Follicular unit transplant (FUT) is one of the surgical procedures which has been recently used to repigment a stable vitiligo patch. Single-hair FUT was done for a 30-year-old male with stable vitiligo...Full Text Available
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.
Full text: A 51-year-old woman with end stage renal failure secondary to Haemolytic Uraemic syndrome underwent a cadaveric renal transplant. A routine post transplant DTPA scan was performed which demonstrated satisfactory renal transplant perfusion and function. Incidental note was made of tracer uptake in the pelvis in the mid-line, which was suspected to be a uterine fibroid. This was confirmed on ultrasonography and at surgery. One week post transplantation the patient became acutely unwell and at laparotomy a perforated diverticular abscess was drained. Intraoperatively the transplant kidney was examined and the surgeon thought there was a area of infarction. This was confirmed on biopsy. As the patient's creatinine was rising a repeat DTPA study was performed. Perfusion and function of the transplant kidney was virtually absent while ...
Congenital woolly hair is a disorder with structural defects of the hair shafts. Curled hairs are noticed at birth or soon after birth and often improve with age. Some cases of woolly hairs are associated...Full Text Available
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...
Direct radionuclide cystography is known to be sensitive and safe in children with suspected vesical-ureteral reflux. In this study we have investigated the utility of direct radionuclide cystography in renal transplant recipients with a recent history of pyelonephritis or recurrent urinary infections. Direct radionuclide cystography is a simple test, however it requires a rigorous methodology in order to obtain images during fill-in as well as during voiding in both men and women. The images must be interpreted using a rigorous image display methodology. Twenty-eight radionuclide cystographies were performed in 17 patients. Among the 17 tests performed for the initial diagnosis of reflux , 12 were positive. Four patients with positive results and four patients with negative results were also investigated by radiologic cystography. Similar results were obtained in those patients. Nine scintigraphies were done after treatment by surgery or ...
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.
Purpose: To evaluate the results of radiotherapy in cholangiocarcinoma patients managed with various combinations of chemotherapy and surgical resection with selective liver transplantation. Methods and Materials: From January 1990 to December 1995, 61 patients with histologically confirmed biliary duct adenocarcinoma were seen in the Radiation Oncology Department of the University of Pittsburgh. Median follow-up was 22 months (1 to 91 months). The extent of surgery was complete resection in 23 patients (including 17 with orthotopic liver transplant), partial resection in 4, and biopsy in 34. All patients had radiotherapy; median dose was 49.5 Gy. Thirty patients received chemotherapy: 5-fluorouracil (5-FU)-leucovorin with interferon alpha (IFN#alpha#) in 27, and taxol in 3. Results: The median survival was 20 months (95% CI 15-25 months). The 5-year actuarial survival was 23.8 #+-# 6.8%. The only significant variable in ...
The hair follicle cycle successively goes through the anagen, catagen, telogen, and latency phases, which correspond, respectively, to hair growth, arrest, shedding, and absence before a new anagen...Full Text Available
Segments of the chick basilar papilla were isolated and maintained in culture medium. The sensory hair bundle of individual hair cells was observed with light microscopy and stimulated with a water...Full Text Available
Hair shaft melanin components (eu- or/and pheomelanin) are a long-lived record of precise interactions in the hair follicle pigmentary unit, e.g., between follicular melanocytes, keratinocytes,...Full Text Available
The hair follicle develops from the primitive embryonic epidermis as a result of complex epithelial-mesenchymal interactions. The full follicle, consisting of epithelial cylinders under control of a...Full Text Available
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...
Methods of sample treatment in XRF analysis of hair are studied in view of the effect on analytical results. A new method is proposed based on the incomplete ashing of hair followed by pellet preparation. Its suitability is estimated on the XRF analysis of real hair samples collected from 4 healthy adults. (author) 12 refs.; 4 figs.; 1 tab.
Human hair fibers experience tensile forces during grooming and styling processes. The tensile response of hair is hence of considerable interest to the cosmetics industry. In this study, in situ tensile characterization studies have been carried out in an atomic force microscope (AFM) on different hair under different conditions. A custom-built AFM sample stage allows hair fibers to be loaded in tension. A technique to locate and image the same control area at different strains has been developed to study the changes in morphology that occur with deformation. Virgin Caucasian, Asian and African hair were studied to understand the differences between different ethnic hair types. Also, the tensile response and morphological changes of virgin, chemically damaged and conditioner-treated Caucasian hair after soaking were compared against the ...
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 ...
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 ...
Minoxidil induces hair growth in male pattern baldness and prolongs the anagen phase. All-trans retinoic acid (ATRA) has been reported to act synergistically with minoxidil in vivo:...Full Text Available
The appearance of hair plays an important role in people’s overall physical appearance and self-perception. With today’s increasing life-expectations, the desire to look youthful plays...Full Text Available
Silver-haired bat rabies virus (SHBRV) infection induces a strong virus-specific immune response in the periphery of the host, but death is common due to the failure to open the blood-brain barrier...Full Text Available
The etiology of alopecia areata (AA), a putative autoimmune disease characterized by sudden hair loss, has remained obscure. It is not understood, how the characteristic inflammatory infiltrate that...Full Text Available
Background: CD1d belongs to a family of antigen presenting molecules that are structurally and distantly related to the classic major histocompatibility complex class I (MHC I)...Full Text Available
Hair is preserved for millennia in permafrost; it enshrines a record of biologic rhythms and offers a glimpse at chronobiology as it was in extinct animals. Here we compare biologic rhythms gleaned...Full Text Available
This study was performed to investigate the association between hair mineral levels and nutrient intakes, age, and BMI in female adults who visited a woman's clinic located in Seoul. Dietary intakes...Full Text Available
Skin and hair phenotypes are powerful cues in human communication. They impart much information, not least about our racial, ethnic, health, gender and age status. In the case of the latter parameter,...Full Text Available
Here, we provide the first study of prolactin (PRL) and prolactin receptor (PRLR) expression during the nonseasonal murine hair cycle, which is, in contrast to sheep, comparable with the human scalp...Full Text Available
In order to better understand the molecular mechanisms of human hair growth control and to test hair growth-modulatory drugs, appropriate in vitro models are required. Here, we report the long-term...Full Text Available
ObjectiveTo achieve osteochondral regeneration utilizing transplantation of cartilage-lineage cells and adequate scaffolds, it is essential to characterize the behavior of transplanted...Full Text Available
Goldstein SL, Mattoo TK, Morgenstern B, Martz K, Stablein D, Talley L. Anemia and growth status in pediatric patients receiving maintenance dialysis after a failed renal transplant course: An NAPRTCS report.Pediatr Transplantation 2006. Copyright 2006 Blackwell Munksgaard Abstract: We conducted a retrospective review of the North American Renal Transplant Cooperative Study (NAPRTCS) Registry transplant and dialysis arms to assess anemia and growth patterns in children who returned to dialysis after a failed renal transplant from January 1, 1992 to February 3, 2004. Of the 1807 potential study subjects, 1451 had transplant removal data (TxIn vs. TxOut) available for analysis. Four hundred and twenty-one of 1451 patients (29%) had a transplant nephrectomy at the time of entry into the NAPRTC...
BACKGROUNDHirsutism is the presence of excess body or facial terminal (coarse) hair growth in females in a male-like pattern, affects 5–15% of women, and is an important...Full Text Available
HypothesisBiomarkers, commonly expressed in breast cancer cells, may be correlated with their expression in breast skin of the same subjects.MethodsThe...Full Text Available
The electrical responses of the neurons associated with the various types of chemosensory hairs of the blowfly, Phormia regina Meigen, following stimulation by chemical and mechanical...Full Text Available
Background:Alopecia areata (AA) is an immune-mediated form of hair loss that occurs in all ethnic groups, ages, and both sexes. Helicobacter pylori has...Full Text Available
To reconstruct the profiles of heavy metal levels in the South Ocean ecosystem of Antarctica, the concentrations of lead (Pb), copper (Cu), arsenic (As), cadmium (Cd), and zinc (Zn) in seal hairs and lake sediments spanning the past 1500?years from Fildes Peninsula of King George Island and in weathering lake sediments from Nelson Island of West Antarctica were determined. The lead contents in the seal hairs and the weathering sediments show a sharp increase since the late 1800s, very likely due to anthropogenic contamination from modern industries. After the 1980s, the Pb content in seal hairs dropped by one-third, apparently due to the reduced usage of leaded gasoline in the Southern Hemisphere. Copper arises mainly from the weathering process, and its level may be substantially affected...
Iron overload is common in patients undergoing allogeneic hematopoietic cell transplantation (HCT), but the mechanisms leading to overload are unknown. Here, we determined iron levels and the expression...Full Text Available
BackgroundThe study of small airway diseases such as post-transplant bronchiolitis obliterans syndrome (BOS) is hampered by the difficulty in assessing peripheral airway function...Full Text Available
The most publicly justifiable application of human cloning, if there is one at all, is to provide self-compatible cells or tissues for medical use, especially transplantation. Some have argued that...Full Text Available
BackgroundAirway complications are among the most challenging problems after lung transplantation, and Self-Expandable Metallic Stents (SEMS) are used to treat airway complications...Full Text Available
The acute shortage of human organs and tissues for transplantation has been attributed in part to health professionals, including nurses, for their reluctance to recognize and refer suitable candidates...Full Text Available
BackgroundAllogeneic hematopoietic cell transplantation is a potentially curative treatment for patients with acute lymphoblastic leukemia. However, the majority of older adults...Full Text Available
A Legionella-like organism (strain 1087-AZ-H) was isolated from a pleural-fluid specimen from a renal transplant patient undergoing immunosuppressive therapy. Growth characteristics and gas-liquid chromatography...Full Text Available
Many patients who undergo hematopoietic cell transplantation (HCT) present with anemia and have received red blood cell transfusions before HCT. As a result, iron overload is frequent and appears...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
BackgroundHealth related quality of life (HRQoL) is one of the most important outcomes to measure effectiveness of an intervention, especially for islet transplantation...Full Text Available
The outcome of various osteoprogenitor-cell transplantation protocols was assessed using Col1a1-GFP reporter transgenic mice. The model requires the recipient mice to undergo lethal total body irradiation...Full Text Available
IntroductionAutologous chondrocyte transplantation (ACT) is a routine technique to regenerate focal cartilage lesions. However, patients with osteoarthritis (OA) are lacking an appropriate...Full Text Available
Stem cell therapies for neurodegenerative disorders require accurate delivery of the transplanted cells to the sites of damage. Numerous studies have established that fluid injections to the hippocampus...Full Text Available
The propriety of the cosmic no-hair conjecture to the Bianchi-type-IX spacetime is discussed from a quantum cosmological point of view. It is shown that most, but not all, classical universes which are created quantum cosmologically are inflationary. The probability of inflation among such universes is also discussed.
The propriety of the cosmic no-hair conjecture to the Bianchi-type-IX spacetime is discussed from a quantum cosmological point of view. It is shown that most, but not all, classical universes which are created quantum cosmologically are inflationary. The probability of inflation among such universes is also discussed.
The possibility of having inflation in a renormalizable cosmological model is investigated. The cosmic no-hair conjecture is proved to hold for all Bianchi types except Bianchi type IX. By the use of a conformal transformation on the metric we show that these models are equivalent to the ones described by the Einstein-Hilbert action for gravity minimally coupled to a set of scalar fields with inflationary potentials. Henceforth, we prove that inflationary solutions behave as attractors in solution space, making it a natural event in the evolution of such models.
The possibility of having inflation in a renormalizable cosmological model is investigated. The cosmic no-hair conjecture is proved to hold for all Bianchi types except Bianchi type IX. By the use of a conformal transformation on the metric we show that these models are equivalent to the ones described by the Einstein-Hilbert action for gravity minimally coupled to a set of scalar fields with inflationary potentials. Henceforth, we prove that inflationary solutions behave as attractors in solution space, making it a natural event in the evolution of such models.
The cosmic no hair theorem is studied in anisotropic brane worlds. Assuming anisotropic Bianchi models with an inflaton field it is shown that, during slow-roll inflation, anisotropy in all Bianchi models except a Bianchi type-IX universe washes out. Brane worlds admit both exponential and power law inflation. We consider here only exponential expansion of the universe. It is found that isotropization occurs much faster in a brane world than in the general theory of relativity.
