...
Purpose: We present an update analysis of the multiinstitutional Ewing's sarcoma study CESS 86. Methods and Materials: From January 1986 through June 1991, 177 patients with localized Ewing's sarcoma of bone, aged 25 years or less, were recruited. Chemotherapy consisted of four 9-week courses of vincristine, actinomycin D, cyclophosphamide, and adriamycin (VACA) in low-risk tumors (extremity tumors =# 100 cm"3). Local therapy was an individual decision in each patient and was either radical surgery (amputation, wide resection) or resection plus postoperative irradiation with 45 Gy or definitive radiotherapy with 60 Gy (45 Gy plus boost). Irradiated patients were randomized concerning the type of fractionation in either conventional fractionation (once daily 1.8-2.0 Gy, break of chemotherapy) or hyperfractionated split-course irradiation simultaneously with the VACA/VAIA chemotherapy (twice daily 1.6 Gy, break of 12 days after 22.4 Gy and 44.8 Gy, total dose and ...
PurposeTo review the frequency of hemorrhagic complications with sub-Tenons anesthesia in patients on aspirin, warfarin or clopidogrel.SettingSt. Jamess University Hospital, Leeds, United Kingdom.MethodsData were collected prospectively for patients having elective phacoemulsification under sub-Tenons anesthesia. Seventy-five patients were on aspirin, 65 were on warfarin, and 40 were on clopidogrel. Seventy-five patients on no anticoagulants were used as the control group. No changes in the anticoagulant regimen were made prior to surgery.ResultsNo sight-threatening hemorrhagic complications were noted, and no surgery was postponed or cancelled due to an anesthesic complication. Subconjunctival hemorrhage occurred in 19% in the control group, 40% in the clopidogrel group, 35% in the warfar...
Background Stimulated by the concept of Natural Orifice Transluminal Endoscopic Surgery (NOTES), minimizing the access even further has become a new trend in minimally invasive surgery. We compare our recently described new method of endoscopic single-access adrenalectomy with the conventional retroperitoneoscopic approach in a matched-pairs study. Methods Fifty single-access retroperitoneoscopic adrenalectomies (SARA) were performed in 47 selected patients suffering from Conn?s adenomas (n?=?20), pheochromocytomas (n?=?15), Cushing?s adenomas (n?=?6), and other diseases (n?=?6). For SARA, a single 2-cm skin incision beneath the 12th rib was used. Following creation of the retroperitoneal space with the rigid endoscope, dissection was carried out single-handed. Another 47 patients served a...
Study Type - Therapy (case series)Level of Evidence 4 OBJECTIVE To present our experience of retroperitoneoscopic partial adrenalectomy (RPA) for small adrenal tumours, as with modern imaging methods small adrenal lesions are being diagnosed more commonly, and retroperitoneoscopic adrenal surgery for small adrenal tumours (PATIENTS AND METHODS We retrospectively reviewed the records of 389 consecutive retroperitoneoscopic adrenalectomies from September 2005 to December 2008, 88 of which were small adrenal tumours and treated by RPA. Ultrasonography and computed tomography (CT) were used in all patients before RPA, and magnetic resonance imaging or positron emission tomography/CT in some patients. We used RPA for adrenal tumours and total adrenalectomy for adrenal cancer. During the surgery...
Background The lateral femoral cutaneous nerve (LFCN) can be at risk during, for example, the insertion of pins in the anterior superior iliac spine (ASIS) during external fixation of the pelvis, total hip arthroplasty through a direct anterior approach, open surgery for impingement in the hip through an anterior approach, and periacetabular osteotomy. During surgery, the surgeon usually assumes the location of the LFCN by using the ASIS as a landmark. Questions/purposes We investigated (1) whether there is any relationship between the LFCN and the ASIS and (2) the anatomy of the LFCN at the lateral border of the psoas major. Methods Using 25 formalin-fixed cadavers, we determined the location of the LFCN emergence point as above, same level with, or below the iliac crest (IC). We measured...
The aims of this study were to identify risk factors and evaluate the association with clinical outcomes of postoperative cardiac surgery-associated acute kidney injury (CSA-AKI). Data from 2488 consecutive adult patients were analyzed. Patients were classified as having CSA-AKI based on the risk, injury, failure, loss of kidney function, and end-stage kidney disease (RIFLE) criteria using peak postoperative creatinine in the postoperative intensive care unit (ICU). Multiple stepwise logistic regression analysis was used to identify independent risk factors for CSA-AKI. CSA-AKI occurred in 584 patients (23.5%). CSA-AKI patients had significantly longer aortic cross-clamp and cardiopulmonary bypass times. Furthermore, CSA-AKI patients had higher hospital mortality (5.5% vs 1.5%, PCopyright2...
Aim To better define the indications for adrenalectomy for adrenal metastasis we have analysed factors predicting survival in our institutional series. Methods A consecutive series of 30 patients undergoing adrenalectomy for metastasis (1996-2007), excluding patients with simultaneous ipsilateral renal cell carcinoma (RCC), was studied. Metastases were regarded as synchronous (6 mo), depending on the interval after primary surgery. Survival was calculated from time of adrenalectomy and factors influencing survival were identified. Results The tumour diagnoses were RCC n = 9, malignant melanoma n = 5, non-small-cell lung cancer n = 5, colorectal carcinoma n = 4, foregut carcinoid n = 2, adrenocortical carcinoma, breast cancer, hepatocellular carcinoma, urothelial c...
Introduction Postoperative alopecia is a relatively rare event, and therefore both patients and surgeons are puzzled once it develops even though it is said to improve spontaneously with time in most cases. We report a parieto-occipital pressure-induced alopecia firstly developed in a patient who had undergone repeated surgery for 10?years after a traffic accident. Case report A 29-year-old male underwent segmental osteotomy at the upper and lower frontal edentulous areas for distraction osteogenesis. Throughout the operation, he was in the supine position with the hair covered with a paper cap and the head on a plastic vinyl chloride-covered soft foam horseshoe-shaped urethane sponge placed on the horseshoe-shaped headrest. About 2?weeks after the surgery, two patches of parieto-occipital...
Objectives Vietnamese patients? views on healthcare are changing as surgical interventions become more commonplace, but their views on perioperative care have remained largely unstudied during this period of rapid change. This study assesses Vietnamese patients? impression of anesthesia safety and postoperative pain in relation to clinical outcomes with the aim of improving patient-centered perioperative care. Methods The study cohort consisted of 180 hospitalized patients who were followed for 24?h following abdominal surgery. The assessments of these patients on the use of anesthesia and postoperative pain were measured by means of a 5-point Likert scale survey. Perioperative events were recorded on standardized forms by medical staff. The relationship between relevant factors affecting ...
Summary Penile injury is common as an emergency and should be accurately diagnosed and treated. We analysed 22 patients with penile injury admitted to the emergency unit of Dubrava University Hospital during a 4-year period. According to the American Association for the Surgery of Trauma five-grade classification of penile injuries, there were 14 grade I, 6 grade II and 2 grade III cases. Diagnosis was mainly based on clinical and ultrasonography findings, and in some cases on cavernosography. Nineteen patients underwent immediate surgery and three patients received conservative therapy. On outpatient follow up, sexual function was assessed by use of the 5-item International Index of Erectile Function (IIEF-5) test at 3 and 12-months of injury. At 3-month follow up, moderate, mild and no e...
Local control of Ewing's sarcoma was analysed in a series of 67 patients treated by surgery and/or radiotherapy as well as combination chemotherapy. Radiotherapy was employed with or without surgery in 60 patients and produced an overall local control rate of 55%; complete excision of the primary lesion seemed to be beneficial. There was a marked variation in control rates depending on the site of the primary lesion: limb 85%, rib 53%, pelvis 31% and other sites 33%.Primary tumours greater than 10 cm in diameter were significantly less likely to be controlled. Using daily fractions of approximately 180 cGy, total doses in excess of 6000 cGy seem more likely to produce serious late morbidity amd may not increase the local control rate. No cases of second malignancy arising in irradiated tissue have been observed to date, but one patient developed acute lymphoblastic leukaemia. (author).
Purpose Elective laparoscopic sigmoid resection (LSR) for symptomatic diverticular disease is supposed to have significant short-term advantages compared to open surgery (open sigmoid resection (OSR)). This opinion is rather based on inferences from trials on colonic resections for malignant diseases or minor laparoscopic surgery. This randomized controlled trial was conducted to compare quality of life as well as morbidity and clinical outcome after LSR vs. OSR following a midterm follow-up period. Methods Patients presenting with a symptomatic sigmoid diverticular disease stage II/III (Stock/Hansen) were randomly allocated to LSR or OSR in a prospective multicenter trial. Endpoints included the quality of life assessed with a standardized questionnaire, postoperative mortality, and compl...
Objective:- To review the rate of inadvertent cystotomy during laparoscopic hysterectomy performed by the Sydney West Advanced Pelvic Surgery Unit (SWAPS). To compare this rate with other published data. To identify the risk factors for bladder injury at laparoscopic hysterectomy and to review the management and outcome following such injury. Method:- This was a retrospective observational study. All hysterectomies where the SWAPS clinical fellow was involved were included. The study period was from January 2001 to June 2009. Simple statistical formulae were used to analyse data in this study. Results:- There were 1223 hysterectomies performed during this period. Eighty-one percent of these were performed laparoscopically. There were 14 (1.1%) bladder injuries reported during this period. ...
Background The Norwood procedure consists of three palliative operations, performed in neonates with hypoplastic left heart syndrome. Especially the first stage (Norwood I) is associated with the highest mortality rates in paediatric cardiac surgery (up to 25%). During surgery, the aorta is reconstructed and a systemic-to-pulmonary shunt is applied. Originally the modified Blalock-Taussig shunt was used, but recently the right-ventricle-to-pulmonary-artery shunt is increasingly being employed. We reviewed the results of our operative strategy, where an individualised choice of shunt is made. Furthermore, attempts to reduce interstage mortality (between Norwood I and II) were assessed. Methods All neonates who underwent Norwood stage I palliation from August 2004 until November 2010 were in...
Background An emerging imaging tool, the functional lumen imaging probe (Endoflip; Crospon Ltd, Galway, Ireland), provides a real-time measurement of esophagogastric junction (EGJ) capacity and diameter, which would be of particular interest in functional esophageal surgery such as Heller myotomy and antireflux procedures. This study aimed to demonstrate the intraoperative use of endoflip in the treatment of achalasia and gastroesophageal reflux disease (GERD). Methods In the first case, Heller myotomy was performed under endopflip guidance, for persistent dysphagia after failed endoscopic dilatation. In the second case, the endoflip was used to calibrate a Nissen fundoplication. With the patient under general anesthesia, the endoflip catheter was inserted orally and positioned to straddle...
Purpose Video-assisted thoracic surgery (VATS) has recently been adopted for complicated anatomical lung resections. During these thoracoscopic procedures, surgeons view the operative field on a two-dimensional (2-D) video monitor and cannot palpate the organ directly, thus frequently encountering anatomical difficulties. This study aimed to estimate the usefulness of preoperative three-dimensional (3-D) imaging of thoracic organs. Methods We compared the preoperative 64-row three-dimensional multidetector computed tomography (3DMDCT) findings of lung cancer-affected thoracic organs to the operative findings. Results In comparison to the operative findings, the branches of pulmonary arteries, veins, and bronchi were well defined in the 3D-MDCT images of 27 patients. Conclusion 3D-MDCT imag...
"Pillar pain" is a relatively frequent complication after surgical release of the median nerve at the wrist. Its etiology still remains unknown although several studies highlight a neurogenic inflammation as a possible cause. Pillar pain treatment usually includes rest, bracing and physiotherapy, although a significant number of patients still complain of painful symptoms two or even three years after surgery. The aim of this study was to investigate the efficacy of low-energy, flux density-focused extracorporeal shock wave therapy (ESWT) in the treatment of pillar pain. We treated 40 consecutive patients with ESWT who had pillar pain for at least six months after carpal tunnel release surgery, and to our knowledge, this is the first study that describes the use of ESWT for treating this c...
Abstract Intense controversy surrounds the management of disorders of sex development, particularly in relation to the validity of parental consent for genital surgery and the removal of gonadal tissue carried out during infancy or childhood. Past practices have been heavily criticised on ethical grounds by patient advocacy organisations, who have demanded a moratorium on these kinds of operations unless authorised by a court. Some doctors and hospital administrators have been influenced by the controversy and have referred cases to the Family Court of Australia, where a series of judgements have now established legal precedents that apply across Australia, restricting the circumstances in which parents can give consent for surgery. An alternative approach is to use a hospital-based Clinic...
Reasons for variation in transfusion practice in orthopedic surgery are not well understood. This systematic review identified and appraised the quality of the literature in this area to assess the impact of factors associated with the use of allogeneic red blood cell (RBC) transfusion in orthopedic procedures. MEDLINE and EMBASE databases were searched for relevant English language publications. Articles containing a range of MeSH and text terms regarding ''blood transfusion,'' ''predictors,'' and ''multiple logistic regression'' were retrieved. Articles that focused on patients undergoing orthopedic procedures and that met prespecified inclusion criteria were appraised in terms of potential bias and the appropriateness of statistical approach. A total of 3641 citations were retrieved, an...
Dynamic CT and MRT were performed in 21 patients who had undergone prosthetic replacement of the aorta because of dissection of the thoracic aorta. There is no difference between MRI and dynamic CT in the demonstration of a persistent intimal flap, the formation of a thrombus and the assessment of the aortic diameter in patients who underwent surgery for thoraco-abdominal aortic dissection. MRI, however, is superior in the identification of the true and false lumen and the demonstration of the distal anastomotic site. The major advantages of MRI are that there is no need for intravenous contrast agents, that it is high sensitive to flow phenomena, and that it can demonstrate the aortic arch and the ascending aorta on sagittal oblique sections. The major disadvantages of MRI are the limited access to the patient during the procedure, and the inability to examine patients fitted with pacemakers or who are on assisted ventilation. Today, MRI is considered the method ...
Abstract Purpose: We evaluated complications of urologic laparoscopic surgery at our institution. Patients and Methods: From December 1991 to January 2009, 1017 urologic laparoscopic surgical procedures were performed in Kansai Medical University, including 277 radical prostatectomies, 13 donor nephrectomies, 74 partial nephrectomies, 158 radical nephrectomies, 55 pyeloplasties, 97 nephrouretectomies, 54 simple nephrectomies, 128 adrenalectomies, 34 varicocelectomies, and 127 other procedures. Medical records of each procedure were retrospectively evaluated. The difficulty of each procedure was classified according to the European Scoring System (ESS). Intraoperative and postoperative complications were graded according to the Satava and Clavien classifications, respectively. Results: Amon...
PurposeTo compare the effectiveness and safety of 25- and 23-gauge sutureless microincision vitrectomy surgery (MIVS) in the management of various vitreoretinal diseases.MethodsEighty-five consecutive patients undergoing sutureless vitrectomy during January to April 2008 were randomized to either 25- or 23-gauge MIVS. Data collected prospectively included best-corrected visual acuity (BCVA), operation time, postoperative visual recovery, postoperative anterior segment change, and complications.ResultsThe most common indications for MIVS were macular hole, macular pucker, vitreous haemorrhage, and diabetic traction retinal detachment. Mean operation times of the 25-gauge (n=38) and 23-gauge groups (n=47) were 33.68 and 34.47?min, respectively (P=0.942). Mean BCVA improved significantl...