The prototypic pituitary hormone prolactin (PRL) exerts a wide variety of bioregulatory effects in mammals and is also found in extrapituitary sites, including murine skin. Here, we show by reverse...Full Text Available
This book contains 49 chapters. Some of the titles are: Molecular, Genetic, and Clinical Aspects of the HLA System; The Normal Immune Response; Significance of the ABO Antigen System; The Role of Dialysis in the Management of End-Stage Renal Disease; Access for Dialysis; Patient Selection for Renal Transplantation; The Living Donor in Kidney Transplantation; and Kidney Preservation by Cold Storage.
Cord blood transplantation (CBT) with units containing total nucleated cell (TNC) dose >2.5×107/kg is associated with improved engraftment and decreased transplant-related...Full Text Available
Hematopoietic stem cell transplantation provides the only potential curative option in many patients with hematological malignancies. Finding a suitably matched donor in a timely manner is often difficult. However, most patients have a partially HLA-mismatched (HLA-haploidentical) first-degree relative readily available. Historically, HLA-haploidentical bone marrow transplantation (BMT) has been considered extremely high risk due to high rates of life-threatening graft-versus-host disease (GVHD) and non-relapse mortality (NRM). Modifications of the stem cell graft, such as T-cell depletion, have resulted in poor rates of engraftment. We have recently completed a phase II clinical trial of nonmyeloablative HLA-haploidentical hematopoietic BMT followed by post-transplantation high-cyclophosp...
BackgroundSince implementation of the Model for End-stage Liver Disease (MELD), the number of simultaneous liver-kidney transplantations (SLKT) has increased in the United States. However, predictors and survival benefit of SLKT compared to liver transplantation alone (LTA) are not well defined. MethodsOrgan Procurement and Transplantation Network data of patients with end-stage liver disease (ESLD) with estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 who had not been on dialysis while on the waiting list and underwent liver transplantation between 2002 and 2008 were analyzed. To identify predictors of undergoing SLKT versus LTA, multiple logistic regression analysis was performed. Cox proportional hazards regression analysis was used to assess the association between...
Much progress has been made in the clinical, biological and technical aspects of the T-cell-depleted haploidentical hematopoietic stem cell transplantation (HSCT). Our experience demonstrates that infusing a megadose of extensively T-cell-depleted hematopoietic peripheral blood stem cells after an immuno-myeloablative conditioning regimen in acute leukemia patients ensures sustained engraftment with minimal GvHD without the need of any post-transplant immunosuppressive treatment. Since our first successful pilot study, our efforts have concentrated on developing new conditioning regimens, optimizing the graft processing and improving the post-transplant immunological recovery. The results we have so far achieved in high risk acute leukemia patients show that haploidentical transplantation ...
ContextMusic and surgery.ObjectiveTo determine the effect of live classical piano music on vital signs of patients undergoing ophthalmic surgery.DesignRetrospective...Full Text Available
Vladimir P. Demikhov was born in a Russian peasant family in 1916. As a biology student at The Moscow University in 1937, he constructed a metal artificial heart and maintained the circulation of a dog for 5.5 hours. From 1946, after his military service, he worked in the Surgical Institute of The Moscow Academy of Sciences performing heterotopic heart transplantations in dogs. In 1947, he performed the first orthotopic lung transplant. Later he performed complex cardiothoracic transplantations as well as renal and hepatic transplantations. He restarted his investigations with the artificial heart and performed coronary bypass operations in dogs. In 1954 he performed a head transplantation, for which he gained worldwide infamy. Stalinist propaganda advertised this fact as the superiority of Soviet science. In fact, it was the upper body of a smaller dog to the neck of a bigger one. ...
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
Transient receptor potential (TRP) ion channels have been implicated in detecting chemical, thermal and mechanical stimuli in organisms ranging from mammals to Caenorhabditis elegans....Full Text Available
In the labellar chemosensory hairs of the blowfly, Phormia regina Meigen, stationary amplitudes of the slow potentials induced by salt and sugar stimulations were decreased to 50–80%...Full Text Available
Human skin is a local source of corticotropin-releasing hormone (CRH) and expresses CRH and CRH receptors (CRH-R) at mRNA and protein levels. Epidermal melanocytes respond to CRH by induction...Full Text Available
BackgroundStem cells divide to reproduce themselves and produce differentiated progeny. A fundamental problem in human biology has been the inability to measure how often stem cells...Full Text Available
BackgroundCalcium homeostasis is a known target of several environmental toxicants including lead and mercury.ObjectiveOur goal was to determine...Full Text Available
Objective: The aim of this study was to characterize using flow cytometry cultured human primary keratinocytes isolated from the epidermis and hair follicles by different methods. Methods:...Full Text Available
The sensations of sound and motion generated by the inner ear are controlled by the brain through extensive centripetal innervation originating within the brain stem. In the semicircular canals, brain...Full Text Available
This study was designed to compare the levels of chromium (Cr) and manganese (Mn) in scalp hair, blood, and urine of night blindness in children age ranged (3-7) and (8-12) years of both genders, comparing them to sex- and age-matched controls. A microwave-assisted wet acid digestion procedure, was developed as a sample pretreatment, for the determination of Cr and Mn in biological samples of night blindness children. The proposed method was validated by using conventional wet digestion and certified reference samples of hair, blood and urine. The digests of all biological samples were analyzed for Cr and Mn by electrothermal atomic absorption spectrometry. The results indicated significantly higher levels of Cr, whilst low level of Mn in the biological samples (blood and scalp hair) of male and female night blindness children, compared with control subjects of both genders. These data present guidance to clinicians and ...
Behavioral responses to labellar stimulation with 19 L-amino acids were predicted on the basis of electrophysiological responses of largest labellar hairs. With the exceptions alanine, aspartic...Full Text Available
Albendazole binds to parasite's tubulin inhibiting its glucose absorption. Its common adverse effects are nausea, vomiting, constipation, thirst, dizziness, headache, hair loss and pruritus. Although...Full Text Available
The vanilloid receptor-1 (VR1, or transient receptor potential vanilloid-1 receptor, TRPV1) is activated by capsaicin, the key ingredient of hot peppers. TRPV1 was originally described on sensory neurons...Full Text Available
To reconstruct the profiles of heavy metal levels in the South Ocean ecosystem of Antarctica, the concentrations of lead (Pb), copper (Cu), arsenic (As), cadmium (Cd), and zinc (Zn) in seal hairs and lake sediments spanning the past 1500 years from Fildes Peninsula of King George Island and in weathering lake sediments from Nelson Island of West Antarctica were determined. The lead contents in the seal hairs and the weathering sediments show a sharp increase since the late 1800s, very likely due to anthropogenic contamination from modern industries. After the 1980s, the Pb content in seal hairs dropped by one-third, apparently due to the reduced usage of leaded gasoline in the Southern Hemisphere. Copper arises mainly from the weathering process, and its level may be substantially affected by climatic conditions. The concentrations of Cd, As, and Zn do not show any clear temporal trends.
We prove a cosmic no-hair theorem for Bianchi models in power-law inflation. Provided that the potential of an inflaton {phi} is exp({minus}{lambda}{kappa}{phi}) with 0{le}{lambda}{lt} {radical}2/3 , we find that the isotropic power-law solution is the unique attractor for any initially expanding Bianchi-type models except type IX. For Bianchi type IX, this conclusion is also true if the initial ratio of the vacuum energy to the maximum three-curvature is larger than one half.
To determine the demographics, imaging findings, clinical symptoms, and prognosis of primary vertebral Ewing's sarcoma (PVES). A retrospective review of medical records and radiological studies of patients diagnosed with PVES from 1936 through 2001 in our institution and Department of Pathology consultation files was undertaken. Metastatic and soft tissue Ewing's sarcoma cases were excluded. From a total of 1,277 cases of Ewing's sarcoma, 125 (9.8%) had a primary vertebral origin. There were 48 females and 76 males. Patient ages ranged from 4 to 54 (mean 19.3, standard deviation 10.7, median 16) years. Vertebral column distribution was four cervical (3.2%), 13 thoracic (10.5%), 31 lumbar (25%), and 67 sacrum (53.2%). More than one vertebral segment was involved in ten cases (8%). Satisfactory imaging studies were available in 51 patients: 49 radiographs, 27 computerized tomography (CT), and 23 magnetic resonance imaging (MRI) studies. The majority of tumors were lytic (93%). Three ...
Patients with end stage renal failure (ESRD) require renal replacement therapy in the form of dialysis or renal transplantation. There is an increasing number of people receiving maintenance dialysis as patients with ESRD are increasing faster than the supply of transplantable organs. The mortality rate on dialysis is 4-6 times that of the general population and is substantially reduced by transplantation. For the past 8 years, dialysis research has focused on improving patient outcomes and quality of life on dialysis. This review examines recent advances in haemodialysis and peritoneal dialysis in a historical context and considers future research possibilities. PMID:19329705
BackgroundTacrolimus (FK-506) is an immunosuppressant that binds to a specific immunophilin, resulting in the suppression of the cellular immune response during transplant rejection....Full Text Available
High-risk neuroblastoma is a childhood malignancy with a poor prognosis. Gradual improvements in survival have correlated with therapeutic intensity, and the ability to harvest, process and...Full Text Available
Cytoreductive conditioning regimes designed to allow for successful allogeneic hematopoietic stem cell transplantation (allo-HSCT) paradoxically are also detrimental to recovery of the immune system in general but lymphopoiesis in particular. Post-transplant immune depletion is particularly striking within the T cell compartment which is exquisitely sensitive to negative regulation, evidenced by the profound decline in thymic function with age. As a consequence, regeneration of the immune system remains a significant unmet clinical need. Over the past decade studies have revealed several promising therapeutic strategies to address ineffective lymphopoiesis and post-transplant immune deficiency. These include the use of cytokines such as IL-7, IL-12 and IL-15; growth factors and hormones li...
Purpose. To evaluate the efficacy of percutaneous transluminal angioplasty (PTA) in the management of arterial stenosis located close to the allograft anastomosis (close-TRAS)....Full Text Available
Diagnostic accuracy of the currently available serum markers of cardiac injury, such as myoglobin, creatine kinase and its myocardial isoform, are altered in patients with renal failure. It is shown...Full Text Available
The author reports 10 studies concerning the diagnosis of renal osteodystrophy and extraskeletal calcification in patients on maintenance hemodialysis as well as some aspects of persistent hyperparathyroidism after renal transplantation. The majority of the studies focus on the value of bone scintigraphy with Tc-99m HEDP in the diagnosis of these disorders. (Auth.).
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 ...
The incidence of anogenital malignancies is greatly increased in patients who have received a renal transplant, but this has not been well studied in patients receiving maintenance dialysis. Our aim was to assess the incidence of these malignancies in patients on dialysis and compare these to transplanted patients. The age standardized incidence ratio (SIR) for anogenital malignancies was calculated by comparing the observed number of malignancies to the expected number. The expected number was calculated by multiplying the age specific incidence rates for each malignancy by the person years at risk in 5-year age cohorts. Of 15,820 patients in the Australia and New Zealand data base, 8,215 had received a renal transplant. A total of 39,750 person years at risk were contributed by patients who had received a renal transplant, while 29,276 person years at risk were contributed by dialysis patients who had ...
Transplantation procedures using intraparenchymal injection of stem cells result in tissue injury in addition to associated surgical risks. Intravenous injection of mesenchymal stem cells gives engraftment to lesions, but the method has low efficiency and specificity. In traumatic brain injuries (TBI), there is a transient breakdown of the blood-brain barrier and an inflammatory response, which increase migration of cells from blood to parenchyma. The aim of this investigation was to analyze the effect of intra-arterial administration on cellular engraftment. Experimental TBI was produced in a rat model. Endovascular technique was used to administer human mesenchymal stem cells in the ipsilateral internal carotid artery. Evaluation of engraftment and side effects were performed by immunohistochemical analysis of the brain and several other organs. The results were compared to intravenous administration of stem cells. Intra-arterial ...
We conducted a retrospective review of the North American Renal Transplant Cooperative Study (NAPRTCS) Registry transplant and dialysis arms to assess anemia and growth patterns in children who returned to dialysis after a failed renal transplant from January 1, 1992 to February 3, 2004. Of the 1807 potential study subjects, 1451 had transplant removal data (TxIn vs. TxOut) available for analysis. Four hundred and twenty-one of 1451 patients (29%) had a transplant nephrectomy at the time of entry into the NAPRTCS Registry Dialysis arm. Anemia rates steadily decreased from 72.2% at 30 days after dialysis initiation to 59.5% at 12 months after dialysis initiation. Factors associated with anemia at 30 days after dialysis initiation included hemodialysis, lack of Epo use, and patients who comprised earlier study era cohorts. At one yr after return to dialysis, earlier study cohort era ...
Pinealectomy completely prevented gonadal regression as well as reduction in body weight and white adipose tissue content of the gonadal and retroperitoneal fat deposits in male meadow voles transferred from long to short day lengths. Pineal influences on pelage characteristics depended on which parameter was assessed. For instance, the increase in guard hair length observed in short-day control voles was blocked by pinealectomy; however, a similar increase in underhair length was unaffected by removal of the pineal gland. Photoperiod-dependent changes in fat deposition, testicular activity, and guard hair length presumably rely on altered pineal secretory activity to transduce the effects of day length on the neuroendocrine axis; however, mechanisms independent of pineal activity may be capable of mediating photoperiodic control of underhair growth. PMID:2979644
The losses of Hg from phenol formaldehyde resin - bound standards and hair samples in neutron activation analysis in case of their irradiation in the water filled nuclear reactor channel is studied. The mean losses of Hg during 20-30 hrs irradiation at (2-3)x10"1"8 n/cm"2 are 15-20% with their stopping at double Al-covers. The mean losses of Hg from standards at 200, 250 and 300 deg C are 30, 61 and 86% respectively and do not occur at 150 deg C after their 5 hour heating. The losses of Hg from hair samples packed in polyethylene tubes through the package walls in experimental conditions are not observed.
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
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
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
Pai ALH, Gray E, Kurivial K, Ross J, Schoborg D, Goebel J. The Allocation of Treatment Responsibility scale: A novel tool for assessing patient and caregiver management of pediatric medical treatment regimens. Pediatr Transplantation 2010: 14:993 999. 2010 John Wiley & Sons A/S. Abstract: The purpose of the current study is to report preliminary psychometric properties of the ATR scale, a brief measure of the distribution of treatment tasks across the family members of children with a kidney transplant. Pediatric patients with renal transplants (ages 7 18 yr) and their caregivers completed the ATR and measures of adherence and family functioning. Internal consistency for the ATR (total score and subscales) was strong (range = 0.75 0.93). Validity for the ATR was supported by significant co...
The most advanced frontier of allogeneic hematopoietic stem cell transplantation (allo-HSCT) is represented by the use of an HLA-partially matched relative as donor. In this type of transplantation, donor-derived natural killer (NK) cells, which are alloreactive towardtoward recipient cells, significantly contribute to the eradication of leukemia blasts. Alloreactive NK cells may also kill host dendritic cells and T lymphocytes, thus preventing graft-versus-host disease and graft rejection, respectively. Sophisticated strategies of adoptive infusion of T-cell lines/clones specific for the most life-threatening pathogens (namely cytomegalovirus, Epstein-Barr virus, Aspergillus and Adenovirus) have been envisaged, and successfully tested in a few pilot trials, to protect the recipient in the...
Acute kidney injury (AKI) is a common complication after allogeneic stem cell transplantation (SCT). Although various risk factors for AKI have been reported, the influence of pretransplant comorbidity on the incidence of AKI has not been well investigated. We performed a retrospective analysis of 207 consecutive patients undergoing myeloablative or nonmyeloablative SCT between 2001 and 2009, using the hematopoietic cell transplantation-specific comorbidity index (HCT-CI) as a representative of pretransplant comorbidities. According to Risk, Injury, Failure, Loss, and End-stage kidney disease (RIFLE) criteria, 158 patients (76.3%) developed AKI, and 92 patients (44.4%) developed severe AKI (RIFLE class I or class F) within 100 days after SCT. The cumulative incidence of severe AKI within 1...
Phenotypic plasticity can facilitate reproductive strategies that maximize mating success in variable environments and lead to differences in sex allocation among populations. For simultaneous hermaphrodites with sperm competition, including Serranus tortugarum a small coral reef fish, proportional male allocation (testis in total gonad) is often greater where local density or mating group size is higher. We tested whether S. tortugarum reduced male allocation when transplanted from a higher density site to a lower density site. After 4?months, transplants mirrored the sex-allocation patterns of the resident population on their new reef. Transplants had significantly lower male allocation than representatives from their source population, largely as a result of reduced testis mass relative...
Allogeneic stem-cell transplantation (SCT) is potentially curative therapy in AML by providing both dose-intensive chemo-radiotherapy and induction of graft-versus-leukemia (GvL) effect. Historically, more emphasis was given to the intensity of conditioning. Over the last decade the pendulum turned more towards induction of GvL as the primary goal. A plethora of non-myeloablative (NMA) and reduced-intensity conditioning regimens (RIC) were introduced trying to reduce transplant-related toxicities and allow SCT in elderly and medically infirm patients. In addition, reduced-toxicity myeloablative regimens (RTC) based on fludarabine and myeloablative alkylating-agent doses were designed to allow safer administration of dose-intensive therapy. Conditioning dose-intensity is highly correlated w...
This study highlights a methodology to detect the transplanting operation of wetland rice at a regional scale using SSM/I brightness temperature in frequencies like 19, 37 and 85 GHz with vertical polarization. A cloud removal algorithm was used to make weekly composites of the brightness temperature, which were used to estimate the soil wetness index (SWI). Flooding of rice fields with water for transplanting induces very high change in SWI due to contrasting dielectric constant of water (80) and soil (4). Different weather conditions and fractional wet area under the footprint of sensor affect SWI, hence absolute value of SWI was not adequate. Therefore, multi-year SWI anomaly was used to generate a threshold value of SWI change to detect when SWI change between two consecutive weeks was...
Ex vivo expanded peripheral blood progenitor cells (PBPC) have been shown to provide rapid neutrophil engraftment, and in some patients, to eliminate neutropenia after transplantation to support high-dose chemotherapy. However, the effect of expansion culture on stem cell content and potential loss of stem cells caused by induction of differentiation remains a concern. We have transplanted 21 patients with breast cancer with expanded autologous PBPC, with 11 patients receiving expanded PBPC as their sole hematopoietic cell source. In these studies, the CD34+ cells were selected and cultured for 10 days in defined media containing 100 ng/mL each of recombinant human stem cell factor (rhSCF), recombinant human granulocyte colony stimulating factor (rhG-CSF), and recombinant human megakaryocy...
Introduction: Haploidentical transplantation, with extensive T cell depletion to prevent GvHD, is associated with a high incidence of infection-related deaths. The key challenge is to improve immune recovery with allogeneic donor T cells without triggering GvHD. As T regulatory cells (Tregs) controlled GvHD in pre-clinical studies, the present study evaluated the impact of an infusion of donor CD4/CD25 + Tregs, followed by an inoculum of donor mature T cells (Tcons) and positively immunoselected CD34 + cells in the setting of haploidentical stem cell transplantation. Patients and methods: Twenty-eight patients were enrolled in this study (22 AML; 5 ALL; 1 NHL). All received immunoselected Tregs (CliniMACS, Miltenyi Biotec) followed by positively immunoselected CD34 + cells together with Tc...
BackgroundMore than 11 million Americans live with chronic lung disease; in search for an alternative to donor organs, we attempted to regenerate lungs based on perfusion decellularized lung scaffolds that can be transplanted similar to a donor organ. MethodsCadaveric rat lungs were decellularized by detergent perfusion. Resulting scaffolds were mounted in bioreactors and seeded with endothelial and fetal lung cells. Biomimetic organ culture was maintained for 7 days. Resulting bioartificial left lungs were transplanted in orthotopic position after left pneumonectomy in rats. Cadaveric left lung transplants and pneumonectomies served as controls. Blood gas analyses, compliance testing, and fluoroscopies were performed on postoperative days 1, 7, and 14. Lungs were removed for final analysi...
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...
We have established a reliable method to induce invasive and non-invasive carcinomas in the heterotopically transplanted urinary bladder of rats by repeated injection of N-methyl-N-nitrosourea (MNU),...Full Text Available
Devastating central nervous system injuries and diseases continue to occur in spite of the tremendous efforts of various prevention programs. The enormity of and annual escalation of healthcare...Full Text Available
Genetically identical rhesus monkeys would have tremendous utility as models for the study of human disease and would be particularly valuable for vaccine trials and tissue transplantation studies where...Full Text Available
Successful implementation of bone marrow transplantation for hematopoietic reconstitution is limited by the lack of suitably HLA-matched donors and by the occurrence of graft-versus-host disease that...Full Text Available
The long-term goal of nuclear transfer or alternative reprogramming approaches is to create patient-specific donor cells for transplantation therapy, avoiding immunorejection, a major complication in...Full Text Available
Lytic activity and recovery of natural killer (NK) cells was monitored in pediatric patients with leukemias (ALL, AML, CML, JMML) and myelodysplastic syndromes after transplantation of T cell depleted stem cells from matched unrelated (n = 18) and mismatched related (haploidentical, n = 29) donors. CD34 + selection with magnetic microbeads resulted in 8 x 10^3/kg residual T cells. No post-transplant immune suppression was given. NK cells recovered rapidly after transplantation (300 CD56+/@mL at day 30, median), whereas T cell recovery was delayed (median: 12 CD3+/@mL at day 90). NK activity was measured as specific lysis of K 562 targets several times (mean: 3 assays per patient). Four temporal patterns of lytic activity could be differentiated: consistently low, consistently high, decreas...
Caribou were extirpated from the Kenai Peninsula by 1912 and reintroduced via transplants from the Nelchina Herd in the mid 1960's and again in the mid 1980's. The reintroductions resulted in the establishment of five herds: the Kenai Mountains Herd, Kena...
The principal cause of primary non-function in orthotopic liver transplantation is thought to be preservation injury to the microvasculature. We, therefore, evaluated if effluent levels of hyaluronate,...Full Text Available
Background and objectives: Few studies have examined health literacy in patients with end stage kidney disease. We hypothesized that inadequate health literacy in a hemodialysis population is common...Full Text Available
For the evaluation of the kidney impairment, serum creatinine concentrations or glomerular filtration rates are mainly used, and the conditions of solitary or transplanted kidney and chronic dialysis...Full Text Available
Model systems to study the effects of chemicals of environmental concern on bacterial and parasitic diseases as well as the immunosurveillance and destruction of transplantable tumor cells were described...Full Text Available
G6PD activity was assayed in 20 Sardinian heterozygotes for G6PD deficiency and related to that of LDH and MDH. One of these heterozygotes showed a deficient phenotype in all her follicles, while the...Full Text Available
In this short note we report our finding that within the context of alternative version of the Brans-Dicke theory (for #omega# #>=# -3/2, where #omega# is the Brans-Dicke parameter) the anisotropic Bianchi type cosmological models evolve towards the de Sitter isotropic universe. In short it is shown that during inflation there is no difference between the Brans-Dicke theory and General Relativity. Our result can thus be viewed as a generalization of the Wald's theorem for General Relativity. (author). 5 refs.
A survey is presented of studies dealing with radionuclide X-ray fluorescence analysis (RXFA) of impurities in the air, water, soil, sediments and biological materials, mainly blood, urine, hair, soft tissues and bones. Tabulated are lists of published works on RXFA of the air, water and biological materials. (ES).
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...
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.
Resistance and tolerance are two types of host defense mechanisms that increase fitness in response to fungi. Several genetic polymorphisms in pattern recognition receptors, most remarkably Toll-like receptors (TLRs), have been described to influence resistance and tolerance to aspergillosis in distinct clinical settings. TLRs on dendritic cells pivotally contribute in determining the balance between immunopathology and protective immunity to the fungus. Epithelial cells also contribute to this balance via selected TLRs converging on indoleamine-2,3-dioxygenase (IDO). Studies in experimental hematopoietic transplantation confirmed the dichotomy of pathways leading to resistance and tolerance to the fungus providing new insights on the relative contribution of the hematopoietic/nonhematopoi...
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 ...