The paper reports the results of a preliminary experience with volume rendering technique of virtual computerized tomography colonoscopy and compares it with endoscopy and surgery showing its capability in detecting colon and rectal cancers. [Italian] Scopo del lavoro e' riportare l'esperienza personale preliminare nell'uso della colonscopia TC virtuale confrontando i risultati con quelli dell'endoscopia e dei riscontri operatori, dimostrandone l'efficacia nella diagnosi delle malattie tumorali del colon-retto.
Bowel infarction is a rare and typical condition of the elderly; despite improvements in diagnostic imaging and vascular surgery, bowel infarction remains a major cause of acute abdomen, with mortality rates ranging 70-80%. Diagnosis on often late because clinical sings, laboratory data and radiologic findings are a specific. The authors investigated radiographic and particular CT patterns of intestinal infraction in 56 patients submitted to surgery within 12 hours of admission. We also report the CT findings of 5 of these patients who had reversible mesenteric ischemia. CT is more sensitive than radiography and does not exhibit the limitations of angiography (i.e., invasiveness, radiation exposure an complex organization. Therefore CT can presently be considered the method of choice in patients with suspected bowel infarction.
The interscalenic block technique is widely used for ambulatory shoulder surgery despite a substantial number of failures and adverse effects. We prospectively evaluated satisfaction in 40 consecutive patients who underwent open Bankart repair under a single general anesthesic performed in an ambulatory care unit. The mean age of the patients was 23 years. There were 29 men and 11 women. Patients were evaluated postoperatively with a visual analog scale of pain (in the recovery room, at the time of discharge, and the day after and 1 week after surgery) via a home assessment questionnaire that included the following: effectiveness of oral pain medication, ability to perform activities of daily life, and overall satisfaction. One patient failed to be discharged because of a feeling of faintn...
BackgroundDue to improvements in cancer survival the number of people of working age living with cancer across Europe is likely to increase. UK governments have made commitments...Full Text Available
Purpose. To validate a protocol for creating virtual models to be used in the construction of solid prototypes useful for the planning-simulation of maxillo-facial surgery, in particular for very complex anatomical and pathologic problems. To optimize communications between the radiology, engineering and surgical laboratories. Methods and materials. We studied 16 patients with different clinical problems of the maxillo-facial district. Exams were performed with multidetector computed tomography (MDCT) and single slice computed tomography (SDCT) with axial scans and collimation of 0.5-2 mm, and reconstruction interval of 1 mm. Subsequently we performed 2D multiplanar reconstructions and 3D volume-rendering reconstructions. We exported the DICOM images to the engineering laboratory, to recognize and isolate the bony structures by software. With these data the solid prototypes were generated using stereolitography. To date, surgery has been ...
Purpose: To evaluate the importance of surgical margins for local and systemic control of Ewing's sarcoma family tumors (ESFT). Methods and Materials: Between 1979 and 1999, 512 patients with ESFTs entered 4 different adjuvant and neoadjuvant studies performed at a single institution. Of these patients, 335 were treated with surgery alone (196) or surgery followed by radiotherapy at doses of 44.8 Gy (139). We compared their outcome with that of the 177 patients who were locally treated by radiotherapy at 60 Gy. Results: Local control (88.8% vs. 80.2%, p < 0.009) and 5-year disease-free survival (63.8% vs. 47.6%, p < 0.0007) were significantly better in patients treated with surgery and, among them, in those with adequate surgical margins (96.6% vs. 71,7%, p < 0.0008, and 69.6% vs. 46.3%, p < 0.0002). Nonetheless, better results were observed only in extremity tumors. Conclusions: Surgery is ...
Cerebral blood flow (CBF) and cerebrovascular reserve capacity (CRC) were measured by stable xenon computerized tomography (Xe-CT) and acetazolamide test in 15 patients with cerebrovascular disease before and after extracranial-intracranial (EC-IC) bypass surgery for minor stroke, reversible ischemic neurological deficit or transient ischemic attack. All had angiographically shown occlusive lesions of the major arterial trunk. In the present series, global analysis showed that the bypass did not increase the resting rCBF, but did increase the rCRC. We divided the patients into four groups according to the preoperative resting rCBF and rCRC. All 3 patients with normal resting rCBF and reduced rCRC showed postoperative improvement of rCRC. Of 6 patients with reduced CBF and reduced CRC, three had postoperative increase in resting CBF and four had increased CRC. One of two patients with reduced CBF and normal CRC showed only an increase in CRC. We propose that reduced ...
Purpose: Treatment results and the pattern of relapse were evaluated in the multimodal treatment of Ewing's sarcomas of the chest wall. Methods and Materials: In a retrospective analysis, 114 patients with non-metastatic Ewing's sarcoma of the chest wall were evaluated. They were treated in the CESS 81, CESS 86, or EICESS 92 studies between January 1981 and December 1993. The treatment consisted of polychemotherapy (VACA, VAIA, or EVAIA) and local therapy, either surgery alone (14 patients), radiotherapy alone (28 patients) or a combination of both (71 patients). The median follow-up was 46.6 months (range 5-170). A relapse analysis for all patients with local or combined relapses was performed. Results: Overall survival was 60% after 5 years, event-free survival was 50%. Thirty-seven patients had a systemic relapse (32.4%), 11 patients had a local relapse alone (9.6%), and 3 patients had a combined local and systemic relapse (2.6%). The risk to relapse locally ...
A 56-year-old man admitted to our hospital for cardiac tamponade due to dilated cardiomyopathy did not respond to treatment by usual medical means or surgery. Pericardio-peritoneal drainage was conducted using a subcostal approach. Seven months later, the patient remains well and free of signs of pericardial tamponade. This method has proved to be safe and effective in patients with persistent massive pericardial effusion. PMID:10496067
Breast cancer represents today more than 30% of all cancers and is responsible for about 20% of deaths due to cancer. The potentialities of mammography have increased in recent years through improvements in equipment and methodologies. In this paper the conventional mammography using film and image intensifiers is compared with digital mammography. Digital mammography presents clear advantages in storage and handling of information. Also its higher sensitivity will lead to an earlier detection of anomalies and a decrease in the number of invasive exams and surgeries
Primary Ewing's sarcoma of the skull is a very rare entity. We report MRI findings in a case of Ewing's sarcoma of the greater wing of sphenoid in a 4-year-old patient. Magnetic resonance imaging showed markedly heterogenous signal intensity with areas of haemorrhage and necrosis. It also demonstrated the exact extent of tumour due to its multiplanar capabilities and was, therefore, helpful in planning surgery. Copyright (2002) Blackwell Science Pty Ltd
The review provides a general idea about the types of metallic alloys and the pure metals used as implant materials in dental and orthopedic surgery. Their corrosive behavior in both real solutions and various media that model human biological fluids is described. Based on the literature data, it is concluded that multicomponent alloys containing titanium, niobium, zirconium, tungsten, molybdenum, aluminum, and silicon are the most resistant to corrosion. Implants made of different types of stainless steel are preferred when manufacturing orthopedic devices for short-term use.
One hundred and thirty-seven lung cancer patients (123 non-small-cell lung cancers (NSCLC), 10 small-cell lung cancers (SCLC) and four carcinoid tumours) who underwent surgery in an attempt at complete...Full Text Available
IntroductionPharyngo-laryngeal tumors classified as T3-4, N0-3, M0, are conventionally treated by mutilating surgery (total (pharyngo)-laryngectomy). Neo-adjuvant chemotherapy with...Full Text Available
A review of main issues in diagnosing, complex treatment and prognosis of Ewing's sarcoma is presented. Current trend in chemotherapy, radiotherapy and surgery of the disease is discussed. Unfavourable prognosis is attributed to the systematic character of the disease, necessitating a complex therapeutic approach. Attempts to make an optimal combination of the three therapeutic methods in order to improve survival and reduce the rate of post-treatment complications are analyzed. 37 refs., 4 tabs. (author).
Intrahepatic cholangiocarcinoma is an uncommon tumor as primary hepatic neoplasm. Five cases of cholangiocarcinoma, mass forming peripheral type, are reported about its CT findings. They were manifested as a poorly marginated low density mass with a irregular stellate area. In one case, a cut section of the gross specimen following surgery showed a central callagenous scar and vessels within the necrotic tumor. (author).
integrates multiple fisheries information systems to obtain a view of U.S. freshwater fish distribution. Information about NFDI National Framework for Early Detection, Rapid...
Mission losses were incurred by an early warning satellite and a Milstar-2 communications satellite when their launch vehicles malfunctioned, the first, ...
The immediate early gene Arc is emerging as a versatile, finely tuned system capable of coupling changes in neuronal activity patterns to synaptic plasticity, thereby optimizing information...Full Text Available
4) Expand to include client-server interaction (small-scale archive interactions with the goal of evaluating information management capabilities) -- Early ...
instrument is shown in Figure 4-9 The incoming radiation is focused onto ...... An early rocket-borne ultraviolet spectrometer of the Ebert type by ...
Four low activation alloy classes, two austenitic and two ferritic, have been incorporated into the MOTA-1B experiment in the FFTF reactor to provide an early assessment of the suitability of such alloys for reactor service.
The early and precise diagnosis, the prognosis, and the clinical management of multiple sclerosis, remain a considerable challenge. In recent years, the development of novel and powerful proteomic...Full Text Available
This paper reviews the historical aspects of nuclear physics. The scientific aspects of the early transuranium elements are discussed and arms control measures are reviewed. 11 refs., 14 figs. (LSP)
in early 1992 from Lord Corporation, were also found. For both the reflective and absorptive polyurethanes, the fresh paint fluoresces significantly ...
Weaning of beef calves is usually done abruptly and early compared to the natural weaning of the species, and is associated with simultaneous exposure of calves to a range of social and environmental...Full Text Available
Models can be useful at many different levels when considering complex issues such as biological control of mosquitoes. At an early stage, exploratory models are valuable in exploring the characteristics...Full Text Available
Background and AimsIt is well known that genome size differs among species. However, information on the variation and dynamics of genome size in wild populations and on the early...Full Text Available
Two-way communication between the conceptus and the mother during early pregnancy is essential if the pregnancy is to survive. In this review, our primary focus is on biochemical communication...Full Text Available
We propose an approach to achieving early recognition of gesture patterns. Early recognition is a method for recognizing sequential patterns at their earliest stage. Therefore, in the case of gesture recognition, we can get a recognition result for human gestures before the gestures are finished. The most difficult problem in early recognition is knowing when the system has determined the result. Most traditional approaches suffer from this problem, since gestures are often ambiguous. At the start of a gesture, in particular, it is very difficult to determinate the recognition result since insufficient input data have been observed. Therefore, we have improved on the traditional approach by using a self-organizing map.
The purpose of this report is to provide management with performance data on key performance indicators selected from the FFTF Early Warning System performance indicators.
rotor flow field in which the main rotor operates. The majority of ..... early separation predicted by their CFD code was ...... Airfoil, AGARD Fluid Dynamics Panel ...
A growing number of environmental toxicants found in pesticides, herbicides, and industrial solvents are believed to have deleterious effects on development by disrupting hormone-sensitive processes....Full Text Available
Specialized olfactory lobe glomeruli relating to sexual or caste differences have been observed in at least five orders of insects, suggesting an early appearance of this trait in insect evolution....Full Text Available
PurposeEarly detection of appendicitis has increased due to development of computed tomography and ultrasonography, yet we are frequently meeting complicated appendicitis, including...Full Text Available
BackgroundAutofluorescence bronchoscopy is more sensitive than conventional bronchoscopy for detecting early airway mucosal lesions. Decreased specificity can lead...Full Text Available
Documents an early American industrial process of making blast furnace coke using techniques and equipment from the 19th century. Photographed at Bretz, WV.
Mutations in the Drosophila gene drop-dead (drd) result in early adult lethality and neurodegeneration, but the molecular identity of the drd...Full Text Available
Experience gained with a wide variety of missile injuries of the brain is presented. Clinical signs and intracranial pressure (ICP) studied in the early post-injury period have been correlated with...Full Text Available
Following a brief overview of the terrestrial distribution of boron in rocks, soil, and water, the history of the discovery, early utilization, and geologic origin of borate minerals is summarized....Full Text Available
Purpose: To assess long-term outcomes following percutaneous transluminal angioplasty (PTA) of congenital aortic coarctation in adults.Methods: Seventeen patients underwent PTA for symptomatic adult coarctation of the aorta. Sixteen patients, with a mean age of 28 years (range 15-60 years), were reviewed at a mean interval after angioplasty of 7.3 years (range 1.5-11 years). Assessment included magnetic resonance imaging (MRI), Doppler echocardiography, and clinical examination. Current clinical measurements were compared with pre- and immediate post-angioplasty measurements.Results: At follow-up 16 patients were alive and well. The patient not included in follow-up had undergone surgical repair and excision of the coarctation segment following PTA. Mean brachial systolic blood pressure for the group decreased from 174 mmHg before angioplasty to 130 mmHg at follow-up (p 0.0001). The mean gradient had fallen significantly from 50.9 to 17.8 at follow-up (p = 0.001). The average number of ...
The 5'-terminal structures of human adenovirus type 2 (Ad2) early region 2 (E2) mRNA were investigated. The E2 transcription unit has several interesting properties, including the presence of a TATA-like...Full Text Available
Epulopiscium sp. type B is an enormous intestinal symbiont of the surgeonfish Naso tonganus. Intracellular offspring production in Epulopiscium shares features with endospore formation. Here, we characterize the spoIIE homolog in Epulopiscium. The timing of spoIIE gene expression and presence of interacting partners suggest that the activation of ?(F) occurs early in Epulopiscium offspring development. PMID:21398534
Several early genes of murine cytomegalovirus (MCMV) encode proteins that mediate immune evasion by interference with the major histocompatibility complex class I (MHC-I) pathway of antigen presentation...Full Text Available
Three transcription units are present in the adenovirus type 2 region EII. Transcription units EIIaE and EIIaL encode the mRNA for the 72,000-dalton DNA binding protein, early and late in the lytic...Full Text Available
...notice de en es fr it nl European Commission Research Index aeronews All keywords Index feedback The number of documents that contain the keyword aeronews is: 1 EU Transport lsquo;AERONEWSrsquo; -good news for early detection of microdamage European Commission - lsquo;AERONEWSrsquo; -good news for early detection of microdamage ...
Recent nucleosynthesis calculations of Type II supernovae using advanced neutrino transport determine that the early neutrino winds are proton-rich. However, a fraction of the ejecta emitted at the same time is composed of neutron-rich pockets. In this paper we calculate the nucleosynthesis contribution from the neutron-rich pockets in the hot convective bubbles of a core-collapse supernova and show that they do not contribute significantly to the total nucleosynthesis.