Bone is a complex, highly structured, mechanically active, three-dimensional (3-D) tissue composed of cellular and matrix elements. We previously published a report on in situ collagen gelation using a rotary 3-D culture system (CG-RC system) for the construction of large tissue specimens. The objective of the current study was to evaluate the feasibility of bone tissue engineering using our CG-RC system. Osteoblasts from the calvaria of newborn Wistar rats were cultured in the CG-RC system for up to 3 wk. The engineered 3-D tissues were implanted into the backs of nude mice and calvarial round bone defects in Wistar rats. Cell metabolic activity, mineralization, and bone-related proteins were measured in vitro in the engineered 3-D tissues. Also, the in vivo histological features of the transplanted, engineered 3-D tissues were evaluated in the animal models. We found that metabolic activity increased in the engineered 3-D tissues during cultivation, and that ...
We evaluated 190 children with very high-risk leukemia, who underwent allogeneic hematopoietic cell transplantation in 2 sequential treatment eras, to determine whether those treated with contemporary protocols had a high risk of relapse or toxic death, and whether non-HLA-identical transplantations yielded poor outcomes. For the recent cohorts, the 5-year overall survival rates were 65% for the 37 patients with acute lymphoblastic leukemia and 74% for the 46 with acute myeloid leukemia; these rates compared favorably with those of earlier cohorts (28%, n = 57; and 34%, n = 50, respectively). Improvement in the recent cohorts was observed regardless of donor type (sibling, 70% vs 24%; unrelated, 61% vs 37%; and haploidentical, 88% vs 19%), attributable to less infection (hazard ratio [HR] = 0.12; P = .005), regimen-related toxicity (HR = 0.25; P = .002), and leukemia-related death (HR = 0.40; P = .01). Survival probability was dependent on ...
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
Abstract: We tested the effects on the early-stage wound healing of poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) nanofiber matrices cultured with hair follicular cells. PHBV only, PHBV/collagen, and PHBV/gelatin at a 7/3 weight ratio were produced by electrospinning, and their in vitro cell culture and in vivo wound healing as biological dressings were examined. In cell attachment and growth on matrices, dermal sheath (DS) cells attached to hydrophilic PHBV/collagen and PHBV/gelatin faster than hydrophobic PHBV at the early incubation stage (up to 6 h). From 6- to 24-h incubation, PHBV/collagen showed the best results in cell culture. Furthermore, PHBV/collagen cocultured for 3-5 days with DS and epithelial outer root sheath (ORS) cells expressed more extracellular materials, such a...
''Hair-on-end'' skull changes resembling thalassemia were rarely described in the 1950s and 1960s in children with cyanotic congenital heart diseases; these changes were described almost entirely in patients with tetralogy of Fallot or D-transposition of the great arteries. As these lesions have become correctable, the osseous changes, never common, seem now only to exist in a small number of patients with uncorrectable complex cyanotic congenital heart disease who survive in a chronic hypoxic state. We present two cases: a case of marked marrow expansion in the skull of a 5-year-old boy with uncorrectable cyanotic heart disease studied by CT, and a second case of an 8-year-old with tetralogy of Fallot and pulmonary atresia studied by plain skull radiographs. The true incidence of these findings is unknown. (orig.)
It is shown that all contracting, spatially homogeneous, orthogonal Bianchi cosmologies that are sourced by an ultra-stiff fluid with an arbitrary and, in general, varying equation of state asymptote to the spatially flat and isotropic universe in the neighbourhood of the big crunch singularity. This result is employed to investigate the asymptotic dynamics of a collapsing Bianchi type IX universe sourced by a scalar field rolling down a steep, negative exponential potential. A toroidally compactified version of M*-theory that leads to such a potential is discussed and it is shown that the isotropic attractor solution for a collapsing Bianchi type IX universe is supersymmetric when interpreted in an 11-dimensional context.
Previous studies have revealed that cell therapy using bone marrow stromal cells (BMSCs) could promote motor functional recovery in animals with spinal cord injury (SCI). We describe here the development of cell biology technique and the experimental study of regeneration in SCI. The aim of this study was to investigate the potential for neurological recovery by transplantation neurospheres (NS) derived from BMSCs into thoracic SCI. Adult Fisher rats were used: 45 were subjected to complete thoracic SCI performed by the balloon compression method. BMSCs were cultured in vitro to obtain NS. Seven days after thoracic SCI, groups of 15 rats each received transplants of BMSCs-NS (group A), BMSCs (group B), or injection of medium only (group C) into the SCI lesion. Rats from each group were eva...
The purpose of this review is to consider the hypothesis that cancer frequently originates from stem cells. Using the spleen transplantation assay where stem cells were transplanted in the spleen of mice lethally irradiated by ionizing radiation, the author undertook a study aimed at defining the risk of radiogenic cancer per susceptible cells with use of rat radiogenic mammary and thyroid cancers because of the high incidences of these cancers in a-bomb survivors. Measured were the number of cancer-susceptible cells initially present in the tissue, the number of such cells that survived at a given dose and the number of cancers that developed per surviving cell. Thyroid cell differentiation and proliferation in rats transplanted with thyroid cells were enhanced by thyroidectomy and low iodine diet. Further, the relationship between the low LET radiation dose and thyroid clonogen survival was also investigated. Data showed ...
The aim of this pilot study was to evaluate the feasibility of long-term subcutaneous application of low-dose IL-2 in children with malignancies at very high risk of relapse who underwent highly T cell and B cell depleted HLA-identical (MUD) or full haplotype mismatched related hematopoetic stem cell transplantation. We studied 11 patients with acute leukemias/myelodysplastic syndrome and juvenile myelomonocytic leukemia (active disease and/or second stem cell transplantation, n = 8; >=CR 2, n = 2) and relapsed or progressive Ewings sarcoma (n = 2) who received prophylactic IL-2 treatment for a high probability of disease recurrence after allo-HSCT. Toxicities from IL-2 were transient fever, fatigue and local inflammation. In one patient GvHD grade III with no clear association to IL-2 adm...
Although the intracellular ultrastructural processing of epidermal growth factor (EGF) and its receptor have been described in cell culture systems, very few studies have examined this phenomenon in intact tissues. We have examined the ultrastructural and biochemical handling of ["1"2"5I]EGF in the epidermis and hair follicle bulb of intact, viable, 3- to 5-day-old rat skin the EGF receptor distribution of which has already been documented and in which EGF has been shown to be biologically active. After incubation of explants with 10 nM ["1"2"5I]EGF for 2.5 h at 25 degrees or 37 degrees C, radiolabel was detected over the basal cells of the epidermis and hair follicle outer root sheath, confirming previous light microscope observations. More specifically, silver grains were observed near coated and uncoated plasma membrane and coated membrane invaginations, Golgi apparatus, lysosomal structures, and nuclei. Sodium azide inhibited ...
Although the intracellular ultrastructural processing of epidermal growth factor (EGF) and its receptor have been described in cell culture systems, very few studies have examined this phenomenon in intact tissues. We have examined the ultrastructural and biochemical handling of (/sup 125/I)EGF in the epidermis and hair follicle bulb of intact, viable, 3- to 5-day-old rat skin the EGF receptor distribution of which has already been documented and in which EGF has been shown to be biologically active. After incubation of explants with 10 nM (/sup 125/I)EGF for 2.5 h at 25 degrees or 37 degrees C, radiolabel was detected over the basal cells of the epidermis and hair follicle outer root sheath, confirming previous light microscope observations. More specifically, silver grains were observed near coated and uncoated plasma membrane and coated membrane invaginations, Golgi apparatus, lysosomal structures, and nuclei. Sodium azide inhibited ...
The aim of the paper is to review the role of interventional radiology in the management of hemodialysis vascular access and complications in renal transplantation. The evaluation of patients with hemodialysis vascular access is complex. It includes the radiology/ultrasound (US) evaluation of the peripheral veins of the upper extremities with venous mapping and the evaluation of the central vein prior to the access placement and radiological detection and treatment of the stenosis and thrombosis in misfunctional dialysis fistulas. Preoperative screening enables the identification of a suitable vessel to create a hemodynamically-sound dialysis fistula. Clinical and radiological detection of the hemodynamically significant stenosis or occlusion demands fistulography and endovascular treatment. Endovascular prophylactic dilatation of stenosis greater than 50% with associated clinical abnormalities such as flow-rate reduction is warranted to prolong access patency. The ...
Abstract Toll-like receptor 2 (TLR2) is an immune sensor for gram-positive bacterial cell wall components. Single-nucleotide polymorphisms (SNPs) in the TLR2 gene that impair its function may, therefore, influence the risk and outcomes of gram-positive bacterial infections. In a cohort of 694 liver transplant recipients, we assessed the TLR2 SNP that is translated into an amino acid substitution of arginine for glutamine at position 753 (R753Q), and we found that its presence was associated with the clinical characteristics and outcomes of gram-positive bacterial infections. The proportions of patients with the TLR2 R753Q SNP did not significantly differ between those with gram-positive bacterial infections and those without gram-positive bacterial infections (9.6% versus 9.6%, P = 0.999)....
RIFLE criteria have been used to determine the incidence of acute kidney dysfunction (AKD) after orthotopic liver transplantation (OLT). However, no studies have focused on the incidence of AKD after OLT in patients with normal pre-OLT kidney functions. Using the RIFLE criteria, we determined the incidence and risk factors for AKD after OLT in patients with normal pre-OLT kidney function. We retrospectively analyzed the records of 112 patients who underwent OLT from January 2000 to February 2009 with normal prior kidney function. We investigated three levels of renal dysfunction outlined in the RIFLE criteria: risk (R); injury (I); and failure (F). Preoperative, intraoperative, and postoperative variables were collected. AKD occurred in 64 (57%) OLTs with risk, injury, and failure frequenc...
In several vertebrate classes, the M?ller glia are capable of de-differentiating, proliferating, and acquiring a progenitor-like state in response to acute retinal injury or in response to exogenous growth factors. Our previous study has shown that M?ller cells can be activated and de-differentiated into retinal progenitors during Royal College of Surgeons (RCS) rats' degeneration, although the limited proliferation cannot maintain retinal function. We now report that rat retinal stem cells (rSCs) transplanted into RCS rats slowed the progression of retinal morphological degeneration and prevented the functional disruption. Further, we found that retinal progenitor cells labeled with Chx10 were increased significantly after rSCs transplantation, and most of them are mainly from activated M...
Currently, human leukocyte antigen (HLA)-mismatched/haploidentical allografts have been validated as an alternative stem cell source for patients who have no immediate access to an HLA-matched related or unrelated donor. However, relapse remains a challenge after HLA-mismatched/haploidentical hematopoietic stem cell transplantation (HSCT) that is employed in the treatment of patients with hematological malignancies. In recent years, newly developed immunomodulatory strategies, which include prophylactic and therapeutic donor lymphocyte/natural killer (NK) cell infusion, donor selection based on NK alloreactivity/non-inherited maternal antigen (NIMA), immune reconstitution promotion, and application of exogenous cytokines, have made it possible to decrease the relapse rate and improve outco...
Abstract In 46 febrile neutropenic patients who had undergone haematopoietic stem cell transplantation, the fluorescence in situ hybridisation using peptide nucleic acid probes (PNA FISH), Gram stain/acridine orange leukocyte cytospin (Gram/AOLC), and differential time to positivity (DTP) methods were performed for detection of catheter related bloodstream infections (CRBSIs). As compared with the DTP method (which detected 11 patients with CRBSI), the PNA FISH and the Gram/AOLC methods detected ten of 11 CRBSI patients, resulting in a sensitivity, specificity, negative predictive value and positive predictive value of 91%, 100%, 97% and 100%, respectively, for the PNA FISH method as well as for the Gram/AOLC method.
Viral infections are still common causes of morbidity and mortality in immunosuppressed patients after allogeneic hematopoietic stem cell transplantation. Infections caused by virus such as cytomegalovirus, adenovirus and Epstein-Barr virus are well-known. In addition, several other viruses such as polyomavirus and human herpesvirus 6 have been recently reported to be causes of significant complications. As the delay in recovery of virus-specific cellular immune response after transplant is associated with viral reactivation and viral disease, adoptive immunotherapy to restore virus-specific cellular immunity is an attractive option. Recent clinical trials showed the safety and effectiveness of adoptive immunotherapy against viral diseases. In this review, we summarize the current status o...
... 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.
The aim of this study was to document vascular complications that occurred following cadaveric and living donor kidney transplants in order to assess the overall incidence of these complications at our center as well as to identify possible risk factors. In a retrospective cohort study, 1500 consecutive renal transplant recipients who received a living or cadaveric donor kidney between December 1988 and July 2006 were evaluated. The study was performed at the Nemazee Hospital, Shiraz, Iran. The assessment of the anatomy and number of renal arteries as well as the incidence of vascular complications was made by color doppler ultrasonography, angiography, and/or surgical exploration. Clinically apparent vascular complications were seen in 8.86% of all study patients (n = 133) with the most frequent being hemorrhage (n = 91; 6.1%) followed by allograft renal artery stenosis (n = 26; 1.7%), renal artery thrombosis (n = 9; 0.6%), and renal vein ...
Cell therapy is a promising novel option for treatment of cardiovascular disease. Because the role of bone marrow-derived circulating progenitor cells (BM-CPCs) after cell therapy is less clear, we...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.
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)
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...
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 ...
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...
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
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...
Local communities in southern Africa derive many benefits from marula [Sclerocarya birrea (A. Rich.) Hochst. subsp. caffra (Sond.) Kokwaro]. These include the contribution of this species towards health, nutrition, food security and conservation by sharing local skills and knowledge related to it. Marula fruits can be eaten fresh, squeezed to make juice, brewed in traditional beer or used to make jam and jelly. The kernels are also edible and can be pressed to extract oil for cooking and cosmetics, i.e., for skin and hair application. The bark, roots, seeds and leaves are exploited for traditional medicinal purposes. Marula has acquired significant commercial value since its fruits and other products have entered local, regional and international trade in southern Africa. To diversify frui...
In recent years, slightly acid formulas for cosmetics which remove follicular infundibulum obstruction of the hair follicle, have been devised. Therefore, few acne patients experience a problem with cosmetics use. On the other hand, cosmetics use differs from person to person. Thus, an investigation of actual conditions of cosmetics use was done among acne patients. Compared with healthy people, acne patients used more facial wash products more. It has been understood that treatment and skincare instruction are important for the improvement and prevention of acne. We examined skin physiology function and patient's QOL by using a skin care product for women for two months with skincare instruction from a dermatologist for 31 female patients this time. As a result, it was able to be confirme...
The use of indigenous bacterial root endophytes with biocontrol activity against soil-borne phytopathogens is an environmentally-friendly and ecologically-efficient action within an integrated disease management framework. The earliest steps of olive root colonization by Pseudomonas fluorescens PICF7 and Pseudomonas putida PICP2, effective biocontrol agents (BCAs) against Verticillium wilt of olive (Olea europaea L.) caused by the fungus Verticillium dahliae Kleb., are here described. A gnotobiotic study system using in vitro propagated olive plants, differential fluorescent-protein tagging of bacteria, and confocal laser scanning microscopy analysis have been successfully used to examine olive roots?Pseudomonas spp. interactions at the single-cell level. In vivo simultaneous visualization...
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
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
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
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 aneurysm relapse and 1 ...
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 ...
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).
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 ...
Open pit oil sands mining involves the disturbance of thin overburden covers of Boreal forest lands that must be returned to equivalent land capability after mining activities have ceased. Before mining starts, any wetlands are drained, timber is harvested, and peat, topsoils and subsoils are stockpiled for later use. This article discussed wetland reclamation activities conducted by Suncor Energy at its open pit mining operations. Research facilities were constructed in order to determine if wetlands constructed with consolidated tailings (CT) and pond effluent water (PEW) were able to support a sustainable vegetation community. Thirty-three cat-tail plots were established at the facility as well as unplanted plots in order to determine how quickly natural establishment occurred. Shoreline plug transplants and transplants from a natural saline lake were also introduced. Within 5 years, over 23 plant species had naturally colonized the CT ...
The effect of various forms of treatment of renal osteodystrophy was evaluated in 25 dialysis patients by quantitative bone scintigraphy, using 99m-Tc-HEDP. The results were compared with those of biochemical and bone morphometric studies. The total skeletal activity (TSA) decreased in 5 patients after transplantation, in 11 after parathyroidectomy and in 6 out of 9 treated conservatively, but did not normalize in any of the patients. Bone morphometric evaluation of treatment, which could be performed in 19 of the 20 patients who did not receive a transplant, demonstrated a reduction in the degree of hyperparathyroidism in 17 patients (89 percent). Osteoid excess was reduced in 13 patients (68 percent) but an evident reduction of osteomalacic osteoid, i.e. improvement of osteomalacia, occurred in only 4 patients (21 percent). Changes in the TSA correlated significantly with the changes in the biochemical and histological parameters of ...
The effect of various forms of treatment of renal osteodystrophy was evaluated in 25 dialysis patients by quantitative bone scintigraphy, using 99m-Tc-HEDP. The results were compared with those of biochemical and bone morphometric studies. The total skeletal activity (TSA) decreased in 5 patients after transplantation, in 11 after parathyroidectomy and in 6 out of 9 treated conservatively, but did not normalize in any of the patients. Bone morphometric evaluation of treatment, which could be performed in 19 of the 20 patients who did not receive a transplant, demonstrated a reduction in the degree of hyperparathyroidism in 17 patients (89 per cent). Osteoid excess was reduced in 13 patients (68 per cent) but an evident reduction of osteomalacic osteoid, i.e. improvement of osteomalacia, occurred in only 4 patients (21 per cent). Changes in the TSA correlated significantly with the changes in the biochemical and histological parameters of ...
As reported previously (Namba et al., 1985), normal human fibroblasts were transformed by 60Co gamma-ray irradiation into immortal cells with abnormal karyotypes. These transformed cells (KMST-6), however, showed a low cloning efficiency in soft agar and no transplantability. However, upon treatment with Harvey murine sarcoma virus (Ha-MSV), the cells acquired elevated clonability in soft agar and transplantability in nude mice. Ha-MSV alone, however, did not convert normal human fibroblasts into either immortal or tumorigenic cells. The Ha-MSV-transformed KMST-6 cells showed an enhanced expression of the ras oncogene, but normal and 60Co gamma-ray-transformed cells did not. Our current data suggest that gamma rays worked against normal human cells as an initiator, giving rise to chromosome aberrations and immortality, and that Ha-MSV, probably through its ras oncogene, played a role in the progression of the malignant cell population to a more ...
Using a syngeneic p53-null mouse mammary gland tumor model that closely mimics human breast cancer, we have identified, by limiting dilution transplantation and in vitro mammosphere assay, a Lin(-)CD29(H)CD24(H) subpopulation of tumor-initiating cells. Upon subsequent transplantation, this subpopulation generated heterogeneous tumors that displayed properties similar to the primary tumor. Analysis of biomarkers suggests the Lin(-)CD29(H)CD24(H) subpopulation may have arisen from a bipotent mammary progenitor. Differentially expressed genes in the Lin(-)CD29(H)CD24(H) mouse mammary gland tumor-initiating cell population include those involved in DNA damage response and repair, as well as genes involved in epigenetic regulation previously shown to be critical for stem cell self-renewal. These studies provide in vitro and in vivo data that support the cancer stem cell (CSC) hypothesis. Furthermore, this p53-null mouse mammary tumor model may allow ...
Summary The purpose of this study was to evaluate the efficacy of postoperative adjuvant chemotherapy with FOLFOX regimen on the outcome after LT for HCC patients who did not meet the Milan criteria. Ninety-five consecutive HCC patients with liver cirrhosis undergoing LT were enrolled. Fifty-eight who did not meet the Milan criteria were randomized to open-label treatment with or without adjuvant chemotherapy after LT (n?=?29/group). The FOLFOX chemotherapy protocol comprised 3-week cycles of oxaliplatin 100?mg/m2 on day 1, leucovorin (calcium folinate, CF) 200?mg/m2 on day 1 followed by 3-day, and 5-fluorouracil (5-FU) 2000?mg/m2 as a 48-h continuous infusion, for up to six courses in the 1st year after transplantation. Median survival was extended by 4.57?months by combination chemothera...
In mice, coat pigmentation requires a stem cell (SC) system in which the survival, proliferation, and differentiation of melanocytes (MCs) are regulated by microenvironments in hair follicles (HFs). In vitro systems are required to analyze the behavior of single melanocyte stem cells (MCSCs) and their potential to form SC systems in vivo. We describe here an experimental system for the isolation, self-renewal, and differentiation of MCSCs, as well as an in vivo reconstitution assay for assessing their potential. Using Dct(tm1(Cre)Bee)/CAG-CAT-GFP mice, we show that, in the presence of stem cell factor and basic fibroblast growth factor and the XB2 feeder cell line, purified MCSCs can undergo clonogenic proliferation, resulting in c-Kit(low) side scatter(low) cells. In culture, these cells maintain their capacity to differentiate and reconstitute an MCSC system in HFs. As these cells are present in the upper part of the HF near the bulge region, express only low ...
It may result in acute radiation syndrome after body is exposed to ionizing radiation. The one of long-term effects of irradiation injury is leukemia. The bone marrow cells (BMC) transplantation including stem cells is the only effective therapy for acute radiation syndrome patients. Recently, with the advancement of stem cell research that the stem cells have multipotential and can convert each other, it may supply the new stem source for the irradiation injury patients. At the same time with the further research of radioprotective reagents, the hematopoietic stem cells proliferation after irradiation injury is promoted
We report the case of a 22-year-old man with Ewing's sarcoma who attained a complete remission (CR) after combination radiotherapy and chemotherapy. Secondary acute lymphoblastic leukemia with multiple cytogenetic abnormalities involving chromosome 5 and 7 developed 16 years later. The patient underwent induction chemotherapy and entered a CR. Peripheral blood stem cell transplantation from a matched sibling was performed successfully and he is in complete remission of both ALL and Ewing's sarcoma. (Copyright (c) 1999 Elsevier Science B.V., Amsterdam. All rights reserved.)
Acquired cystic kidney disease (ACKD), also known as acquired renal cystic disease (ARCD,) occurs in patients who are on dialysis for end-stage renal disease. It is generally accepted that ACKD develops as a consequence of sustained uremia and can first manifest even before dialysis is initiated while the patient is still in chronic renal failure. The role of immune suppression, particularly in transplant recipients, in the development of ACKD, is still under investigation. The prevalence of ACKD is directly related to the duration of dialysis and the risk of cancer is directly related to the presence of cysts. Herein we review the current understanding of the pathophysiology and imaging implications of ACKD. (orig.)
Peatlands are an important long-term sink for atmospheric carbon dioxide (CO{sub 2}). The storage function of peatland ecosystems is significantly impacted by drainage and extraction processes, which can result in the release of significant amounts of CO{sub 2}. This paper investigated the net ecosystem CO{sub 2} exchange of a newly developed extraction-restoration technique that preserved the acrotelm and replaced it directly on the cut surface of the peatlands. The technique used a modified block-cut method with a back-hoe to create a drainage ditch. Actrotelm and surface vegetation were removed and placed to one side, and the peat was mechanically removed. The acrotelm was then transplanted over the older and more decomposed catotelm peat to create a trench topography in which the natural peatland was higher than the extracted zone. Air temperatures, water table levels, and volumetric moisture content levels were measured throughout the experiment. Measurements ...
The purpose of this study is to investigate the role of femoral marrow MR imaging as predictor of outcome for hemopoietic stem cell transplantation (HSCT) in beta-thalassemia major. MR imaging of the proximal femur, including T1- and T2-weighted spin echo and short-tau inversion recovery and in-phase and out-of-phase fast field echo images, was prospectively performed in 27 thalassemia major patients being prepared for HSCT. The area of red marrow and its percentage of the proximal femur were measured, and the presence of marrow hemosiderosis was assessed. Age-adjusted multivariate logistic regression was used to determine the relationship between red marrow area percentage and marrow hemosiderosis and HSCT outcome. Red area percentage were less in patients with successful (90.25{+-}4.14%) compared to unsuccessful transplants (94.54% {+-}2.93%; p=0.01). Red marrow area percentage correlated positively with duration of symptoms(r=0.428, p=0.026) ...