A large inguino-scrotal hernia was detected in the early phase of a radionuclide bone scan performed for evaluation of a femoral neck fracture not visualized on plain x-rays. The patient was administered 1 GBq of Scrotal scintigraphy using "9"9"mTc-MDP and a regional three-phase bone scan of the pelvis, hips and proximal femora was obtained on the gamma camera. Copyright (1999) Blackwell Science Pty Ltd
BackgroundApoptosis is a major mode of hematological tumor death after radiation. Early detection of apoptosis may be beneficial for cancer adaptive treatment. 99mTc-HYNIC-annexinV...Full Text Available
The non-invasiveness of autofluorescence technology may reduce sampling error and time delay for histopathology diagnosis. We establish biophotonic methods and guidelines to visualize and interpret early epithelial tissue changes that signify disease. Flexible and rigid fiber endomicroscopy instrumentation design parameters feasible for translation towards clinical use are in development.
DescriptionThe overall aim of this application is to examine experimentally environmental influences on the pattern of senescence in birds. We plan to experimentally uncouple chronological age and reproductive effort and examine their effects on reproductive performance and lifespan. We also plan to examine experimentally how these relationships are influenced by nutritional conditions during early development. We will combine the organismal fitness measures of lifespan and reproductive performance with me [continued...
The impact of a single seizure on cognition remains controversial. We hypothesized that a single early life seizure (sELS) on rat post-natal day (P) 7 would alter only hippocampal-dependent...Full Text Available
Elution profiles of total lipoproteins, apolipoprotein B (apoB) concentrations in lipoproteins, and plasma triglyceride (TG) levels were examined in early-, late-, and non-lactating cows. Additionally, arteriovenous (A-V) differences were also measured to elucidate the uptake of TG and apoB-containing lipoproteins in mammary gland. Non-lactating cows showed three major peaks corresponding to triglyceride-rich lipoprotein (TRL), low density lipoprotein (LDL), and high density lipoprotein (HDL) fraction, whereas both early- and late-lactating cows revealed two peaks corresponding to TRL and HDL. The peak area of TRL in early- and late-lactating cows were significantly (p < 0.05) smaller than that in non-lactating cows. The plasma TG levels and apoB-48 concentrations of TRL in early- and late-lactating cows were also significantly (p < 0.01) lower. Furthermore, early lactating ...
Childhood anxiety is impairing and associated with later emotional disorders. Studying risk factors for child anxiety may allow earlier identification of at-risk children for prevention efforts. This study applied an ecological risk model to address how early childhood anxiety symptoms, child temperament, maternal anxiety and depression symptoms, violence exposure, and sociodemographic risk factors predict school-aged anxiety symptoms. This longitudinal, prospective study was conducted in a representative birth cohort (n = 1109). Structural equation modeling was used to examine hypothesized associations between risk factors measured in toddlerhood/preschool (age = 3.0 years) and anxiety symptoms measured in kindergarten (age = 6.0 years) and second grade (age = 8.0 years). Early child risk factors (anxiety symptoms and temperament) emerged as the most robust predictor for both parent-and child-reported anxiety outcomes and mediated the effects ...
Abstract. Purpose: To determine whether vitrectomy with 25-gauge instruments contributes to better postoperative visual recovery after macular hole (MH) surgery. Methods: The medical records for 46 consecutive eyes operated for MH by a single surgeon were retrospectively examined. Vitrectomy had been performed with a 25-gauge instrument in 23 eyes (25-G group) and with a 20-gauge instrument in 23 eyes (20-G group). Postoperative visual acuity (VA) in logMAR (logarithm of the minimum angle of resolution) units after 1 week and 1, 3, 6, 9 and 12 months, operating time, and volume of intraocular irrigating fluid were compared between the two groups. Results: Mean preoperative logMAR VA was 0.72 in the 25-G group and 0.68 in the 20-G group (p = 0.282, unpaired t-test). One week after surgery, ...
Purpose: To evaluate the significance of preoperative localization of abnormal parathyroid glands to the surgical outcome in patients with primary hyperparathyroidism. Material and Methods: Thirty-nine patients with primary hyperparathyroidism were studied preoperatively with US (39 patients), CT (30 patients) and MR imaging (18 patients). The overall diagnostic accuracy for US was 87%, CT 66% and MR 94%. In patients with a single parathyroid adenoma US was the most cost-effective localization technique with a detection rate of 96%. CT had a lower detection rate (78%) but was of particular value for fairly large ectopic adenomas in the root of the neck. MR imaging was a good confirmatory test (93%). In patients with multiple gland disease (primary hyperplasia and multiple adenomas), no single localization study alone was sufficient. Combination of all 3 studies, however, alerted the physician to the presence of disease in more than one gland in 87% of these patients. Conclusion: US, CT ...
We examined 19 patients with post-irradiation intestinal injury in the uterine cervix cancer for 12 years between 1985 and 1996. We discuss the usefulness and complications of surgery, mainly colostomy. The patients aged from 36 to 80 (average age 61) were treated, and their disease states were 12 cases of rectovaginal fistula, 2 of small intestinal fisfula, 1 of rectum posterior membranous fistula, 3 of proctostenosis, and 14 of proctitis with hemorrhage (including duplication). Surgical methods used were 18 cases of colostomy (2 cases were treated under peritoneum mirror) and 2 of enterocolostomy (including duplication). Eleven out of 19 patients who underwent surgery are alive now. Generally the post-irradiation intestinal injury was intractable, and the method of treatments were limited due to the coexistence of various diseases. The colostomy is safe and less invasive. Therefore patients with uterine cervix cancer having various ...
A 52-year-old woman had a history of left hearing loss for 5 years. An acoustic neurinoma with 3.2 cm in diameter was diagnosed and treated with gamma-knife radiosurgery (19 Gy of marginal dose) 1 year and 4 months ago. She developed headache, nausea, and visual disturbance 1 month prior to admission. Slight left facial palsy appeared after radiosurgery. Magnetic resonance imaging demonstrated the tumor with central necrosis in the left cerebellopontine angle cistern, increasing in size to 3.5 cm in diameter, and hydrocephalus. Tumor removal was performed incompletely, because of the fibrous appearance of the tumor and severe adherence with the surrounding cerebellar tissue. Facial palsy did not worsen after surgery. Since the hydrocephalus was not resolved, a right ventriculo-peritoneal shunt was inserted. The clinical course in this case suggests that tumor removal followed by radiosurgery was an approximately effective treatment for large acoustic neurinoma. ...
To investigate the usefulness of a newly developed magnetic resonance (MR) image-guided surgical robotic system for minimally invasive laparoscopic surgery. The system consists of MR image guidance [interactive scan control (ISC) imaging, three-dimensional (3-D) navigation, and preoperative planning], an MR-compatible operating table, and an MR-compatible master-slave surgical manipulator that can enter the MR gantry. Using this system, we performed in vivo experiments with MR image-guided laparoscopic puncture on three pigs. We used a mimic tumor made of agarose gel and with a diameter of approximately 2 cm. All procedures were successfully performed. The operator only advanced the probe along the guidance device of the manipulator, which was adjusted on the basis of the preoperative plan, and punctured the target while maintaining the operative field using robotic forceps. The position of the probe was monitored continuously with 3-D navigation and 2-D ISC ...
The present case report documents the hitherto unusual application of camouflage orthodontics in one of our patients. Our female patient had previously been treated orthodontically alio loco and had also undergone bimaxillary orthognathic surgery. She presented with TMJ complaints, with associated pains. Despite a dental Class I and centrally seated condyles, her discs had prolapsed anteriorly without reduction and she had developed a massive degenerative-inflammatory TMJ disease. Skeletally, she was a Class II case despite previous orthognathic surgery. In addition, there was also an initial suspicion of rheumatic involvement that could not be confirmed. We distalized the entire lower dental arch without bicuspid extraction. Then we advanced the mandible with the Mandibular Anterior Repositioning Appliance (MARA).We discuss exactly how the modified camouflage therapy was structured and how the individual treatment steps took place. ...
Sonography, subtraction scintigraphy, computed tomography and MRI were compared in 100 patients who had surgery 105 times for hyperparathyroidism (HPT). Surgical and pathological data were available for all operations. A total of 105 MR, 77 CT, 84 sonograms and 70 subtraction scintigrams were performed. The ability of the imaging modalities, individually and in combination, to detect HPT, histology, size, concomitant thyroid disease and location of the diseased glands has been evaluated. For primary HPT, sensitivity ranged from 68% for MRI to 40% for scintigraphy but was much lower for tertiary HPT with all modalities. The ability to identify diseased glands was strongly size dependent for all methods. If patients had had previous neck surgery, the most sensitive methods were MRI and scintigraphy and this also held true for patients with concomitant thyroid disease and ectopically located glands. The findings presented suggest that while ...
Ectopically located parathyroid adenomas may be difficult to find during initial neck exploration. They account for over 70 percent of missed adenomas found at reexploration. Preoperative localization of parathyroid adenomas would reduce unnecessary dissection and possibly reduce the number of negative results of initial neck exploration. Before reoperative parathyroid surgery is performed, some means of localization is mandatory to detect ectopic adenomas in the neck and mediastinum. Computed tomography and ultrasonography cannot effectively evaluate the mediastinum. Angiography and venous parathyroid hormone sampling are invasive, costly, and tedious to perform. We have shown that thallium-201 will accurately localize ectopic parathyroid adenomas. All 10 adenomas found in positions not immediately adjacent to the thyroid gland were detected by thallium-201 scintigraphy. One was a mediastinal adenoma resected with a median sternotomy. Our results suggest that ...
Abstract in english INTRODUCTION: Treatment of the cryptorchid testicle is justified due to the increased risk of infertility and malignancy as well as the risk of testicular trauma and psychological stigma on patients and their parents. Approximately 20% of cryptorchid testicles are nonpalpable. In these cases, the videolaparoscopic technique is a useful alternative method for diagnosis and treatment. MATERIALS AND METHODS: We present data concerning 90 patients submitted to diagnostic lapa (more) roscopy for impalpable testicles. Forty-six patients (51.1%) had intra-abdominal gonads. In 25 testicles of 19 patients, we performed a two stage laparoscopic Fowler-Stephens orchiopexy. The other 27 patients underwent primary laparoscopic orchiopexy, in a total of 29 testicles. RESULTS: We obtained an overall 88% success rate with the 2 stage Fowler-Stephens approach and only 33% rate success using one stage Fowler-Stephens surgery with primary vascular ligature. There ...
Objective. To examine the incidence, radiographic and histologic findings of medial femoral neck buttressing in a consecutive group of patients undergoing total hip arthroplasty.Design. Biomechanical parameters were evaluated on standard anteroposterior pelvic radiographs of 113 patients prior to hip replacement surgery. Demographic information on all patients was reviewed and histologic evaluation was performed on specimens obtained at the time of surgery.Results. The incidence of medial femoral neck buttressing was found to be 50% in a consecutive series of patients undergoing total hip arthroplasty. The incidence was slightly higher in women (56% vs 41%). Patients with buttressing had increased neck-shaft angles and smaller femoral neck diameters than were seen in patients without buttressing. Histologic evaluation demonstrated that the buttress resulted from deposition bone by the periosteum on the femoral neck in the absence of any ...
Over 300 cases of femoral neck fractures following radiotherapy for intrapelvic malignant tumor have been reported in various countries since Baensch reported this disease in 1927. In Japan, 40 cases or so have been reported, and cases of bilateral femoral neck fractures have not reached to ten cases. The authors experienced a case of 75 year-old female who received radiotherapy for cancer of the uterus, and suffered from right femoral neck fracture 3 months after and left femoral neck fracture one year and half after. As clinical symptoms, she had not previous history of trauma in bilateral femurs, but she complained of a pain in a hip joint and of gait disturbance. The pain in left femoral neck continued for about one month before fracture was recognized with roentgenogram. As histopathological findings, increase of fat marrow, decrease of bone trabeculae, and its marked degeneration were recognized. Proliferation of some blood vessels was found out, but thickness of the internal ...
Computed tomography allows today to reconstruct three-dimensional (eD) images fram axial scans. The authors report their experience in cranio-facial pathology achived in two Departments of Radiology (University of Trieste, Italy and University of Standford, California). 3D images have been realized using two different softwares, one of which allows to reconstruct both soft tissue and bone structures. The application in maxillo-facial traumas, cranio-facial malformations and head tumours are disscussed. 3D images turned out to be very useful for the optimal visualization and for the spatial demostration of the lesion and have potential applications in cranio-facial surgery and radiotherapy.
A flexible, steerable tube (distal end) of an endoscope for the application in the laparoscopic surgery has been analyzed by means of the finite-element-method (FEM). The unusual mechanical and thermal features of the used shape memory alloy (SMA) of NiTi were taken in account. The analyses showed that the strains remain in the super-elastic region up to the maximum bending of 90 and no plastic deformations occur. The application of the shape optimization (CAO) made possible finding the optimal structure of the distal end and therefore powerful reducing the maximum strains in the critical regions. (orig.)
Interferons, a group of cytokines with antiangiogenic, direct antitumour and immunostimulating properties, have shown significant activity against osteosarcoma in vitro and in xenograft models. They have also been used in osteosarcoma clinical trials as a single adjuvant to surgery, with an apparent increase in relapse-free survival. In the ongoing EURAMOS 1 clinical trial, interferon a-2b is evaluated as an adjuvant treatment in osteosarcoma. This article reviews the rationale for the use of interferon in cancer with special reference to the treatment of osteosarcoma, including all published data of clinical efficacy in this disease. Pediatr Blood Cancer 2010;54:350-354. Copyright 2009 Wiley-Liss, Inc.
Purpose of this work is to investigate the role of Helical CT and the usefulness of three-dimensional (3D) imaging for pre-operative planning and follow-up of reconstructive maxillofacial surgery with alloplastic material in neoplastic disease involving this region. From 1996 to 1999 eleven patients were examined with Helical CT and 3D images for planning of maxillofacial plastic and reconstructive surgery for advanced cancer of this anatomically complex region. A 3D-modulated titanium mesh (100%) or micro nets was used to rebuild the anterior surface of maxillary bone and the orbital floor. The mesh was cut to the appropriate size and shape and curved where necessary. Within the residual sinusal cavity a siliconed filling was used surmounting an acrylic prosthesis with dental arch to rebuild the palate. A rehydrated bovine pericardium was affixed and moduled on the borders in two cases only. Three-dimensionally reconstructed CT images were ...
Advances in the diagnosis of Ewing's sarcoma of the rib were considered and retrospective analysis of the treatment of 32 patients (76% of them were children at the age of 10-15 y.o.) in the clinic of children oncology was performed. It was shown that the diagnosis of Ewing's sarcoma of the rib in children ought to be combined taking into account the course, morphology and radiation examination techniques. Most optimum treatment consisted of combined therapy (cyclic polychemotherapy, lesion focus irradiation at the summary focus dose of 57 Gy, surgery with subsequent polychemotherapy for not less than 1.5 years
The aortovenous fistulas are rare, most of them are aortocaval fistula. The non-caval communication of the fistula is sparse. Herein we report a 47-year-old female diagnosed as traumatic aorto-superior mesenteric vein (Ao-SMV) fistula. The abdominal pain, fullness, and frank bruit on abdominal auscultation suggested the diagnosis of an intra-abdominal arteriovenous fistula. The diagnosis of Ao-SMV was further confirmed by the computed tomography (CT) and aortography. The fistula was successfully treated with transcatheter coil embolization. This is the first case of Ao-SMV fistula. It provides an alternative option of treatment other than conventional surgery. PMID:19327940
Focusing on Sobolev inequalities and their applications to analysis on manifolds and Ricci flow, "Sobolev Inequalities, Heat Kernels under Ricci Flow, and the Poincare Conjecture" introduces the field of analysis on Riemann manifolds and uses the tools of Sobolev imbedding and heat kernel estimates to study Ricci flows, especially with surgeries. The author explains key ideas, difficult proofs, and important applications in a succinct, accessible, and unified manner. The book first discusses Sobolev inequalities in various settings, including the Euclidean case, the Riemannian case,
Primary B-cell lymphoma of thymus is uncommon. We describe the case of a 23-year-old woman with a history of shortness of breath and distended neck veins of 1-month duration. A chest roentgenogram and computed tomographic chest scan of the showed a large anterior mediastinal mass. Tru-cut biopsy revealed primary B-cell lymphoma of thymus. She underwent chemotherapy with no symptomatic improvement. Post-chemotherapy computed tomographic scan of the chest showed no appreciable reduction in tumor size. Surgical excision was carried out with excellent results.