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 purpose of this study was to evaluate the ability to enhance distribution of eelgrass (Zostera marina) in the Columbia River Estuary to serve as refuge and feeding habitat for juvenile salmon, Dungeness crab, and other fish and wildlife. We strongly suspected that limited eelgrass seed dispersal has resulted in the present distribution of eelgrass meadows, and that there are other suitable places for eelgrass to survive and form functional meadows. Funded as part of the Bonneville Power Administration's call for Innovative Projects, we initiated a multistage study in 2008 that combined modeling, remote sensing, and field experimentation to: (1) Spatially predict habitat quality for eelgrass; (2) Conduct experimental plantings; and (3) Evaluate restoration potential. Baseline in-situ measurements and remote satellite observations were acquired for locations in the Lower Columbia River Estuary (LCRE) to determine ambient habitat conditions. These were used to create a ...
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 ...
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 ...
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...
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...
The main aims of the study were: 1) the evaluation of iron and zinc status in women of Lodz aged 18-45 years, 2) adaptation of the whole body counter to in vivo measurements absorption of iron given to the gastro-intestinal tract of volunteers and 3) in rat model estimation iron bioavailability from fortified wheat flour combined with products usually consumed in Poland. During five months investigations thirty seven women were examined each one twice in two months interval. Following variables were measured: iron and zinc in blood serum, in public and scalp hair and in food, taste acuity score, serum ferritin, hemoglobin, total iron binding capacity, red blood cells, mean corpuscular concentration and corpuscular volume. Prevalence of iron deficiency and iron deficient anemia were assessed by two models in terms of the depression of serum ferritin and hemoglobin concentrations. 64 refs, 6 figs, 23 tabs.
Sulfur dioxide emissions from an iron ore sintering plant have severely damaged vegetation up to 16 km northeast of the source. Concentric zones of increasing vegetation loss have formed around the point of maximum ground level concentration of the gas. Species diversity, sulfur and heavy metal concentrations in vegetation and soil amount to SO/sub 2/ injury were measured along a transect through the injury zones. Surrounding a central denuded area were zones dominated respectively by tussock-forming hair grass (Deschampsia flexuosa); low-growing shrubs and trailers (Sambucus pubens, Polygonum cilinode); higher-growing shrubs and suckering Populus tremuloides and Betula papyrifera) stunted forest tree species (Populus, Betula, Picea glauca, Abies Balsamea), and finally, normal boreal forest flora. Although SO/sub 2/ injury is continuing in this area, these zones now appear to be maintained primarily by severe erosion and destruction of suitable habitats for ...
Comprehensive investigation has been made into the application of the polymerization hardening by radiation, particularly electron beam, to the composites of polymers and other materials. The report is divided into four parts, namely 1) characteristics and problems of the reaction of curing by radiation polymerization, 2) improvement of the bonding capability of high molecular weight materials, 3) bonding by radiation, and 4) composites made by the impregnation and polymerization hardening of monomers. The first part includes the effects of dose rate, temperature rise during the hardening, the peculiarity of electron beam irradiation at high dose rate, reaction environment and additive effects. Main conclusions are as follows: caution must be taken to the amount of residual double bonds because they affect the quality of hardened polymers; the polymerization hardening reaction at high dose rate cannot be analogized by that at low dose rate; and the presence of the inhibitors of radical ...
In this article is reviewed the role of Computed Tomography (CT) in thoracic complications following ortho topic liver transplantation (OLT). In a post-OLT population of 567 patients transplanted in the Italian institutions, 100 patients (17.6%) were examined with chest CT. It was reviewed data relative to the total number of examinations, clinical and/or radiographic indications, the CT technique-i.e., conventional (with (out) intravenous, i.v., contrast material) or high-resolution (HRCT). It also reviewed the radiologic patterns and their correlation with the other clinical, bronchoscopic and/or laboratory results. Of 152 chest CT examinations, 45 (29.6%) were performed because of clinical indications, 31 (20.4%) because of a radiographic abnormality, 64 (42.1%) because of clinical and radiographic abnormality, 64 (42.1%) because of clinical and radiographic indications, while in 12 cases (7.9%) the reasons were unknown; 133/152 (87.5%) ...
Background Limited data is available for investigating the long-term safety and effects of intracoronary progenitor cell therapy in patients with acute myocardial infarction (AMI). Objective To assess the clinical course, NT-proBNP and MRI data as objective markers of cardiac function of the TOPCARE-AMI patients at 5-year follow-up. Design The TOPCARE-AMI trial was the first randomized study investigating the effects of intracoronary infusion of circulating (CPC) or bone marrow-derived progenitor cells (BMC) in 59 patients with successfully reperfused AMI. Results Five-year follow-up data were completed in 55 patients, 3 patients were lost to follow-up. None of the patients showed any signs of intramyocardial calcification or tumors at 5?years. One patient died during the initial hospitali...
Background.There are no suitably powered epidemiological studies of `transient azotaemia' (TA). The objective of this study was to describe the epidemiology of TA and its independent association with hospital mortality. We hypothesized that TA would be associated with an independent increase in the risk of death. Methods.We retrospectively studied all patients admitted to a university-affiliated hospital in Australia between January 2000 and December 2002. Patients were excluded if they were <15 years old, were on chronic dialysis, had kidney transplant or if their length of hospital stay was <24 hours. We defined TA as rapidly recovering acute kidney injury (AKI) (return to no-AKI risk, injury, failure, loss, end stage (RIFLE) class within 72 hours of onset). We performed descriptive and ...
In patients subjected to bone marrow transplantation the aggressive measures necessarily preceding this treatment lead to drastic metabolic changes which, in turn, are a cause of marked disturbances of homeostasis. The general preparatory measures in the form of cytoreduction by cytostatic drugs are broadened for leukaemic patients to include wholebody irradiation. During the study described here investigations were carried out into the resulting strain on the metabolism. One of the most essential changes observed in those patients was a nitrogen loss of up to approx. 20 g/day that occurred during the immunosuppressive phase. This was accompanied by markedly pronounced variations in fluid elimination, which partly were of an iatrogenic nature. An immediate and sufficient substitution of amino acids in connection with complete parenteral nutrition rapidly acted to compensate for the nitrogen losses, even though these could not be totally reversed to achieve a ...
Immune function is critical in health and disease. The control and regulation of immune reactions is an area of intense investigation that has important implications for allogeneic hematopoietic cell transplantation. Immune reactions are regulated in a number of important ways. Compartmentalization of immune responses and the production of both pro-inflammatory and anti-inflammatory cytokines play a major role. More recently several populations of T cells that regulate immune responses termed regulatory T cells have been identified. This manuscript will focus on CD4^+CD25^+FoxP3^+ natural regulatory T cells (T"r"e"g) and @a@bTCR^+CD4^+NK1.1^+ natural killer T (NK-T) cells which both suppress graft vs host disease but appear to function by distinct mechanisms.
Aims: Rapamycin (sirolimus) is an antibiotic that inhibits protein synthesis through mammalian targeting of rapamycin (mTOR) signaling, and is used as an immunosuppressant in the treatment of organ rejection in transplant recipients. Rapamycin confers preconditioning-like protection against ischemic-reperfusion injury in isolated mouse heart cultures. Our aim was to further define the role of rapamycin in intracellular Ca^2^+ homeostasis and to investigate the mechanism by which rapamycin protects cardiomyocytes from hypoxic damage. Main methods: We demonstrate here that rapamycin protects rat heart cultures from hypoxic-reoxygenation (H/R) damage, as revealed by assays of lactate dehydrogenase (LDH) and creatine kinase (CK) leakage to the medium, by MTT (3-[4,5-dimethylthiazol-2-yl]-2,5-d...
This study investigated the occurrence of free-living amoebae (FLA) in immunodeficiency wards of hospitals in Tehran, Iran. A total of 70 dust and biofilm samples from wards serving transplant, pediatric (malignancies), HIV, leukemia and oncology patients of five university hospitals were collected and examined for the presence of FLA using culturing and molecular approaches. Based on the morphology of the amoebae in plate cultures, primer sets were applied for molecular identification of Acanthamoeba, vahlkampfiid amoebae and Hartmannella. Out of 70 samples, 37 (52.9%) were positive for FLA. Acanthamoeba belonged to the T4 genotype was the most prevalent isolate. Presence of the T4 genotype on medical instruments, including an oxygen mask in an isolation room of an immunodeficiency pediat...
Recent improvements in cell purification and transplantation techniques have contributed to the identification of cell populations known as tumor-initiating cells (TIC). This discovery has led to the -cancer stem cell hierarchy- concept, which holds that tumors are organized as a hierarchy of malignant tissues sustained by such TIC. However, this concept remains controversial. In this review, we examine recent advances in cancer stem cell research that have been generated from studies of Philadelphia (Ph) chromosome-positive leukemia. The abnormal Ph chromosome, which arises from a translocation creating the BCR-ABL1 fusion gene, is most commonly associated with chronic myelogenous leukemia (CML) and precursor B cell acute lymphoblastic leukemia (B-ALL). Examination of the pathophysiology ...
Background. A 19-year-old girl was diagnosed with systemic lupus erythematosus, based on findings of arthritis, malar rash, positive antinuclear antibody test and high levels of antibodies to double-stranded DNA. Two months after diagnosis, the patient presented with a sudden drop in blood hemoglobin level. Several days later, she developed bloody sputum, rapidly progressive dyspnea and hypoxemia. High-resolution CT showed diffuse alveolar infiltrates in both lung fields.Investigations. Physical examination, complete blood count, erythrocyte sedimentation rate, urinalysis, 24-h urine protein excretion, fecal occult blood test, d-dimer test, acid hemolysis test, activated partial thromboplastin time and prothrombin time, direct and indirect Coombs tests, bone marrow smear, arterial blood ga...
The findings reported in this study highlight several important features of the development of hematopoietic stem cells after transplantation into irradiated recipients. First, they demonstrate the existence of a class of primitive multipotential stem cells that can function for a significant portion of the lifetime of a mouse (15 mo). In addition, they clearly show that these primitive stem cells can be infected with recombinant retroviruses and thus would be appropriate targets for gene therapy in somatic tissues. Second, our data indicate that the progeny of some, but not all, of the primitive stem cells have fully expanded into the various hematopoietic lineages by 2 mo after reconstitution. Finally, our analysis of the secondary recipients provides strong evidence suggesting that the primitive stem cell population can actually clonally expand. Our current experiments are aimed at determining the extent to which this expansion can occur and whether or not this ...
Summary 1.-Plant-plant interactions fluctuate between competition and facilitation depending upon ecological conditions and species traits. Facilitative interactions are expected to increase in frequency via associational defences with increasing consumer pressure. The ability of species to cope with competition and/or ecological stressors may alter the outcome of plant-plant interactions. 2.-We conducted a transplant experiment to determine if native and non-native grasses and forbs respond similarly to interactions with Juncus effusus L., an unpalatable benefactor species, along a grazing intensity gradient in two contrasting pasture types: intensively managed and semi-natural. We expected competitive taller, erect species (grasses) and non-natives to obtain stronger facilitative effects...
Abstract Background- Cyclosporine is used for treatment of transplanted patients and for immune-mediated diseases. Cyclosporine is known to cause a combination of metabolic side effects including hypertension, hyperkalemia, hypercalciuria and hypomagnesemia. These side effects except for hypomagnesemia are the cardinal features of familial hyperkalemia and hypertension (FHHt), also called pseudohypoaldosteronism type II (PHA II). FHHt is caused by mutations in the kinases WNK1 and WNK4 resulting in an increase in renal Na-Cl cotransporter (NCC) apical distribution and function. Therefore, we studied whether cyclosporine-s metabolic side effects are mediated by WNK4 and NCC. Design- Sprague-Dawley (SD) rats were treated by cyclosporine 25-mg-kg-1 subcutaneously for 14-days. Blood pressure, ...
Glioblastoma multiforme is the most aggressive form of human brain tumor, which has no effective cure. Previously, we have demonstrated that overexpression of the C-terminal fragment of the human telomerase reverse transcriptase (hTERTC27) inhibits the growth and tumorigenicity of human cervical cancer HeLa cells. In this study, the therapeutic effect and molecular mechanisms of hTERTC27-mediated cancer gene therapy were further explored in vivo in established human glioblastoma xenografts in nude mice. We showed that intratumoral injection of adeno-associated virus carrying hTERTC27 (rAAV-hTERTC27) is highly effective in reducing the growth of the subcutaneously transplanted glioblastoma tumors. Histological analyses showed that rAAV-hTERTC27 treatment leads to profound necrosis, apoptosi...
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).
Results are presented of trials in W. Germany involving Populus tremula X P. tremuloides. In a nursery in late August - early September 1971, some 1300 buds from 38 selected 3-yr-old hybrid aspen seedlings were grafted into T-slits at nodes 10-20 cm above root' collars of 1 and a half yr-old hybrid aspen stock (products of controlled crossings, and in some cases of similar parentage to the transplanted buds). In spring 1972, each stock (from which its own buds were removed) was cut back to a 'peg' 15-20 cm above the level of the graft; the 'peg' was later used to support the new shoot developed from the transplanted bud. By Sept. 1972, 33% of grafts were successful, the success rate being significantly different (3-67%) within clones; average height of scion shoots ranged from 79 to 375 cm (no significant difference between clones). In spring 1973, some 190 grafts from 35 clones were row-planted in ...
We irradiated proton beams on the ears of rabbits and the Harding-Passey mouse melanoma and observed their morphological change. We used 52 MeV proton beams from the INS-FM cyclotron. We adjusted the energy of the proton beams to be at the plateau part of the Bragg curve, at the half-way point of the Bragg peak, and at the Bragg peak. The amount of radiation was 5000rad in each case. The Harding-Passey mouse melanoma was transplanted into the subcutan of a three week old mouse. In this experiment, we used tumors, the diameter of which grew up to 1.5-2cm in 2-3 weeks after the transplantation. Using the jroscope, we observed both lightly and severely damaged cells. Using proton irradiation with the Bragg peak located at depth of 1mm in the rabbit's ears, we studied the change in the tissue. Irradiated epidermis fell off and was eroded because of radiation damage, but the rear surface of the rabbit's ears was only slightly ...
(1) Young chrysanthemums were planted after being irradiated at the time of shoot tip culture and the influence of irradiation was evaluated from the point of view of establishment of mutants. (2) Two cultivars, Kin-tenryu and Tenryu-no-asa were used in this experiment. The percentage of cultivars healthy enough to transplant on June 10, 1972 showed a decrease in proportion to the increase of dosage. Some plants of cultivar Kin-tenryu died after being transplanted. (3) Few plants of either cultivar could overwinter, and in particular no plant irradiated by gamma-rays of 20 kR. (4) Plant height showed a tendency of inhibition in both cultivars. (5) Three chlorophyll mutants showing chimera appeared. One of them was in the cultivar Tenryu-no-asa irradiated by 10 kR at 3 days after planting; two of them were in the cultivar Tenryu-no-asa irradiated by 10 kR at 5 days after planting. One mutant exhibiting malformation of entire leaves appeared in ...
Purpose: The predictive potential of tumor cell kinetic parameters may be improved when they are studied in relation to other microenvironmental parameters. The purpose of this investigation was to quantitatively categorize human tumor samples according to proliferation patterns. Second, it was examined whether these characteristics are retained after xenotransplantation. Methods and Materials: Fifty tumor samples from head-and-neck cancer patients were immunohistochemically stained for Ki-67 and vessels. Also, parts of the samples were transplanted into nude mice. Tumors were categorized according to previously described patterns of proliferation. Vascular and proliferation patterns were analyzed using an image processing system. Results: The 50 tumors were categorized into four patterns of proliferation by visual assessment: marginal (6), intermediate (10), random (21), and mixed (12). One tumor could not be classified. These patterns were quantified by ...
We have presented evidence that the functional thyroid follicles (follicular units, FU) which are formed in grafts of monodispersed rat thyroid cells, and hence the thyroid tumors which later develop in such grafts, are clonal in origin. Recent studies have been designed to investigate: whether cell number-dependent inhibition of promotion-progression is mediated by remote hormonal feed-back, local cell-cell interactions, or both; the cell population kinetics of the clonogen subpopulation during goitrogenesis and goiter involution; and the effect of prolonged exposure to high levels of TSH (thyrotropin) on the capacity of the clonogens to give rise to functional FU. The results indicate that local cell-cell interactions play an important role in the cell number-dependent suppression of neoplastic promotion-progression. They also show that if sufficient thyroid cells are grafted, the thyroid-pituitary axis can be reestablished in thyroidectomized rats fed normal diets. In such animals ...
Abstract in english The outcome of the interaction between Biomphalaria and Schistosoma mansoni depends on the response of the host internal defence system (IDS) and the escape mechanisms of the parasite. The aim of this study was to evaluate the responsiveness of the IDS (haemocytes and soluble haemolymph factors) of resistant and susceptible Biomphalaria tenagophila lineages and Biomphalaria glabrata lineages in the presence of in vitro-transformed primary sporocysts and secondary sporocys (more) ts obtained from infected B. glabrata. To do this, we assayed the cellular adhesion index (CAI), analysed viability/mortality, used fluorescent markers to evaluate the tegumental damage and transplanted secondary sporocysts. B. tenagophila Taim was more effective against primary and secondary sporocystes than the susceptible lineage and B. glabrata. Compared with secondary sporocysts exposed to B. tenagophila, primary sporocysts showed a higher CAI, a greater percentage ...
A human cholangiocarcinoma, Ch-1, serially transplanted to nude mice was used for experimental chemotherapy, radiotherapy, and conbination chemoradiotherapy. In the group of chemotherapy with single drug, Mitomycin C (MMC) revealed greater effectiveness than Adriamycin in terms of tumor regression, histological findings, and minor side effects. MMC and radiotherapy by Linac X-ray showed exponential linear dose response curve against tumor weight. Their effects were equivalent at doses of MMC 1 mg/kg and radiation 1,000 rads/mouse in the changes of tumor weight and of histological findings which were similar to each other. Combination chemoradiotherapy showed the synergistic action when the radiation (500 rads/mouse) was performed before MMC (0.5 mg/kg) administration, whereas only the additive effect was observed when the sequence was reversed. The cell kinetic analysis was performed by the impulse cytophotometry, "3H-thymidine uptake labeling index (L.I.), and ...
A transplant experiment was conducted to determine whether standard metabolic rate (SMR) of a freshwater shrimp (Palaeomonetes paludosus) would be affected by exposure to trace element-enriched coal combustion waste (coal ash). Shrimp were transplanted into replicate cages in a coal ash-polluted site and a reference site for 8 months. The coal ash-polluted site was characterized by elevated sediment concentrations of As, Cd, Cr, Cu, Ni, Pb and Se compared to sediments in the reference site. After 8 months in the study sites, shrimp in the polluted site appeared to have accumulated As, Cd and Se from the habitat, but there were on differences in survival between the study sites. However, mean SMR of shrimp (measured as O{sub 2} consumption at rest) held in the polluted site was 51% higher than mean SMR of shrimp held in the reference site. The elevation in SMR indicates that the energetic costs of maintenance are greater for shrimp chronically ...
Background and Purpose: Total-body irradiation (TBI) is an important part of the conditioning regimen for hematopoietic stem cell transplantation (HSCT) in patients with hematologic malignancies. The results after treatment with various TBI regimes were compared, and dose-effect relationships for the endpoints relapse incidence, disease-free survival, treatment-related mortality, and overall survival were derived. The aim was to define requirements for an optimal treatment schedule with respect to leukemic cell kill and late normal-tissue morbidity. Material and Methods: A literature search was performed. Three randomized studies, four studies comparing results of two or three TBI regimens, and nine reports with results of one specific TBI regimen were identified. Biologically effective doses (BEDs) were calculated. The results of the randomized studies and the studies comparing results of two or three TBI regimens were pooled, and the pooled relative risk (RR) was ...
Background and Purpose: Total-body irradiation (TBI) is an important part of the conditioning regimen for hematopoietic stem cell transplantation (HSCT) in patients with hematologic malignancies. The results after treatment with various TBI regimes were compared, and dose-effect relationships for the endpoints relapse incidence, disease-free survival, treatment-related mortality, and overall survival were derived. The aim was to define requirements for an optimal treatment schedule with respect to leukemic cell kill and late normal-tissue morbidity. Material and Methods: A literature search was performed. Three randomized studies, four studies comparing results of two or three TBI regimens, and nine reports with results of one specific TBI regimen were identified. Biologically effective doses (BEDs) were calculated. The results of the randomized studies and the studies comparing results of two or three TBI regimens were pooled, and the pooled relative risk (RR) was ...
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. ...
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 possible second line ...
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 ...
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 satisfactory ...
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 satisfactory ...
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 ...
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...
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 ...
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
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 ...
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 aim of this study was to compare the results of different treatment strategies for osteochondral defects (OCD) of the talus. Electronic databases from 1966 to June 2000 were systematically screened. Thirty-nine studies fulfilled our inclusion criteria. No randomized clinical trials could be identified. The results of nonoperative treatment were described in 14 studies, of excision alone in 4, of excision and curettage in 10, of excision, curettage and drilling in 21, of cancellous bone grafting in 2, of fixation in 3, and of osteochondral transplantation in 1. Good or excellent results were found in 45% of the cases. Comparison of different surgical procedures showed that excision, curettage and drilling resulted in the highest mean success rate (86%), followed by excision and curettage (76%) and excision alone (38%). From the results of this systematic review we conclude that nonoperative treatment and excision alone are not to be recommended for treatment of ...
We have investigated the properties of nerve cell precursors in hydra by analyzing the differentiation and proliferation capacity of interstitial cells in the peduncle of Hydra oligactis, which is a region of active nerve cell differentiation. Our results indicate that about 50% of the interstitial cells in the peduncle can grow rapidly and also give rise to nematocyte precursors when transplanted into a gastric environment. If these cells were committed nerve cell precursors, one would not expect them to differentiate into nematocytes nor to proliferate apparently without limit. Therefore we conclude that cycling interstitial cells in peduncles are not intermediates in the nerve cell differentiation pathway but are stem cells. The remaining interstitial cells in the peduncle are in G1 and have the properties of committed nerve cell precursors. Thus, the interstitial cell population in the peduncle contains both stem cells and noncycling nerve precursors. The ...
PurposeTo evaluate the efficacy of photorefractive keratectomy (PRK) for residual refractive error after penetrating keratoplasty (PKP) for keratoconus. SettingPrivate ophthalmic clinic. DesignCase series. MethodConsecutive patients who had PRK augmented with topical mitomycin-C (MMC) after PKP for keratoconus were retrospectively reviewed. Patients were divided into a a low cylinder group (refractive cylinder 6.00 D). Visual acuity, refraction, and keratometry were analyzed preoperatively and 1, 3, 6, and 12 months postoperatively. ResultsThe study comprised 47 eyes (41 patients). The spherical equivalent (SE) decreased from -4.24 D +- 3.23 (SD) preoperatively to -0.71 +- 1.03 D 12 months postoperatively in the low cylinder group and from -4.19 +- 3.54 D to -2.45 +- 3.42 D, respectively, ...
This study evaluates the correlation between transplanted Asiatic clam and indigenous community responses to acid mine drainage and nutrient loading in first-to-third-order streams, by comparing the toxicological endpoints of clam survival and growth with benthic macro-invertebrate community indices as community responses to both acid mine drainage and nutrient loading. Clam survival was found to be positively correlated with water column pH and negatively correlated with conductivity and metal concentrations. There was also a positive correlation with the relative abundance of the macro-invertebrate Ephemeroptera, the most sensitive taxonomic group, to acid mine drainage in this watershed. No correlation was found between clam growth and acid mine drainage inputs, but there was evidence of positive correlation with nitrate concentrations and the relative abundance of collector-filterer functional feeding groups. These results suggest that clam growth is related to ...
Hepatobiliary scintigraphy is the only non-invasive technique providing real-time assessment of hepatocytes function and bile progression from the liver to the intestine; for this reason it is of great importance in the study of jaundice and many other disorders of the liver and the biliary tract in children. Ultrasonography is the initial method of evaluating the intra- and extrahepatic bile ducts dilatation: the differential diagnosis between biliary atresia and neonatal hepatitis cannot however be done without hepatobiliary scintigraphy. Cystic fibrosis patients also require hepatobiliary scintigraphy; liver and biliary tract disease can really occur independently of the underlying disease severity and the presence of steatorrhoea. Hepatobiliary imaging in children who have undergone liver transplantation is of major importance; it can assess vascularity, parenchymal function biliary drainage, possible presence of a bile leak and obstruction; it has very good ...