Pulmonary embolism complicated by transcatheter arterial chemoembolization (TACE) in known to be due to the use of large amount of lipiodol as an embolic agent. To our knowledge, massive tumoral pulmonary embolism following TACE and confirmed by surgery has not been described in the literature. In this report, we detail the cas of a 49-year-old man in whom cyanosis and hypotension developed abruptly on the day of TACE.. Chest CT revealed diffuse low-attenuated lesions in both pulmonary arteries. Histopathological specimens after emergent pulmonary arterial embolectomy confirmed the presence of massive tumor emboli of hepatocellular carcinoma.
Menopause is characterized by the progressive reduction of estrogens resulting to cessation of menses. It is associated with an increase of cardiovascular risk factors such as hyperglycemia, hypertension, dyslipidemia and of abdominal and/or selective visceral fat mass deposition. Obesity, a modern day epidemic, is promoted by an obesogenic environment that interacts with the genetic background. The result is a positive energy balance materialized by the accumulation of the adipose tissue. This process is marked by great individual variation. Obesity is also associated with the presence of cardiovascular risk factors. In this review, the main pathophysiologic processes for the increase of obesity in menopause and the possible effects of pre-menopausal obesity regarding the cessation of ova...
In the Wajima lung cancer screening program conducted under the auspices of Kanazawa University Hospital, Fuji Computed Radiography (FCR) was utilized in a new chest radiography trial. The results of the screening program are that the necessity of repeat examinations due to poor image quality are less common and the method enables detection of small pulmonary nodular shadows which are possibly candidates for surgery. Oblique chest X-ray with FCR is remarkably effective for the detection and the identification of small lesions. However, the disadvantage of slow processing and high cost must be fully satisfied if FCR is to become a new imaging modality for mass screening.
In the Wajima lung cancer screening program conducted under the auspices of Kanazawa University Hospital, Fuji Computed Radiography (FCR) was utilized in a new chest radiography trial. The results of the screening program are that the necessity of repeat examinations due to poor image quality are less common and the method enables detection of small pulmonary nodular shadows which are possibly candidates for surgery. Oblique chest X-ray with FCR is remarkably effective for the detection and the identification of small lesions. However, the disadvantage of slow processing and high cost must be fully satisfied if FCR is to become a new imaging modality for mass screening. (author).
Spinal cord stimulation (SCS) is frequently used for relief of chronic benign pain resistant to conservative therapies. Clinical practice suggests, at least in patients with failed back surgery syndrome (FBSS), the possibility that SCS significantly improves motor performances. We present here the case of a 41-years-old female patient with FBSS, who showed a clear improvement in muscle strength after SCS, persisting at 6-months follow-up. We speculate that the electrical stimulation of posterior columns could potentiate the caudal, segmental spinal reflexes resulting in a facilitation of motoneurons activation. PMID:16175150
A 1.5-year-old male Belgian Malinosis Military Working Dog presented with a 1-month history of intermittent hematuria. Diagnostic ultrasound and contrast radiography demonstrated large blood clots in the urinary bladder and a filling defect in the right renal pelvis. At surgery, clotted blood was present in the right ureter and bladder. Following right nephrectomy, the dog returned to training. One month later, elevations in urea nitrogen and creatinine were noted. Hematuria recurred at 3 months and the dog was found dead in its kennel. Necropsy showed a blood-filled left renal pelvis and ureter. PMID:1454185
Background This report describes the authors? experience with a unique endoluminal, endoscopically delivered and retrieved gastroduodenojejunal bypass sleeve, including short-term weight loss and changes in comorbidities. Methods A prospective, single-center trial was designed. The patients were morbidly obese individuals who met the National Institutes of Health criteria for bariatric surgery. The device used was a unique gastroduodenojejunal bypass sleeve secured at the esophagogastric junction with endoscopic and laparoscopic techniques and designed to create an endoluminal gastroduodenojejunal bypass. At completion of the trial, the device was explanted with endoscopic retrieval. The primary end points were safety and incidence of adverse events. The secondary outcomes included the per...
Most papers appearing in the surgical literature dealing with wound ballistics concern themselves with wound management in the civilian setting. The pathophysiology of modern war wounds is contrasted with ballistic wounds commonly encountered in peacetime, but it should be noted that even in peacetime the modern terrorist may have access to sophisticated military weaponry, and that patients injured by them may fall within the catchment area of any civilian hospital. Management problems associated with both wound types are highlighted; areas of controversy are discussed. The orthodox military surgical approach to ballistic wounds is expounded and defended. PMID:1996857
The purpose of this paper is to describe a technique of forced surgical rotation of the mandible used in skeletal Class II patients with deep bite and prominent chin. Posterior occlusal composite onlays combined with preoperative orthodontic treatment without anterior intrusion increase the posterior rotational component of the surgical mandibular advancement, when removed during operation. This manoeuvre allows for the surgical closure of the posterior open bite, while anteriorly the deep bite is opened. This technique avoids bimaxillary rotation surgery with dorsal impaction in mild to moderate cases. In any case, a chin setback osteotomy with compromised aesthetics can be avoided.
Thirty-seven patients with histologic proof of cholangiocarcinoma at the confluence were examined by computed tomography (CT) to determine whether this examination is of value in the assessment of these patients for surgery and whether there are any features specific to this type of tumor. Thirty-two patients showed intrahepatic duct dilatation; six of these showed dilatation of ducts in one lobe only. Eighteen patients had intrahepatic low-attenuation areas, while eight had a mass lesion in the porta hepatis. The results of this study show that CT provides useful anatomic information preoperatively but that the appearances are nonspecific. Lobar atrophy is highly suggestive of hilar cholangiocarcinoma, either of long-standing or with unilateral portal venous involvement.
In order to evaluate the role of Computed Tomography (CT) in prediction of nature, staging and follow-up of soft-tessue tumors, the authors examined by CT 124 patients with soft tissue neoplasms who later underwent surgery (116 cases) or fine needle biopsy (8 cases). Comparison between CT and surgical or anatomical results showed that CT was able to correctly predict the benignancy or malignancy of the masses in 76% of cases but it was very seldom able to allow an hystological prediction. On the contrary CT was found to be a very useful tool for pre-therapeutic staging and follow-up of the tumors, because it gave many diagnostic information which influenced therapeutic choiches and strategies.
Carcinoma en cuirasse of the breast, which invades the skin via lymphatics and may encase the entire thorax and abdomen, is poorly controlled by surgery, chemotherapy, or conventional irradiation. Palliation of patients with breast carcinoma en cuirasse is a difficult clinical problem which must be effectively managed over extended periods due to the indolent nature of this disease. The management of three cases is reported, and the new technique of rotational subtotal skin electron-beam therapy (SSEBT) is presented. (author).
Parathyroid imaging based on the principle of differential uptakes of Tc-99m and T1-201 in the anterior neck to localize parathyroid (PT) disease has been reported with widely varying results. To evaluate the usefulness of this method, we have performed PT imaging on 47 patients prior to exploratory surgery for PT disease. Using pinhole collimation and digital acquisition, a 50k count image of the thyroid was obtained 20 minutes after injection of 1mCi99m Tc-pertechnetate. Then a lmCi dose of Tl-201 chloride was injected and a series of images acquired for 30 minutes at 30 sec/image. Raw data was spatially filtered and normalized by summing sufficient T1-201 images to equal the Tc-99m image scale of maximum cts/pixel. Image subtraction (Tl-Tc) gave the final PT image. Of 10 pts who had previous neck exploration, all had PT pathology accurately localized by preoperative scanning (7=single adenoma, 2=single hyperplastic gland, 1=two hyperplastic glands). In two ...
The structure of newly synthesized proteoglycans from explant cultures of cartilage from joints subjected to transection of the anterior cruciate ligament (osteoarthritic) and from normal (non- or sham-operated) joints was examined. The structure of the products of proteoglycan turnover was also examined using explants of normal and osteoarthritic cartilage maintained in culture for a 48 h chase period. The findings were as follows: Newly synthesized (/sup 35/S)-proteoglycans extracted from cartilage explants from osteoarthritic joints whether examined 3 weeks, 3 months, or 6 months after surgery were larger than those from corresponding normal cartilage. This can be explained by the synthesis in osteoarthritic cartilage of abnormally long chondroitin sulfate chains on newly synthesised proteoglycans. The extracts also contained a newly formed small proteoglycan species that was unable to interact with hyaluronic acid. The proportion of this species was higher in ...
Bariatric surgical procedures have become important therapeutic options for treatment of morbid obesity in both adults and adolescents co-morbidities of obesity such as glucose intolerance, type 2 diabetes (T2DM), metabolic syndrome, steatohepatitis, hyperlipidemia and cardiovascular disease. These co-morbidities of obesity have significant impacts on the overall quality of life of the individual and our society at large. Roux-en-Y gastric bypass (RYGB) and the relatively newer procedures of gastric banding (GB) and vertical sleeve gastrectomy (VSG) have proven to be efficacious in achieving rapid weight loss and reversing the comorbidities of obesity. Unfortunately, bariatric procedures are not without risks including micronutrient deficiency, failure to maintain lost weight, and mortality. Further, the resolution of T2DM has long been understood to precede weight loss, and this finding provides important clues about the physiologic underpinnings of the observation. In order to design ...
Purpose: To identify results and prognostic factors on long-term survival and local control following treatment of localized Ewing's sarcoma. Patients and Methods: Between 1979 and 2004, a total of 60 children and young adults with Ewing's sarcoma were treated. Patients with distant metastases at presentation (n = 6) and recurrent cases (n = 2) were excluded from this analysis. Patients were exclusively treated within ongoing national and international protocols CESS-81, CESS-86, EICESS-92, EURO-EWING-99. All patients received local irradiation with a total dose of 45-60 Gy; in addition, 41 (79%) of the patients had local surgical procedures, 27 (52%) of them with clear margins. Results: Overall survival rates at 5 and 10 years were 56% and 45%, respectively. Patients #<=# 14 years at diagnosis had overall survival rates of 66% and 61% at 5 and 10 years compared to older patients with corresponding survival rates of 47% and 31%, respectively (p = 0.05). Patients with tumors of lower ...
Homologous and heterologous arterial segments were implanted in Fisher rats subcutaneously for the purpose of examining the antibody titer of the recipients' serum after implantation by means of the immune-adherence hemagglutination method. The antibody titer after implantation both of homologous and heterologous grafts decreased to 1/8 by 2.0 million (M) rads irradiation of high voltage cathode rays. The results suggested that high voltage cathode ray irradiation was not enough for heterologous graft to suppress its tissue reaction. Homografts taken from dogs 3 or 6 hours after sacrifice were irradiated with 2.0 M rads and transplanted in canine carotid artery using the technic of end-to-end anastomosis. Angiograms 6 months after operation revealed excellent patency rate in all the grafts of 28 dogs. furthermore, findings of the grafts from 1 week to 5 years after operation on scanning and transmission electron microscopies were evaluated. Clinical application of bypass ...
Homologous and heterologous arterial segments were implanted in Fisher rats subcutaneously for the purpose of examining the antibody titer of the recipients' serum after implantation by means of the immune-adherence hemagglutination method. The antibody titer after implantation both of homologous and heterologous grafts decreased to 1/8 by 2.0 million (M) rads irradiation of high voltage cathode rays. The results suggested that high voltage cathode ray irradiation was not enough for heterologous graft to suppress its tissue reaction. Homografts taken from dogs 3 or 6 hours after sacrifice were irradiated with 2.0 M rads and transplanted in canine carotid artery using the technic of end-to-end anastomosis. Angiograms 6 months after operation revealed excellent patency rate in all the grafts of 28 dogs. furthermore, findings of the grafts from 1 week to 5 years after operation on scanning and transmission electron microscopies were evaluated. Clinical application of bypass ...
In not infected knee prostheses bone scintigraphy is a possible method to diagnose mechanical loosening, and therefore, to affect treatment regimes in symptomatic patients. However, hitherto studies showed controversial results for the reliability of bone scintigraphy in diagnosing loosened knee prostheses by using asymptomatic control groups. Therefore, the aim of our study was to optimize the interpretation procedure and to evaluate the accuracy using results from revision surgery as standard. Methods: Retrospectively, we were able to examine the tibial component in 31 cemented prostheses. In this prostheses infection was excluded by histological or bacteriological examination during revision surgery. To quantify bone scintigraphy, we used medial and lateral tibial regions with a reference region from the contralateral femur. Results: to differentiate between loosened and intact prostheses we found a threshold of 5.0 for the maximum tibia to ...
In not infected knee prostheses bone scintigraphy is a possible method to diagnose mechanical loosening, and therefore, to affect treatment regimes in symptomatic patients. However, hitherto studies showed controversial results for the reliability of bone scintigraphy in diagnosing loosened knee prostheses by using asymptomatic control groups. Therefore, the aim of our study was to optimize the interpretation procedure and to evaluate the accuracy using results from revision surgery as standard. Methods: Retrospectively, we were able to examine the tibial component in 31 cemented prostheses. In this prostheses infection was excluded by histological or bacteriological examination during revision surgery. To quantify bone scintigraphy, we used medial and lateral tibial regions with a reference region from the contralateral femur. Results: to differentiate between loosened and intact prostheses we found a threshold of 5.0 for the maximum tibia to ...
The paper investigates early Soviet policies regarding the institution of waqf (charitable endowment) in Turkestan, questioning the issue of the post-colonial character of the early Soviet administration. After taking into consideration practices related to waqf management in modern Muslim states and European colonial empires, the paper briefly describes the tsarist administrative approach to the issue. We then address the ambiguity inherent in Soviet policies on waqf requisition and restitution during Civil War years. In the section that follows we deal with different groups of Muslim intellectuals that attempted to use the Soviet state in their mutual struggle over authority in Central Asian society and describe the creation and functioning of the bureaucracies responsible for managing w...
This longitudinal study examined a model of early school achievement in reading and math, as it varies by socioeconomic context, using data from the NICHD Study of Early Child Care and Youth Development. A conceptual model was tested that included features of family stress, early parenting, and school readiness, through both a single-group analysis and also a multiple-group analysis. Latent profile analysis was used to identify subgroups of more advantaged and less advantaged families. Family stress and parenting were shown to operate differently depending on the socioeconomic context, whereas child-based school readiness characteristics were shown to operate similarly across socieodemographic contexts. Implications for intervention are discussed.
There are no specific diagnostic tests or a gold standard method for measuring disease activity and outcome in spondyloarthropathies (SpA). Many different methods have been developed to assess the signs and symptoms in SpA. The aim of this study was to evaluate the value of scintigraphy, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and Bath Ankilosing Spondylitis Disease Activity Index (BASDAI) in the evaluation of disease activity in early axial SpA diagnosed with magnetic resonance imaging (MRI). Thirty early MRI-positive axial SpA patients (23 males, 7 females) with a median age of 35 (18?55) years and a median duration of inflammatory low back pain of 24 (8?60) months were included in the study. In the patients with sacroiliitis, the sensitivity, specificity, and pos...
The early diagnosis of such disorders is of major importance because, in most cases, severe consequences can only be averted by early treatment. The value of magnetic resonance imaging (MRI) in many orthopaedic and traumatological conditions is generally accepted. The value of MRI in this particular field is illustrated by typical case reports on common clinical problems [Deutsch] Der Fruehdiagnose von Erkrankungen des Kindes- und Jugendalters kommt grosse Bedeutung zu, da oftmals nur durch eine daraus resultierende Fruehbehandlung schwerwiegende Folgen vermieden werden koennen. Die Kernspintomographie (Magnetresonanztomographie=MRT) ist in zahlreichen orthopaedischen-traumatologischen Fragestellungen bereits etabliert. An ausgewaehlten Fallbeispielen haeufiger klinischer Problemstellungen soll in der vorliegenden Arbeit der Stellenwert der MRT dargestellt werden. (orig.)
Climate variability greatly affects animals through direct and indirect effects. Animals with slow reproductive adaptation to ecological changes such as large mammals are likely to have evolved mechanisms to anticipate early such impacts of climate variability on the environment. One of the adaptive mechanisms between reproductive costs and benefits in mammals affects parental investment through biases in sex ratio. Deer might be likely to show an early detection of climate variability because conception takes place in early autumn, but the main raising cost in deer concerns lactation, which takes place at the end of the following spring. The aim of this paper is to assess whether there is a relationship between global indices of climate variability such as El Ni?o-Southern Oscillation (EN...
Necrotizing enterocolitis (NEC) is the most common severe gastrointestinal emergency that affects premature newborns. This disease often has a rapid onset with few, if any, antecedent signs that can be used to reliably predict its occurrence. Its rapid onset and progression to death, as well as its severe morbidity when the infant survives, begs for early diagnostic tools that may be used in determining those infants who would be at greatest risk for development of the disease and for whom early preventative measures could be targeted. Although studies have suggested efficacy of several techniques such as breath hydrogen, inflammatory mediators in blood, urine or stool, and genetic markers, these all have drawbacks limiting their use. The application of newly developed "omic" approaches may provide biomarkers for early diagnosis and targeted prevention of this disease. PMID:19190533
Penetrating liver wounds are related to many causes and rank second after blunt abdominal and liver trauma. In this report are examined the clinical and radiological findings of personal series of patients with penetrating trauma, especially by firearms and stab and cut wounds. It will also tried to define the diagnostic workup of these traumas, which is especially based on CT signs of liver damage and associated changes and which is of basic importance for following treatment, both surgical or conservative. In the last seven years it was retrospectively reviewed 31 cases of penetrating liver trauma. The patients were 19 men and 12 women, ranging in age 18 to 73 (mean 42), with penetrating liver injuries from firearms (16 patients) and stab (9 cases) wounds; 6 patients had injuries from different cases. Abdominal CT was carried out in emergency with the CT Angiography (CTA) technique in all patients. In the patients with suspected chest and abdomen involvement CT was performed from the ...
The main purpose of this work is to evaluate the role of CT in identifying other morphological signs of met static lymph node involvement from non small cell bronchogenic carcinoma. This is done to improve N staging, a critical step in this disease. In fact, since diameter is the only criterion used to distinguish normal form abnormal lymph nodes, mediastinal CT only has 80% diagnostic accuracy. 137 patients with known or suspected lung cancer were examined with Helical CT during early and late arterial phases (2 min. delay, 3 mm thickness, 5 mm inter slice gap) to depict node characteristics. Mediastinal lymph nodes, located according to the American Thoracic Society mapping, were considered normal when they were not visible or, if visible, less than 1 cm in diameter and of homogeneous density; lymph nodes over 1 cm in diameter and homogenous density were considered reactive. A lymph node was considered metastatic when, independent of size, the following signs ...
Materials and MethodsThe genomic effects of tumor-endothelial interactions in cancer are not yet well characterized. To study this interaction in breast...Full Text Available
The sequential events and the inflammatory mediators that characterize disease onset and progression of ulcerative colitis (UC) are not well known. In this study, we evaluated the early pathologic events...Full Text Available
Over 30 months 9292 consecutive patients admitted to nine coronary care units with suspected myocardial infarction were considered for admission to a randomised double blind study comparing the effect...Full Text Available
Uterine sarcomas are a rare group of neoplasms with aggressive clinical course and poor prognosis. They are classified into four main histological subtypes in order of decreasing incidence: carcinosarcomas,...Full Text Available
During germination and early growth of castor bean (Ricinus communis), all cellular constituents of the endosperm are eventually transferred to the growing embryo. The present results...Full Text Available
HIV-1 nonsubtype B variants account for the majority of HIV infections worldwide. Drug resistance in individuals who have never undergone antiretroviral therapy can lead to early failure and...Full Text Available
Memory consolidation requires transcription and translation of new protein. Arc, an effector immediate early gene, and zif268, a regulatory transcription factor, have been implicated in synaptic plasticity...Full Text Available
BACKGROUND: A number of studies have shown that the early mortality following TURP is higher for patients with prostate cancer than those with benign disease. This study examines the effect of the histological...Full Text Available
BackgroundIn France, it is estimated that 24% of HIV-infected patients are also infected with HCV. Longitudinal studies addressing clinical and public health questions related to...Full Text Available
BackgroundThe natural history of bronchial preinvasive lesions and the risk of developing lung cancer in patients with these lesions are not clear. Previous studies have treated...Full Text Available
A review is presented of the quest for superheavy elements under the following headings - early history; physical and nuclear properties unique to superheavy elements; searches in nature; terrestrial samples; extra-terrestrial samples; and searches at accelerators. 72 references. (U.K.).
Total thyroidectomy involving the adjacent structures of the trachea can cause tracheal damage such as early tracheal necrosis. The authors describe the first case of anterior tracheal necrosis following...Full Text Available
Allergic rhinitis is common among children and quite often represents a stage of the atopic march. Although sensitization to food and airborne allergens may appear in infancy and early childhood, symptoms...Full Text Available
Randomized clinical trials are designed with stopping boundaries to guide data monitoring committees with their decision making concerning ongoing trials. In particular, when extremely positive results...Full Text Available
Early on, intriguing biological activities were found associated with the EETs using in vitro systems. Although the EETs other than the 5,6-isomer, are quite stable chemically,...Full Text Available
BackgroundThere is a lack of studies considering social disparity in oral health emanating from adolescents in low-income countries. This study aimed to assess socio-demographic...Full Text Available
Mouse lines with behavioral phenotypes relevant to symptoms in neurodevelopmental disorders may provide models to test hypotheses about disease etiology and to evaluate potential treatments....Full Text Available
Objective:This article examines relationships between reproductive onset and lifetime history of smoking, regular smoking, and nicotine dependence, and cannabis and other illicit...Full Text Available
In rats, expression of the immediate early gene, c-fos observed in the brain following male copulatory behavior relates mostly to the detection of olfactory information originating...Full Text Available
The Sleeping Beauty (SB) transposon system represents an important alternative to viral integrating vector systems but may, as its viral counterparts, be subject to transcriptional silencing. To investigate...Full Text Available
Dental caries continues to be a common chronic disease among various population groups. Patient care can be improved with detection at the earliest stage. However, current techniques do not...Full Text Available
of early humanitarians, and the vivisectors turned to Rene Descartes (1596 1650 ) to justify ...A celebrated mathematician, physiologist, and psychologist, Descartes provided a general philosophy of the irrelevance of ethics to the ...Animals, according to Descartes, were insensible and irrational machines; moved, like clocks, but
IntroductionIrradiation of normal, non-malignant bone during cancer therapy can lead to atrophy and increased risk of fracture at several skeletal sites, particularly...Full Text Available
BackgroundTransarterial chemoembolization (TACE) therapy is an effective locoregional treatment in hepatocellular cancer (HCC) patients. For early modification of therapy, markers...Full Text Available
The oxytocin and prolactin responses to suckling were measured in 10 women in early (n = 5) and established lactation (n = 5). Oxytocin was released in a pulsatile manner during suckling in all women,...Full Text Available
Direct identification of group B streptococci from a selective broth medium was performed with the Phadebact streptococcus test to determine the feasibility of this technique for early detection of...Full Text Available
Totipotent stem cells have the potential to differentiate into every cell type. Renewal of totipotent stem cells in the germline and cellular differentiation during early embryogenesis rely upon posttranscriptional...Full Text Available
Breast cancer is a progressive and potentially fatal disease that affects women of all ages. Like all progressive diseases, early and reliable diagnosis is the key for successful treatment and annihilation....Full Text Available
BackgroundLung cancer diagnosis in tissue material with commonly used histological techniques is sometimes inconvenient and in a number of cases leads to ambiguous conclusions. Frequently...Full Text Available
A total of 626 patients undergoing a prostaglandin-induced abortion, the majority in the second trimester, have been analysed for complications occurring during inpatient treatment. Of the last 155...Full Text Available
We investigated the role of early portal hypotensive pharmacotherapy in preventing the development of portal-systemic shunting in a portal hypertensive model of chronic murine schistosomiasis induced...Full Text Available
A 33-year-old man sustained an acute Achilles tendon rupture which was surgically repaired. Early nonweight-bearing range of motion and strengthening of the ankle and the repaired muscle unit was allowed...Full Text Available
ObjectiveTo evaluate the prognostic significance of adjuvant concurrent chemoradiotherapy-induced neutropenia with survival in patients with squamous cell carcinoma of the uterine...Full Text Available
Cervical cancer is known to metastasize primarily by the lymphatic system. Dissemination through lymphatic vessels represents an early step in regional tumor progression, and the presence of lymphatic...Full Text Available
Preterm birth is the leading cause of neonatal mortality and morbidity and long-term disability of non-anomalous infants. Previous studies have identified a prior early spontaneous preterm birth as...Full Text Available
Background. Detection of subjects with early chronic kidney disease (CKD) is important because some will progress up to stage 5 CKD, and most are at high risk of cardiovascular morbidity...Full Text Available
PURPOSE: Visual loss following panretinal photocoagulation was found in the Diabetic Retinopathy and the Early Treatment Diabetic Retinopathy Studies. This study was designed to test the hypothesis...Full Text Available
In terms of managing thrombotic disorders, genotype-based individualized patient care emerged as early as 1994 when the association of factor V Leiden (G1691A), and later, prothrombin (G20210A),...Full Text Available
The new percutaneous mitral valve repair techniques are at an early stage. Preliminary series show that they are feasible; however, they need to be further evaluated in comparison with contemporary...Full Text Available
Phenylketonuria (PKU) is a common genetic disorder in humans that arises from deficient activity of phenylalanine hydroxylase (PAH), which catalyzes the conversion of phenylalanine to tyrosine....Full Text Available
Mucopolysaccharidosis type IIIB (MPS IIIB; Sanfilippo syndrome type B) is a metabolic disorder with devastating clinical characteristics starting in early childhood and leading to premature death. A...Full Text Available
BackgroundThe aim of the present article was to evaluate whether angiogenic parameters as assessed by transvaginal color Doppler ultrasound (TVCD) may predict those prognostic factors...Full Text Available
Microglia provide immune surveillance for the brain through both the removal of cellular debris and protection against infection by microorganisms and “foreign” molecules. Upon...Full Text Available
BackgroundMitochondrial dysfunction, oxidative damage and the accumulation of somatic mutations in mitochondrial DNA (mtDNA) have been associated with certain neurodegenerative disorders....Full Text Available
BACKGROUND: Each component of metabolic syndrome (MS) conveys increased cardiovascular disease risk, but as a combination they become much more powerful. Vigorous early management of the syndrome may...Full Text Available
Hypothalamic systems which regulate appetite may be permanently modified during early development. We have previously reported hyperphagia and increased adiposity in the adult offspring of rodents fed...Full Text Available
BackgroundThe proteomics approach termed proteome pattern analysis has been shown previously to have potential in the detection and classification of breast cancer. Here we aimed...Full Text Available
OBJECTIVE: To examine primary care physicians' management of rheumatoid arthritis, ascertain the determinants of management and compare management with that recommended by a current practice panel....Full Text Available
and antibody responses of rhesus macaques exposed to the human gammaretrovirus XMRV. J Virol. 2011 May ;85(9):4547-57. Epub 2011 Feb 16 . PubMed Surgical staging of early...
The composition of the extracellular matrix (ECM) was examined in the developing lens and optic cup (stages 11-16) of the long-tailed monkey (Macaca fascicularis) using peroxidase immunocytochemistry....Full Text Available
Background:In recent years, breast cancer (BC) mortality rates have declined, reflecting advances in early detection. Prevention and management of treatment sequelae that could impair...Full Text Available
We investigated the pathophysiological mechanism by proteomic approach as a possible tool to detect the marker proteins to develop lower urinary tract symptoms following bladder outlet obstruction (BOO)....Full Text Available
Pancreatic islet transplantation into the liver provides a possibility to treat selected patients with brittle type 1 diabetes mellitus. However, massive early β-cell death increases the number...Full Text Available
BackgroundAlthough the World Health Organization had recommended that every child be vaccinated for Hepatitis B by the early 1980s, large multinational pharmaceutical companies held...Full Text Available
Aquaculture is increasing worldwide, however we have little understanding of its impacts on marine communities. A critical element of many marine communities are seagrasses, a group of globally distributed marine angiosperms that are drivers of many abiotic and biotic processes in estuarine and mari...
Life history theory proposes that early-life cues induce highly integrated responses in traits associated with energy partitioning, maturation, reproduction, and aging such that the individual phenotype...Full Text Available
Suppressed IL-12 production and maladaptive immune activation, both of which are ameliorated by successful highly active antiretroviral therapy (HAART), are thought to play important roles in the immunopathogenesis...Full Text Available
Hyperglycemia and hyperinsulinemia accelerate both aging and cancer. Antidiabetic biguanides such as metformin decrease glucose, insulin and IGF-1 level. Metformin increases lifespan and prevents cancer...Full Text Available
SynopsisEarly detection of late onset neonatal sepsis, prior to obvious and potentially catastrophic clinical signs, is an important goal in neonatal medicine. Sepsis causes a...Full Text Available
Stargardt-like macular degeneration (STGD3) is an early onset, autosomal dominant macular degeneration. STGD3 is characterized by a progressive pathology, the loss of central vision, atrophy...Full Text Available
BackgroundRecessive mutations in guanylate cyclase-1 (Gucy2d) are associated with severe, early onset Leber congenital amaurosis-1(LCA1). Gucy2d...Full Text Available
Assessment of subtle changes in the primary macromolecular components of cartilage, proteoglycan (PG) and collagen, is critical for the diagnosis of early stages of osteoarthritis (OA), but...Full Text Available
A disk formation model during collapse of the protosolar nebula, yielding a low-mass protoplanetary disk is presented. The following subject areas are covered: (1) circumstellar disks; (2) conditions for the formation of stars with disks; (3) early evolution of the protoplanetary disk; and (4) temperature conditions and the convection in the protoplanetary disk.
ContextFatigue is the most common sequela among non-small cell lung cancer (NSCLC) survivors 1–6 years post-treatment and is associated with functional limitations.Full Text Available
On agar plates, daughter cells of Escherichia coli mutually slide and align side-by-side in parallel during the first round of binary fission. This phenomenon has been previously attributed...Full Text Available
BackgroundEarly exposure to ovarian hormones is considered to increase breast cancer incidence. The age at which the ovaries become functional is thus important.Full Text Available
Ammonoids and conodonts, being characterized by exceptionally high background rates of origination and extinction, were vulnerable to global environmental crises, which characteristically intensified...Full Text Available
Zygotes of fucoid algae have long been studied as a paradigm for cell polarity. Polarity is established early in the first cell cycle and is then expressed as localized growth and invariant cell division....Full Text Available
The ternary complex factor (TCF) Elk-1 is a transcription factor that regulates immediate early gene (IEG) expression via the serum response element (SRE) DNA consensus site. Elk-1 is associated with...Full Text Available
A clinical trial was conducted to determine whether prepartum intramammary pirlimycin reduces the proportion of nulliparous heifers with intramammary infection (IMI) during early lactation and improves...Full Text Available
A rise in blood pressure associated with oral contraceptives is well established but the frequency with which it develops is not known. Early results from a controlled long-term prospective study have...Full Text Available
Chickens were bursectomized in ovo on days 18, 19 or 20 of incubation or within 6 h of hatch and immunized at day 28 after hatch by an intravenous injection of sheep red blood cells (SRBC). The immune...Full Text Available
Increasing attention is being paid to the scientific evaluation of traditional Chinese medicine (TCM). As many TCMs are capable of biotransformation in the gastrointestinal tract, attention to biotransformation...Full Text Available
BackgroundAllergic Contact Dermatitis (ACD) is regarded as a T-cell-mediated delayed-type hypersensitivity reaction. We studied the kinetics of the expression of CS-1 fibronectin,...Full Text Available
Early effects of boron neutron capture therapy (BNCT) on malignant glioma are characterized by reduction of the enhancement area and regression of the peritumoral edema radiologically. The aim of this study was to investigate the early histological changes of tumors and inflammatory cells after BNCT in the rat brain. Rats were treated with BNCT using boronophenylalanine (BPA) 7 days after implantation of C6 glioma cells. The tumors were assessed with magnetic resonance imaging and histopathological examination at 4 days after BNCT. The mean tumor volumes were 39#+-#2 mm"3 in the BNCT group and 134#+-#18 mm"3 in the control group. In the BNCT group, tumor cells showed a less pleomorphic appearance with atypical nuclei and mitotic figures. The Ki-67 labeling index was 6.5%#+-#4.7% in the BNCT and 35%#+-#3.8% in the control group. The reactions of the inflammatory cells were examined with ED-1 as macrophage marker and OX42 as microglia marker. ...
Bone metastases of an Ewing's sarcoma were detected by magnetic resonance imaging (MRI), when bone scan, CT and plain films were still normal. This is due to the ability of MRI to detect intramedullary metastases before involvement of the cortex. (Auth.).
IntroductionRadiotherapy outcomes might be further improved by a greater understanding of the individual variations in normal tissue reactions that determine tolerance. Most published...Full Text Available
Non-cemented femoral fixation in hip arthroplasty has become the standard of practice in the USA. However, recent literature has brought attention to an increasing incidence of periprosthetic femur...Full Text Available
The performance of the Lung Imaging Fluorescence Endoscope (LIFE) system was compared with conventional bronchoscopy in 158 patients: 68 patients with invasive cancer, 42 patients with abnormal sputum...Full Text Available
Background:The present study measured longitudinal changes in bone turnover markers in elderly patients with vertebral fracture and investigated the relationship among bone turnover...Full Text Available
Several theories have proposed a functional role for synchronous neuronal firing in generating the neural code of a sensory perception. Synchronous neural activity develops during a critical...Full Text Available
A paradoxical metabolic imbalance in inorganic phosphate occurs from the early onset of diabetes and may lead to a reduction of high energy phosphates and tissue hypoxia. These changes take place in...Full Text Available
Spinal Ewing's sarcomas are rare and cause problems in differential diagnosis. The radiologic, nuclear medicine and CT findings in two children with histologically proven Ewing's sarcoma are presented and problems in differential diagnosis discussed. Biopsy should be done early. (orig.).
Contact scanner system in Wolsung NPP(model ESE-1565) is an early '70 equipment, so most of components are obsolete. To make it 100% compatible, PCBs for this system is the main object of the study. Most of components used in the system are not available ...
OBJECTIVEPrevious studies showed that genetic deletion or pharmacological blockade of the receptor for advanced glycation end products (RAGE) prevents the early structural changes...Full Text Available
BackgroundAlthough the health benefits of breastfeeding are well established, early introduction of formula remains a common practice. Cultural beliefs and practices can have an...Full Text Available
In summer 2000, the Cushing/Whitney Medical Library at Yale University began a demonstration project to digitize classic articles in neurosurgery from the late 1800s and early 1900s. The objective of...Full Text Available
The Cordoba and Wolsung projects mark the entry into the international sales arena of the standardized Canadian 600 MWe CANDU-PHW reactor design. The Cordoba station experienced a setback in the early stages when severe inflation in Argentina led to a ren...
Ripening of `Tydeman's Early' apples (Malus sylvestris L.) assessed by the occurrence of the respiratory climacteric was delayed by succinic acid 2,2-dimethyl hydrazide (B-9) but not...Full Text Available
The purpose of the meeting reported here was to develop a set of national evidence-based standards for assessing and managing patients with potentially resectable rectal cancer. This report represents...Full Text Available
Premature circuit clotting is a major problem in daily practice of continuous renal replacement therapy (CRRT), increasing blood loss, workload, and costs. Early clotting is related to bioincompatibility,...Full Text Available
1. Paired or single recordings of paraventricular and/or supraoptic oxytocin cells at the beginning of suckling in urethane-anaesthetized rats enabled us to study cell recruitment and compare the characteristics...Full Text Available
This paper reviews the development of cerebral scintigraphy from its early days of planar imaging with simple technetium-99m labelled compounds to the recent revival of the technique in the form of...Full Text Available
Fish living in contaminated environments accumulate toxic chemicals in their tissues. Biomarkers are needed to identify the resulting health effects, particularly focusing on early changes at a subcellular...Full Text Available
Research on Be stars from the early work of Merrill and Struve to the present is reviewed, including recent observations from space. A number of models which have been proposed to explain the Be phenomenon are discussed, and the evolutionary status of Be stars is considered. 126 references.
He said due to DoD's early involvement in the creation of the Internet (a product of DARPA), it has more address space at its disposal than most other organizations worldwide....
BackgroundIn vitro data suggest that changes in myocardial substrate metabolism may contribute to impaired myocardial function in diabetic cardiomyopathy (DCM)....Full Text Available
Life-history theory predicts that traits involved in maturity, reproduction and survival correlate along a fast–slow continuum of life histories. Evolutionary theories and empirical results...Full Text Available
We report an unusual case of strangulated diaphragmatic (Morgagni) hernia resulting in ischaemia of the small and large bowel, which was initially diagnosed as a pneumonia. This case highlights the...Full Text Available
Adaptive image processing is one of the most important techniques in visual information processing, especially in early vision such as image restoration, filtering, enhancement, and segmentation. This work focuses on applications of advanced CI techniques in image processing applications
In multiple sclerosis (MS), oligodendrocyte and myelin destruction lead to demyelination with subsequent axonal loss. Experimental demyelination in rodents has highlighted the activation of the subventricular...Full Text Available
A method is presented to derive the absolute dimensions of early-type detached binaries by combining the observed parameters with results of evolutionary computations. The method is used to obtain the absolute dimensions of nine close binaries. We find that most systems have an initial masss ratio near 1.
The single-stranded viral DNA of an M13 phage recombinant containing the early promoter region of SV40 was hybridized with linear, double-stranded replicative form DNA of a related M13 phage containing...Full Text Available
Frontotemporal lobar degeneration is a progressive neurodegenerative syndrome that is the second most common cause of early-onset dementia. Mutations in the progranulin gene are a major cause of familial...Full Text Available
IntroductionVarious multigene predictors of breast cancer clinical outcome have been commercialized, but proved to be prognostic only for hormone receptor (HR) subsets overexpressing...Full Text Available
PurposeHyperglycemia and hypertension contribute to the development of diabetic retinopathy, and this may involve alterations in the normal retinal cell cycle. In this work, we examined...Full Text Available
Thiamin(e), also known as vitamin B1, is now known to play a fundamental role in energy metabolism. Its discovery followed from the original early research on the ‘anti-beriberi factor’...Full Text Available
Antimalarial drugs will be essential tools at all stages of malaria elimination along the path towards eradication, including the early control or “attack” phase to drive down transmission...Full Text Available
Methylphenidate (MPH) is commonly prescribed in childhood and adolescence for the treatment of attention–deficit/hyperactivity disorders. In rodents, MPH exposure during preadolescence...Full Text Available
... 2010-10-01 false Child mental health. 1304.24 Section 1304.24 Public...HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION...AGENCIES Early Childhood Development and Health Services § 1304.24 Child...
BackgroundPathophysiological mechanisms involved in amyotrophic lateral sclerosis (ALS) are complex and none has identified reliable markers useful in routine patient evaluation....Full Text Available
The nature of the first generation of stars in the Universe remains largely unknown. Observations imply the existence of massive primordial stars early in the history of the universe, and the standard theory for the growth of cosmic structure predicts that structures grow hierarchically through gravitational instability. We have developed an ab initio computer simulation of the formation of primordial stars that follows the relevant atomic and molecular processes in a primordial gas in an expanding universe. The results show that primeval density fluctuations left over from the Big Bang can drive the formation of a tiny protostar with a mass of just one percent that of the sun. The protostar is a seed for the subsequent formation of a massive primordial star.
Transplantation has emerged as the therapy of choice for many patients with end organ failure. One of the major goals is to tailor immunosuppressive therapy to the individual needs of every patient to balance the risk for rejection and over-immunosuppression. This will require diagnostic tools that can detect harmful processes in the allograft early, and that can be measured repeatedly. This review will consider recent advances in our understanding of the molecular nature of these processes and how this information is being utilized to design novel diagnostic assays to non-invasively monitor allografts. Highlighted is the need for large-scale prospective multi-centre studies to validate assays that show early promise in single centre studies.
This article reviews antisocial personality disorder, psychopathy, and violence and develops a three factor model of personality traits. Then a discussion of related personality disorders precedes the development of a categorical two factor model of impulsive versus remorseless violence. A paradigm of proactive, medical, and school based early intervention and prevention is advocated as a useful addition to the reactive detention of criminal justice. Integration of psychological tests, neuroimaging, and genomic data in early childhood and school based intervention strategies to prevent the development of conduct disorder and attenuate criminal propensity inform this approach. PMID:20422651
The fact that South Africa had no commercially significant deposits of crude oil necessitated the early development of production of gasoline from coal which was present in abundance in low to medium grade in thick seams, the development of the process since the early 1950s is discussed. Both the Fischer Tropsch and Lurgi processes are used, and three large plants named Sasol One, Two, and Three have been completed. A flow diagram for the Lurgi process as used in these plants is included. Typical products and their properties resulting from the Sasol-type Synthol operation are presented in tabular form. Marketing considerations and economics of production of the Sasol products are discussed briefly. (BLM)
The fact that South Africa had no commercially significant deposits of crude oil necessitated the early development of production of gasoline from coal which was present in abundance in low to medium grade in thick seams, the development of the process since the early 1950s is discussed. Both the Fischer Tropsch and Lurgi processes are used, and three large plants named Sasol One, Two, and Three have been completed. A flow diagram for the Lurgi process as used in these plants is included. Typical products and their properties resulting from the Sasol-type Synthol operation are presented in tabular form. Marketing considerations and economics of production of the Sasol products are discussed briefly. (BLM)
Gallium imaging is increasingly being used for the early detection of complications in patients with AIDS. A 26-year-old homosexual man who was HIV antibody positive underwent gallium imaging for investigation of possible Pneumocystis carinii pneumonia. Widespread cutaneous focal uptake was seen, which was subsequently shown to be due to mycobacterium avium-intracellulare (MAI) septicemia. This case demonstrates the importance of whole body imaging rather than imaging target areas only, the utility of gallium imaging in aiding the early detection of clinically unsuspected disease, and shows a new pattern of gallium uptake in disseminated MAI infection.
A high voltage self-blowing circuit breaker with closing resistors is equipped with an auxiliary contact inserted in the trip control circuit of an electrical circuit breaker. The auxiliary contact is actuated by the mechanical control rod of the circuit breaker in such a way as to prevent any operator closing error. A high-speed mechanism is inserted in the link system connecting the control rod and the auxiliary contact, with dead travel to delay closing of the auxiliary contact when a closing operation takes place and to prevent a tripping order from being transmitted too early. Such an early transmission would be liable to cause a flashover on the inserter contacts and damage to the circuit breaker.
The Median Tectonic Zone (MTZ) of New Zealand is a generally north trending belt of Mesozoic subduction related I-type plutonic, volcanic, and sedimentary rocks in South Island and Stewart Island that separates Permian strata of the Eastern Province Brook Street Terrane from lower to mid Gondwana margin assemblages of the Western Province. High precision isotope dilution U/Pb ages of zircons from 30 rocks are reported. Pre-digestion leaching of zircon in hydrofluoric acid yielded significantly more concordant residues by removing common Pb and dissolving more soluble high-U domains that have been more affected by relatively recent Pb loss. The results show that MTZ magmatism ranges in age from at least Early Triassic to Early Cretaceous (247-131 Ma), with a pronounced gap in the Middle Jurassic. Triassic plutons tend to occur on the eastern side of the MTZ, and they intrude volcanic/sedimentary sequences of the MTZ in Nelson and eastern ...
Clinical studies have proved the effectiveness of local ablading methods in pations with non-resectable liver metastases of a colorectal carcinoma. RF ablation and LITT are a potentially curative therapy option and an alternative to systemic chemotherapy; the latter is carried out primarily for reducing tumour size with the goal of secondary resectability. The number of R0-sesectable metastases can be enhanced by a combined therapy of surgery and local ablading methods, e.g. by preoperative, intraoperative or postoperative ablasion of further non-resectable tumours during surgery. Systemic chemotherapy combined with surgery as an adjuvant method is not recommended unless in cases of non-abladable tumour recidivation. Currently, systemic chemotherapy is used as a neo-adjuvant therapy for tumour size reduction with the goal of secondary resectability or, in case of inoperability, local ablation. (orig.) [German] Abladierende ...
The main facets of professor N.I. Pirogov's professional activity are outlined. Forensic medicine (in the first place its organizational and practical aspects) was an integral component of his scientific and clinical work, along with applied anatomy and surgery. Landmark publications of N.I. Pirogov are listed with special reference to those concerned with forensic medical expertise of medical malpractice cases, postmortem inspection and intravital examination procedures, wound ballistics studies, the atlas of forensic pathology, etc. The surgeon and anatomist N.I. Pirogov can be justly regarded as a founder of forensic medicine in this country. PMID:21866839
The combination of fentanyl and droperidol, Innovar, was compared to flunitrazepam (1-2 mg) in a higher dosage (2.5-5 ml) for i.m. premedication. We measured psychological (ESB) and physiological (blood pressure, heart rate, p.cortisol) stress parameters before and after premedication. Side effects were registered. The day after surgery the patients were asked about the quality of premedication. Flunitrazepam reduced anxiety; Innovar did not. After Innovar the feeling of weakness increased significantly compared to flunitrazepam. Two patients panicked and refused operation. Other severe side effects were not observed. There were slight advantages for flunitrazepam on physiological stress. Patients were more satisfied with flunitrazepam than with Innovar premedication. The results show that Innovar also in a higher dosage cannot be recommended for premedication. PMID:6391270
Paget Schroetter syndrome, or effort thrombosis of the axillosubclavian venous system, is distinct from other forms of upper limb deep vein thrombosis. It occurs in younger patients and often is secondary to competitive sport, music, or strenuous occupation. If untreated, there is a higher incidence of disabling venous hypertension than was previously appreciated. Anticoagulation alone or in combination with thrombolysis leads to a high rate of rethrombosis. We have established a multidisciplinary protocol over 15?years, based on careful patient selection and a combination of lysis, decompressive surgery, and postoperative percutaneous venoplasty. During the past 10?years, a total of 232 decompression procedures have been performed. This article reviews the literature and presents the Exet...
Background. To determine total upper limb function following selective neck dissection over a mean follow-up of 1.6 years. Methods. A retrospective questionnaire study in a tertiary head and neck surgical unit. One hundred forty-eight patients who underwent selective neck dissection for head and neck cancer from January 2000 to December 2005 were invited to participate. The main outcome measure was ipsilateral upper limb dysfunction as measured by the Disability of Arm, Shoulder and Hand (DASH) questionnaire. Results. Sixty-five patients responded to the invitation to join the study from 148 invited. Despite accessory nerve conserving surgery for all the selective neck dissections studied, 23% reported no upper limb dysfunction, 54% reported mild upper limb dysfunction, 15% reported modera...
PurposeThe behavior of trigeminocardiac reflex (TCR) during maxillofacial surgeries has not yet been sufficiently studied and knowledge of its behavior is limited to some case reports. The present study aimed to assess the occurrence of TCR in bilateral sagittal split ramus osteotomy and to determine the possible effect of Gow-Gates block on its incidence. Materials and MethodsTwenty candidates for bilateral sagittal split ramus osteotomy (included were American Society of Anesthesiologists I Class III patients with a prognathism of 3 to 5 mm) were given routine general anesthesia after at least 12 hours of fasting. All patients received Gow-Gates mandibular nerve block on 1 random side (case ramus; the other side was used as the control) after induction of general anesthesia before surger...
Background Adrenalectomy remains the definitive therapy for most adrenal neoplasms. Introduced in the 1990s, laparoscopic adrenalectomy is reported to have lower associated morbidity and mortality. This study aimed to evaluate national adrenalectomy trends, including major postoperative complications and perioperative mortality. Methods The Nationwide Inpatient Sample was queried to identify all adrenalectomies performed during 1998?2006. Univariate and multivariate logistic regression were performed, with adjustments for patient age, sex, comorbidities, indication, year of surgery, laparoscopy, hospital teaching status, and hospital volume. Annual incidence, major in-hospital postoperative complications, and in-hospital mortality were evaluated. Results Using weighted national estimate, 4...
Abstract Purpose: To evaluate the efficacy of transvesical obturator nerve block (ONB) in the prevention of obturator nerve reflex and leg jerking during transurethral resection of bladder tumors (TURBT). Patients and Methods: A total of 60 patients were studied, in whom the transurethral resection of tumors on the posterolateral bladder wall were performed under spinal anesthesia (SA). The patients were randomly divided into two groups. In the first group, we performed transvesical ONB and SA together, while the second group received only SA. The patients underwent TURBT using monopolar cautery. Incidence of leg jerking was registered and compared in these two groups. We used a nerve stimulator to detect the obturator nerve next to the lateral bladder wall. The obturator nerve was identif...
Background The crucial role of cigarette smoking in the development of pneumothorax is unclear because nonsmokers can also develop primary spontaneous pneumothorax. The purpose of this study was to clarify the pathophysiologic effects of cigarette smoking and its clinical correlations in primary spontaneous pneumothorax. Methods Included were 115 specimens of lung tissue from patients with primary spontaneous pneumothorax who underwent video-assisted thoracoscopic surgery from January 2001 to December 2002. We reviewed the clinical features of 56 smokers and 59 nonsmokers with an average follow-up of 67 months. The pathologic findings of resected lung specimens were analyzed retrospectively. Results There were no statistical differences in sex, age, body height, body weight, body mass inde...
The prevalence of hepatic cysts is 0.1% to 0.5% based on autopsy studies, and 2.5% based on US examinations. Percutaneous therapies are a new alternative to surgery. They include simple percutaneous aspiration, catheter drainage alone, and catheter drainage with sclerotherapy. We present an 11-year-old boy admitted to hospital because of abdominal pain. A diagnosis of simple hepatic cyst was made, which was treated with aspiration and tetracycline hydrochloride solution (5%) injection into the cystic cavity. Complete regression was seen on US and MRI examination at 3 months, with total collapse and deflation of the cyst. The cyst regressed totally, leaving a hyperechoic linear scar on US examination at 1 year. On the basis of the clinical and imaging results obtained, percutaneous sclerotherapy of hepatic cysts can be recommended as the treatment of choice and as a valid alternative to laparoscopy in children. (orig.)
PurposeThe purpose of the present study was to compare the effect of submucosal versus intramuscular administration of dexamethasone sodium phosphate on patients' quality of life after surgical removal of impacted lower third molars. Patients and MethodsA randomized, non-blind, clinical trial was planned. The sample was composed of patients requiring extraction under local anesthesia of a single partial bony impacted mandibular third molar with Class II or III and position B or C, according to the Pell and Gregory classification. The patients were randomly distributed into 1 of 3 groups: submucosal dexamethasone, intramuscular dexamethasone, and a control group that received no steroid. A modified translated questionnaire was used to assess the patients' perception regarding different qual...
Purpose: To assess the prognostic value of biologic (p53, Ki-67) and clinical factors in squamous cell carcinoma of the oropharynx after radical surgery and postoperative radiotherapy (RT). Methods and Materials: Between 1985 and 1995, a total of 102 patients with 104 tumor sites were entered onto the study. Fifty-five primary tumors (53%) involved the tonsils, 26 (25%) the soft palate, and 23 (22%) the base of the tongue. Median age was 53 years (range 36-80 years). The clinical T- and N-categories (UICC 1997) were: T1 (30), T2 (47), T3 (22), T4 (5), N0 (33), N1 (28), N2 (42), and N3 (1). Histologically-clear margins were achieved in all patients by initial surgery. Postoperative RT to the primary and regional lymphatics was given, to a total of 60 Gy in 6 weeks, and single daily fractions of 2 Gy. The expression of the nuclear p53- and Ki-67-labeling index (LI) was investigated by immunostaining using the monoclonal antibodies DO-7 and MIB 1. ...
PurposeTo conduct a retrospective analysis within a large university teaching hospital, comparing outcomes between patients receiving either radical surgery or radiotherapy as curative treatment for bladder cancer.Patients and MethodsBetween March 1996 and December 2000, 169 patients were treated radically for muscle-invasive bladder cancer. Data were collected from patient notes. Statistical analyses were performed using Kaplan-Meier methods and Cox proportional hazards regression analysis to compare radiotherapy and surgical outcome data.ResultsThere was no difference in overall, cause-specific, and distant recurrence-free survival at 5 years between the two groups, despite the radiotherapy group being older (median age, 75.3 years vs. 68.2 years). There were 31 local bladder recurrences...
Women treated of localised stages of cervix cancer have a very good prognosis. But do health care professionals have a tendency to underestimate the potential need for rehabilitation of this group? To be able to answer this question this study aimed to develop knowledge concerning these women's own perception of their health during a long period after surgical cancer treatment. A total of 398 women who underwent radical hysterectomy in the period from the 1 January 1983 to 31 December 2000 participated in the study at Aarhus University Hospital, Skejby in Denmark 2001-2003. All patients initially filled in an internally validated questionnaire. Subsequently a sample of 100 women filled in the questionnaires Short Form -36 and Sense of Coherence to evaluate their self-reported health. Analy...
Purpose: During recent years, more intensified systemic and local treatment regimens have increased the 5-year survival figures in localized Ewing's sarcoma to more than 60%. There is, however, concern about the risk of second malignancies (SM) in long-term survivors. We have analyzed the second malignancies in patients treated in the German Ewing's Sarcoma Studies CESS 81 and CESS 86. Materials and Methods: From January 1981 through June 1991, 674 patients were registered in the two sequential multicentric Ewing's sarcoma trials CESS 81 (recruitment period 1981-1985) and CESS 86 (1986-1991). The systemic treatment in both studies consisted of a four-drug-regimen (VACA = vincristine, actinomycin D, cyclophosphamide, and adriamycin; or VAIA = vincristine, actinomycin D, ifosfamide, and adriamycin) and a total number of four courses, each lasting nine weeks, was recommended by the protocol. Local therapy in curative patients was either complete surgery (n = 162), ...
The initial management of nonfunctioning pituitary macroadenomas (NFAs) is usually surgery; however, a significant proportion of NFAs may require further treatment. Radiotherapy is currently used in patients with residual tumour and achieves excellent long-term control, but there are concerns about potential late toxicity. Stereotactic radiotherapy, both in the form of radiosurgery or fractionated stereotactic radiotherapy, has been developed as a more accurate technique of irradiation with more precise tumour localization and consequently a reduction in the volume of normal tissue, particularly the brain, irradiated to high radiation doses. A review of the literature suggests that new radiation techniques offer safe and effective treatment for recurrent or residual pituitary adenomas; how...
Despite high local control rate in Ewing's sarcoma the exact indication of radiation therapy is still controversial as well as the choice of the target volume and the optimal dose of radiation. The importance of the quality of radiotherapy has been stressed in recently published data and has shown a significant impact on long term local control with adequate radiation therapy. The dramatic improvement of precision allowed by the conformal therapy and three dimensional dosimetry allow to expect a decrease of late effects expected for second malignancies. However, late sequelae and radio-induced osteosarcoma still remain the major side effects after radiotherapy. The authors discuss the results of the main trials on Ewing's sarcoma on the choice of dose and target volume. Surgery is still the preferred choice for small tumors if the foreseen outcome is identical. (authors). 28 refs.
Opinion statement Because a minority of patients with D-transposition of the great arteries are diagnosed in utero by ultrasound, most present after delivery with cyanosis. In the absence of apparent lung disease, cyanotic neonates suspected of having a cardiac lesion should be immediately transferred to an intensive care unit at a pediatric tertiary care center for monitoring, resuscitation, and to define the cardiac anatomy and physiology. A prostaglandin E-1 infusion is usually initiated to maintain ductal patency and promote intra-cardiac mixing. In the past, balloon atrial septostomy (BAS) was routinely performed to enlarge the atrial septal defect and improve intra-cardiac mixing while the infants awaited surgery. Recent literature has reported an increase risk of stroke in neonates ...
In a 47-year-old male patient a bronchopleural fistula was apparent 22 days after extended right-sided diaphragma-pericardio-pleuro-pneumonectomy for pleuramesothelioma. The thoracic cavity was infected. Rethoracotomy was performed and the fistula was closed using an omental pedicle flap. The bronchial stump became tight and the cavity fluid became sterile. No abdominal complications were seen. The patient died 8 months later from malignant pericardial infiltration. The ability of greater omentum to revascularize ischemic tissue, to absorb fluid and to resist local infection is proved and used in several subspecialities of surgery. Nevertheless the use of the greater omentum in the management of bronchopleural fistula has been rarely published. The reported case shows that the closure of a large bronchopleural fistula is possible by using the attributes of the omental tissue. PMID:2264043
Bariatric surgical procedures have become important therapeutic options for treatment of morbid obesity in both adults and adolescents co-morbidities of obesity such as glucose intolerance, type 2 diabetes (T2DM), metabolic syndrome, steatohepatitis, hyperlipidemia and cardiovascular disease. These co-morbidities of obesity have significant impacts on the overall quality of life of the individual and our society at large. Roux-en-Y gastric bypass (RYGB) and the relatively newer procedures of gastric banding (GB) and vertical sleeve gastrectomy (VSG) have proven to be efficacious in achieving rapid weight loss and reversing the comorbidities of obesity. Unfortunately, bariatric procedures are not without risks including micronutrient deficiency, failure to maintain lost weight, and mortalit...
A 46-year-old man was referred to us after he presented to his local physician complaining of difficulty eating. Upper gastrointestinal endoscopy revealed a tumor at the esophagogastric junction (EGJ), and moderately differentiated adenocarcinoma was diagnosed from the biopsy findings. Computed tomography (CT) showed apparent enlargement of the pretracheal lymph nodes, the lymph nodes around the bilateral recurrent laryngeal nerves, and the lower thoracic paraesophageal lymph nodes, confirming metastasis. Since the disease was far advanced esophagogastric cancer with marked lymph node metastases throughout the mediastinum, curative resection would have been unlikely. Thus, he was commenced on systemic chemotherapy with cisplatin (90 mg/body, day 8) + S-1 (120 mg/body/day, given for 3 weeks...
The initial series of laparoscopic single stage orchiopexy for the abdominal or emergent impalpable undescended testis is reported. The first laparoscopic orchiopexy was performed at our institution in October 1991. Between October 1991 and January 1993, 14 patients (16 testes) underwent minimally invasive surgery with 6 months of followup in all cases. No evidence of testicular loss or acute atrophy has occurred, with the entire procedure being accomplished by laparo-endoscopic techniques in all cases. Treatment of 3 of the 16 testicles consisted of stage 2 of staged orchiopexy, and to our knowledge these cases represent the first stage 2 orchiopexy completed by laparoscopic techniques. In those cases stage 1 was performed by laparoscopic clipping of the vessels. The details of the procedure as we now perform it are described. PMID:7915336
Partial adrenalectomy is usually performed for the treatment of bilateral pheochromocytomas and in case of sporadic, monolateral tumors, to minimize the risk of adrenal failure, especially in younger patients. Due to the lack of consistent series, many issues such as correct surgical indications and technical aspects still need to be debated. From 2007 to 2010 we performed four unilateral partial adrenalectomies (3 aldosterone-producing adenomas and 1 cortisol-producing adenoma), and three bilateral subtotal adrenalectomies, consisting in total adrenalectomy on one side and partial adrenalectomy on the contralateral gland (3 bilateral pheochromocytomas in MEN IIa). In case of single tumor, partial adrenalectomy was carried out without adrenal vein ligation and the results were similar to t...
Objectives To present our preliminary experience with laparoscopic groin exploration and subsequent laparoscopic orchiectomy and internal ring closure for testicular nubbin in children and discuss the usefulness of our new treatment strategy. The advantages of laparoscopic orchiopexy for intra-abdominal testis are the ability to start treatment as soon as a diagnosis has been made and to permit minimally invasive surgery. These advantages can apply to laparoscopic orchiectomy for a testicular nubbin. Methods A total of 6 boys with a testicular nubbin (age range 14-76 months, mean age 27.3 months) underwent laparoscopic orchiectomy at our institution from June 2007 to June 2008. We opened the posterior parietal peritoneum by incising the peritoneum lateral to the spermatic vessel, distal to...
BackgroundPeritoneal metastasis occurs in up to 30% of patients with gastric cancer. The aim of this experimental study is to develop and validate a novel ex vivo model of the human peritoneum to better identify factors involved in the development of peritoneal metastasis in order to improve its management and prognosis. MethodsPeritoneal discs harvested from hernia sacs obtained at inguinal hernia surgery were suspended in media using Teflon rings. Viability of the tissue was investigated using MTS assay, light and scanning electron microscopy (LM and SEM) over 72 h. To assess validity of the model, phenotypic changes in tumor cells were investigated. Changes in matrix metalloproteinases (MMP)-2 and -9 activities in HGC and AGS gastric adenocarcinoma cells after co-culture were investigat...
The purpose of this study was to investigate whether hydroxyapatite (HAp) coating could induce polyethylene terephthalate (PET) artificial ligament graft osseointegration in the bone tunnel. Twenty-four New Zealand white rabbits underwent artificial ligament graft transplantation in bilateral proximal tibia tunnels. One limb was implanted with HAp-coated PET graft, and the contralateral limb was implanted with non-HAp-coated PET graft as control. The rabbits were randomly sacrificed at four and eight?weeks after surgery. The loads to failure of the experimental group at eight?weeks were significantly higher than those of the control group (p?=?0.0057). Histologically, application of HAp coating induced new bone formation between graft and bone at eight?weeks compared with the controls. Rea...
Outcome from trauma, surgery, and a variety of other medical conditions has been shown to be positively affected by providing treatment at facilities experiencing a high volume of patients with those conditions. An electronic literature search was made to identify English-language articles available through March 2011, addressing the effect of patient treatment volume on outcome for patients with subarachnoid hemorrhage. Limited data were identified, with 16 citations included in the current review. Over 60% of hospitals fall into the lowest case-volume quartile. Outcome is influenced by patient volume, with better outcome occurring in high-volume centers treating >60 cases per year. Patients treated at low-volume hospitals are less likely to experience definitive treatment. Furthermore, t...
Unilateral diaphragmatic paralysis was diagnosed in 2 preterm neonates born at 29 and 25 weeks of gestation, respectively. In both instances, the pathophysiology was phrenic nerve injury after extravasation of parenteral nutrition fluid. Misplacement and infection were predisposing factors. Diaphragmatic movement analysis by time-motion-mode ultrasonography was helpful in achieving a diagnosis. The first neonate required a diaphragmatic placation, whereas the other infant was managed nonoperatively. These cases confirm a rare etiology of diaphragmatic paralysis and possible spontaneous recovery. In neonates with very low birth weight, general anesthesia and thoracic surgery may be associated with a high morbidity, suggesting that nonoperative medical treatment, when possible, is preferable...
The objective of this study was to evaluate the role of collagen membrane and Bio-Oss coverage in healing of an onlay graft to the mandible. Twelve adult sheep each received an onlay bone graft (experiment 1), bone graft+Bio-Gide (experiment 2), and bone graft+Bio-Oss/Bio-Gide (experiment 3) on the lateral surface of the mandible. The animals were euthanized at 4, 8, 12 or 16 weeks after surgery, and findings were analysed by routine microscopy and immunohistochemistry for proliferation (Ki67) and apoptotic (Caspase-3) markers. Grafts were fully incorporated in all specimens. Pronounced resorption was observed in experiment 1. Minimal loss of graft volume was seen in experiment 2 specimens without membrane displacement. A remarkable increase in the augmented region of the mandible was obse...
Therapeutic decisions are quite clear-cut for asymptomatic gallstone disease and acute cholecystitis. However, the appropriate therapeutic course for older patients with chronic cholecystitis may be less obvious. Watchful waiting may be reasonable for patients with mild and infrequent symptoms. For healthy patients, cholecystectomy is recommended if symptoms are becoming more frequent and severe. Laparoscopy may reduce the complication rate and be safely performed even in those with underlying medical illness. Oral dissolution therapy can be attempted for qualifying symptomatic patients who are at poor surgical risk or who refuse surgery. Shock wave lithotripsy and contact dissolution therapy show some promise but are currently experimental. PMID:8339941
Abstract During the past few years, laparoscopy has become the gold standard for some surgical procedures and its applications continue to expand. Because of multiple factors such as loss of tactile perception, two-dimensional visualization of the three-dimensional surgical field, and demanding bimanual hand-eye coordination, special training is required to achieve proficiency with laparoscopy. In this study, as the first step toward evidence-based development of strategies to improve the quality of laparoscopy training from brain activity and behavior relationships, a laparoscopy training simulator was developed for use in functional MRI. Experiments confirmed the functional MRI compatibility of the device. Representative behavioral and functional MRI results for two subjects showed the f...
Placement of dental implants in the interforaminal region of the edentulous mandible is considered a safe and routine surgical procedure. Hemorrhage in the floor of the mouth has been reported as a rare, potentially life-threatening complication related to the placement of implants in this region. In this case report the authors present an immediate and a delayed case of massive bleeding in the floor of the mouth after implant placement. This highly vascularized region is vulnerable and bleeding can be induced easily by instrumentation, causing a vascular trauma, usually by perforation of lingual periostium. In almost all cases the expanding hematoma formation starts during surgery. The effect of the vasoconstrictive agent in the local anesthesic combined with an injury of the lingual arte...
AbstractBackground: Certolizumab pegol (Cimzia, CZP) was approved for the treatment of Crohn's disease (CD) patients in 2007 in Switzerland as the first country worldwide. This prospective phase IV study aimed to evaluate the efficacy and safety of CZP over 26 weeks in a multicenter cohort of practice-based patients. Methods: Evaluation questionnaires at baseline, week 6, and week 26 were completed by gastroenterologists in hospitals and private practices. Adverse events were evaluated according to World Health Organization (WHO) guidelines. Results: Sixty patients (38F/22M) were included; 53% had complicated disease (stricturing or penetrating), 45% had undergone prior CD-related surgery. All patients had prior exposure to systemic steroids, 96% to immunomodulators, 73% to infliximab, and...
Background: Superficial inferior epigastric artery (SIEA) flap has a great advantage over other flaps of the area, that is, readily non-existent donor-site problems. The main reason why the SIEA flap has never been extensively used in breast reconstruction is the small diameter and variable anatomy of its donor artery. This study presents a possibility of enlarging the SIEA diameter using the delay-phenomenon mechanism. Methods: A prospective clinical study of 26 patients was undertaken. Prior to surgery, ultrasound examinations were performed, measuring the diameter of SIEA and the velocity of blood flow in SIEA. The ipsilateral deep inferior epigastric artery (DIEA) was then ligated in all patients who had a measurable SIEA preoperatively. Two weeks later, measurements were repeated. The...
In a retrospective study of 21 patients, in whom the acetabular fractures were suspected on initial radiographs, we compared and analysed the computed tomographic findings and plain radiographic findings. The results were as follow: 1. In patients with multiple trauma, no further change in position was required during CT examinations. 2. CT showed intraarticular loose bodies, which were invisible on plain radiographs. 3. CT was useful in detecting the fractures of acetabular rims, medial wall of acetabulum, and femoral head. 4. CT permitted better evaluation of shape, extent, and degree of separation of fracture fragments. 5. CT was helpful in detecting the associated fractures and soft tissue injuries. 6. CT also demonstrated the adequacy of reduction, the position of metallic fixation devices, and the presence or absence of remaining intraarticular osseous fragments after surgery.
The growth of a middle ear cholesteatoma behind a normal tympanic membrane is a rate though possible event. In such cases, CT may provide useful information for diagnosis. The results are presented of a CT study carried out on 14 patients affected with unilateral conductive hearing loss and with normal tympanic membrane. CT allowed the diagnosis of meddle ear cholesteatoma to be made in all cases. All patients were treated with surgery: 8 of them underwent tympanoplasty and 6 explorative tympanotomy. While the diagnosis of cholesteatoma was confirmed in 13 patients, in 1 case tympanosclerosis was diagnosed. CT diagnosis of middle ear cholesteatoma is based on the demonstration of a low-density soft-tissue mass, in association with bone erosion or ossicular dislocation. The author emphasizes the difficulty of a CT diagnosis of cholesteatoma in the patients with middle ear soft-tissue masses in the absence of bone alterations.
Abstract Purpose: To compare the safety and efficiency of conventional monopolar, plasmakinetic and holmium laser transurethral resection of bladder tumor (CM-TURBT, PK-TURBT and HoL-TURBT) while managing primary non-muscle invasive bladder cancer. Patients and Methods: From 2005 to 2009, 173 patients with primary non-muscle invasive bladder cancer underwent endoscopic surgery. Among them, 51 patients underwent CM-TURBT, 58 patients underwent PK-TURBT, and 64 patients underwent HoL-TURBT. All patients were divided into three risk groups (low, intermediate, and high) based on the European Association of Urology guidelines and prognostic factors of recurrence. Clinical data, included preoperative, operative, and postoperative management and follow-up, were recorded. Results: Patient demograp...
In 9 over 12 patients who underwent cardiac transplantation computed tomography was performed. In 5 of them CT was obtained also before the surgical treatment. In all patients angio-CT technique was performed, while the ECG-gated technique was employed only before surgery. CT shows changes in morphology of both atria but over all of the right one, and rotation of the heart on the longitudinal axis. The conditions of the pericardium are particulary well demonstrated: in 5 cases pericardial effusion was observed, 3 times localized and 2 times diffuse. Only in 1 patient a small thrombus in the right atrium was demonstrated. CT allows the possibility to obtain simultaneously information on mediastinum, lung and pleura. Pleural effusion, pulmonary infections and mediastinal complications are easily demonstrated.
AbstractBACKGROUND: Disparities in treatment and mortality for colorectal cancer (CRC) may reflect differences in access to specialized care or other characteristics of the area where an individual lives. METHODS: Surveillance, Epidemiology and End Results Program-Medicare data for seniors diagnosed with CRC were linked to area measures of the sociodemographic characteristics and the capacity of surgeons, medical oncologists, and radiation oncologists. Outcomes included receipt of stage-appropriate CRC care and mortality. RESULTS: After adjustment, blacks and Hispanics were less likely than whites to undergo surgery (odds ratio [OR] 0.57, 95% confidence interval (CI) 0.52-0.63 and OR 0.82, 95% CI 0.70-0.95, respectively). Individuals who lived in areas with the highest tertile of surgeon c...
Fuji Computed Radiography (FCR) is a new system of digital radiography that is based on the latest computer technologies. We applied this FCR system to the X-ray diagnosis of the laryngeal disease. Twenty patients with various laryngeal diseases were evaluated by both FCR frontal tomography and conventional screen-film frontal tomography under the same exposure condition. Both tomograms were then compared on the subject of the clarity of delineation of laryngeal structures. As the result, FCR tomograms revealed the feature of the laryngeal lumen and cartilages more clearly than conventional tomograms. In addition, energy subtraction method, which is one of FCR image processing systems, was presented as a new technical procedure to extinguish cervical spine shadows in plain anteroposterior laryngeal X-photograph. We stress that FCR system is the suitable procedure for X-ray analysis of laryngeal diseases, especially in the region related with the phono-surgery. ...
The present research scholars are having keen interest in doing their research activities in the area of Data mining all over the world. Especially, [13]Mining Image data is the one of the essential features in this present scenario since image data plays vital role in every aspect of the system such as business for marketing, hospital for surgery, engineering for construction, Web for publication and so on. The other area in the Image mining system is the Content-Based Image Retrieval (CBIR) which performs retrieval based on the similarity defined in terms of extracted features with more objectiveness. The drawback in CBIR is the features of the query image alone are considered. Hence, a new technique called Image retrieval based on optimum clusters is proposed for improving user interaction with image retrieval systems by fully exploiting the similarity information. The index is created by describing the images according to their color characteristics, with ...
The aim of this study was the evaluation of contralateral hip fractures after a previous hip fracture. For this retrospective analysis patients were selected from the database of the LUMC, a teaching hospital in the south-west of the Netherlands. We analyzed all patients with a second fracture of a hip between 1992 and 2007. The exclusion criteria were high impact trauma and patients with diseases or medication known to have a negative effect on bone metabolism. A total of 1,604 hip fractures were identified. The possible predictive factors for the second fracture and descriptive statistics related to surgery (Hb and HT before and after the operation, total amount of intra- and postoperative blood loss, type of osteosynthesis, complications, time of death after the last fracture, time betw...
We have developed a flexible radioactive polyurethane patch incorporating {beta}-emitting radionuclide (166Ho) to treat malignant skin lesions. We covered the tumor surface (n=133) with the radioactive patch for 33.58 {+-} 5.33 minutes. Radiation dose delivered was 35 Gy for Bowen's disease (n=78), Kaposi sarcoma (n=25), actinic keratosis (n=5), and 50 Gy for BCC (n=17) and squamous carcinoma (n=8). Complete response was observed in 91.7% after the first therapeutic trial, 96.2% after 2nd and 97.7% after 4th trial with excellent cosmetic outcome for 31.15{+-}13.88 months of follow-up. Radioactive patch therapy is effective for superficial skin cancers that are impractical for surgery.
The usefulness of helical CT early phase images optimized by the SmartPrep method for evaluation of wall invasion by colorectal cancer was investigated. Between August 1997 and September 1998, CT was performed to evaluate the primary tumor and local extension in 10 consecutive patients with colorectal cancer confirmed by barium enema- and/or colonoscopy. Early-phase images were acquired by using SmartPrep application software. This method allows the optimal scan delay time to be obtained by continuous monitoring of increases in CT values after injection of contrast medium. Sections of the surgical specimens, close to the same plane as the CT images, and of the same slice thickness, were analyzed histopathologically. All 10 cancers, regardless of size, showed strong enhancement on the early-phase images (81.4-112 HU, mean: 95.1 HU). The strongly enhanced image areas on CT corresponded to the primary cancer areas on ...
Objective. To compare turbo inversion recovery magnitude (TIRM) with standard T1-weighted (T1-W) and T2-weighted (T2-W) MR sequences in the very early detection of acute osteomyelitis in children. Materials and methods. In 15 children with osteomyelitis, 15 sets of T1-W spin-echo (SE) (TR/TE, 400-640/12-17), T2-W turbo spin-echo (TSE) (TR/TE/ETL, 3290-4465/112-120/11), and TIRM (TR/TE/TI, 4000-6120/60/160) images were acquired with a 1.0-T magnet. Contrast-to-noise (C/N) ratios and percentage of signal between lesion and normal bone marrow were analysed with a computer-assisted image analysing system in a region of interest (ROI). Results. In 13 of 15 patients, the absolute signal enhancement in a ROI on the TIRM images was better than on the T1-W SE and T2-W TSE images and in 14 of 15 cases, C/N ratios were also better on the TIRM images than on the other sequences. In the other cases, the TIRM signal was diagnostically equivalent. On the TIRM images, the signal ...