A field experiment was conducted during 2004 and 2005 at the research farm of Central Institute of Medicinal And Aromatic Plants, Lucknow located at 26.5^o N 80.5^o E and 120m above the mean sea level to study the effect of harvesting stage and cutting height on growth, yield and quality of Indian basil. The objective of this study was to increase the essential oil yield of Indian basil without adverse effect on quality by taking two harvests through manipulating harvesting stage and cutting height and to increase the land and rain water utilization efficiency under rain fed condition. The treatments consisted of four stages of first harvest (40, 60, 80 and 100 days after transplanting (DAT)) and three cutting height (0, 7.5 and 15.0cm above ground level). The Indian basil (Ocimum basilicu...
Hematopoietic stem cells (HSCs) have remained at the forefront of stem cell research for the past 50 years, since the therapeutic potential of bone marrow transplantation was realized. Uniquely, among stem and progenitor cells, research progress has been made in parallel between the laboratory benchtop and hospital bedside during this period. Integral to this work has been the role of the transfusion medicine services in the collection, storage, and processing of HSCs. The next decade promises to bring further developments: with new fields of cellular therapies, stem cell vaccination, and stem cell drug testing opening up. This article summarizes exciting areas of research concerning the behavior and potential clinical applications of HSCs. For the purposes of clarity, we describe in turn the trafficking and transfer of HSCs; ex vivo expansion of HSC units from different sources; and finally, applications of specifically selected subsets of hematopoietic cells and ...
The coupling between cerebral metabolic rate of oxygen (CMRO2) and blood flow (CBF) in response to visual stimulation was evaluated by means of a model of oxygen delivery. The model predicted a nonlinear relationship between stimulus-evoked changes of oxygen consumption and blood flow. The magnitude of the CMRO2/CBF ratio index (IO2) was used to indicate the degree of flow-metabolism coupling prevailing in specific areas of the brain during physiological stimulation. Therefore, the index provided a measure of the blood oxygenation level dependent (BOLD) magnetic resonance contrast. To evaluate the changes of IO2 in response to visual stimulation, the model was applied to the effect of a changing flicker rate of a visual stimulus on the magnitudes of CBF, CMRO2, and oxygen diffusion capacity, in the human brain. Positron emission tomography (PET) was used to measure the CBF and the CMRO2 in 12 healthy volunteers who viewed a cross-hair (baseline) or a yellow-blue ...
To assess the contribution of adrenal-derived androgens in women with hirsutism, adrenal scintigrams under dexamethasone suppression (DS) were performed on 35 women with increasing facial or body hair and irregular or absent menses. Based upon the DS regimen chosen (8 mg/d for 2 days or 4 md/d for 7 days before the injection of 6..beta..-(/sup 131/I)iodomethylnorcholesterol), three imaging patterns were identified. The first was the absence of uptake before 3 days (8-mg DS) or before 5 days (4-mg DS) after injection. This imaging pattern was seen in 17 of the 35 patients studied and was considered normal. The second pattern was bilateral uptake earlier than 3 days (8-mg DS regimen) or 5 days (4-mg DS) after injection. This was seen in 13 of the 35 patients and was interpreted as bilateral early visualization. Adrenal-vein catheterization performed on six patients with this pattern showed increased adrenal-vein testosterone. The third pattern, observed in five ...
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.)
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 ...
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), ...
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.
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...
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...
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 purpose of this study was to correlate histopathological with CT findings in patients suffering from hepatocellular carcinoma (HCC) eligible for orthotopic liver transplantation (OLT), with a special focus on the antitumoral effect of transarterial chemoembolization (TACE) therapy. A total of 42 consecutive patients suffering from HCC had been treated prior to OLT by means of TACE. TACE was carried out with a mixture of Lipiodol (10-20 ml) and mitomycin C (max. dosage, 10 mg). TACE was performed at 6- to 8-week intervals. Follow-up investigation included contrast-enhanced multislice CT controls and laboratory control. Liver explants were evaluated macroscopically and microscopically to determine the number and size of the tumor lesions as well as the degree of tumor necrosis. Necrosis was investigated in H and E-stained sections. The degree of necrosis was classified as follows: 0-25%, 26-50%, 51-75%, 75-99%, and complete necrosis. Two hundred thirty-one TACE ...
Purpose: Antitumor activity of the dichloroplatinum(II)-histamine complexes labeled with I-125 or I-131 was investigated in a transplantable murine adenocarcinoma (MA) model. Methods: The tumor model was obtained in C3H/W female mice after subcutaneous inoculation of the tumor cells derived from the mice bearing a mammary tumor of spontaneous origin. Antitumor activities of the platinum-histamine complexes were investigated in three independent experiments, which differed in applied doses of preparations (PtCl{sub 2}Hist, PtCl{sub 2}[{sup 125}I]Hist, PtCl{sub 2}[{sup 131}I]Hist, PtCl{sub 2}Hist/PtCl{sub 2}[{sup 125}I]Hist and PtCl{sub 2}Hist/PtCl{sub 2}[{sup 131}I]Hist), treatment schedules as well as stages of the disease progress in the animals used. Experiment 1 included long-term, multidose treatment with low single doses (treatment duration 31-32 days; 8-10 doses of ca. 0.25{center_dot}MTD{sub Pt} each). Experiment 2 included short-term, multidose treatment ...
Problems and solutions in the diagnosis and operative treatment were clarified by retrospective evaluation of cases of intramedullary tumor in which MRI and surgery had been performed. The subjects were 16 patients (21-75 years old, mean age: 45 years) whose tumor was surgically removed between 1991 and 1998. MRI was performed preoperatively, and T1-weighted images, T2-weighted images, and enhanced images were obtained. Angiography was also performed in some cases. The histological diagnosis based on the MRI findings before surgery were compared with the pathological diagnosis after the operation. In 9/16 cases (56%), the preoperative histological diagnosis based on the MR images was the same as the pathological diagnosis after the operation. In 8 of the 11 cases (73%) whose images showed clear tumor margins and well shaped the tumor, the tumors were completely removed. The concordance rate between the pathological diagnosis during and after ...
Objective: To determine whether asymptomatic bacterial vaginosis (BV) is associated with upper genital tract inflammation or bacterial colonization.Methods: Fifty nonpregnant women with intact uteri who planned to undergo gynecologic surgery and had no recent symptoms of vaginal infection were enrolled. We obtained a vaginal swab for Gram stain, endocervical swab for chlamydia and gonorrhea DNA probe testing, and Pipelle endometrial biopsy for aerobic and anaerobic cultures and histology. We correlated surgical findings and histology of available surgical specimens with the microbiologic results. The diagnosis of BV was made according to Speigel's criteria. Bacteria isolated from the uterus were classified as high virulence versus low virulence. Contingency tables were analyzed using the chi-square or Fisher Exact tests.Results: Twenty-one of 50 patients had BV on Gram stain, 3 had intermediate BV, and 3 had unreadable slides. Eleven patients had histologic ...
The aim of this study was to evaluate the results of postoperative radiotherapy in a case of perihilar cholagiocarcinoma by analyzing overall survival rate, patterns of failure, prognostic factors for overall survival, and toxicity. Between January 1998 and March 2008, 38 patients with perihilar cholangiocarcinoma underwent a surgical resection and adjuvant radiotherapy. The median patient age was 59 years (range, 28 to 72 years), which included 23 men and 15 women. The extent of surgery was complete resection in 9 patients, microscopically positive margins in 25 patients, and a subtotal resection in 4 patients. The tumor bed and regional lymphatics initially received 45 Gy or 50 Gy, but was subsequently boosted to a total dose of 59.4 Gy or 60 Gy in incompletely resected patients. The median radiotherapy dose was 59.4 Gy. Concurrent chemotherapy was administered in 30 patients. The median follow-up period was 14 months (range, 6 to 45 months). The 3-year overall ...
Purpose: To 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 Methods: Between 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. Results: There 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 in the radiotherapy group (24 solitary), but there was no significant difference in distant recurrence-free survival. In a more recent (2002-2006) cohort, the median age ...
From 1981 up to February 1985, a total of 93 protocol patients entered the study CESS 81. The protocol recommended an initial 18-week period of polychemotherapy (VACA) followed by local therapy and two additional cycles of chemotherapy. Local therapy consisted either of radical surgery or of incomplete resection plus postoperative irradiation with 36 Gy or of radiotherapy alone (46 and 60 Gy). Centrally located lesions were always irradiated with 60 Gy. This article summarizes the data after 5 years. Data of 93 patients were analysed in October 1986 after a median follow-up of 37 months. The projected 5-year survival is 50%. The relapse rate was 42%, distant relapses occurred in 19%, local (plus distant) relapses in 23%. Most of the relapses occurred during the first 3 years of observation. Failure rate was high in patients undergoing irradiation alone (44%). Initial tumour mass (> 100 ml) and histopathologic response to initial chemotherapy were identified as ...
This report deals with the preliminary results of trials in the DATECA project with stage I, II and III patients with non-seminomatous germ cell tumours. Stage 1 patients were randomized between infradiaphragmatic irradiation and observation. No significant difference in recurrence rates has been observed as yet. Eighteen of 95 patients had recurrence with a median time to relapse of 3 months. Fifteen patients achieved complete remission after treatment by combination chemotherapy while 3 patients are still undergoing treatment. Stage II patients received 6 series of cis-platinum, bleomycin, and vinblastine. The patients were initially randomized to receive chemotherapy alone versus chemotherapy plus irradiation. Irradiation led to increased toxicity and decreased doses of the antineoplastic drugs. Fifty-one patients were studied. The overall complete remission rate was 89 per cent including 7 patients who achieved complete remission after secondary surgery. Three ...
This report deals with the preliminary results of trials in the DATECA project with stage I, II and III patients with non-seminomatous germ cell tumours. Stage 1 patients were randomized between infradiaphragmatic irradiation and observation. No significant difference in recurrence rates has been observed as yet. Eighteen of 95 patients had recurrence with a median time to relapse of 3 months. Fifteen patients achieved complete remission after treatment by combiantion chemotherapy while 3 patients are still undergoing treatment. Stage II patients received 6 series of cis-platinum, bleomycin, and vinblastine. The patients were initially randomized to receive chemotherapy alone versus chemotherapy plus irradiation. Irradiation led to increased toxicity and decreased doses of the antineoplastic drugs. Fifty-one patients were studied. The overall complete remission rate was 89 per cent including 7 patients who achieved complete remission after secondary surgery. Three ...
The results of 144 previously untreated cases of primary Ewing's sarcoma of bone are reported with a minimum follow-up of 5 years. This series was treated between 1972 and 1982 at Istituto Ortopedico Rizzoli with a combined therapy. The local control of the disease consisted of amputation (ten cases), resection followed by radiation therapy (35-45 Gy) (48 cases) and radiation therapy alone (40-60 Gy) (86 cases). Adjuvant chemotherapy, rigorously standardized, was performed according two different protocols: the first (85 cases treated in the period 1972-1978) consisted of vincristine (VCR) Adriamycin (doxorubicin) (ADM), and cyclophosphamide (EDX); the second (59 cases treated in the period 1979-1982) of VCR, ADM, EDX and dactinomycin (DACT). At a follow-up of 5 to 16 years (median, 9), 59 patients (41%) are continuously disease-free (CDF), 81 (56%) developed metastatic disease and/or local recurrence, and four (3%) had a second malignancy. Three factors seem to be correlated to ...
Purpose: To analyze p53, bcl-2, c-myc, and cyclooxygenase-2 protein expression changes and examine their relationship with various antioxidant enzymes in esophageal carcinoma patients. Methods and Materials: Patients in Group 1 underwent transhiatal esophagectomy and those in Group 2 were administered chemoradiotherapy followed by surgery after 4 weeks of neoadjuvant therapy. Results: The relationship analysis among the various protein markers and antioxidant enzymes showed an inverse correlation between bcl-2 and superoxide dismutase/catalase in tumor tissues, irrespective of the treatment arm followed. An important positive association was observed between bcl-2 and reduced glutathione levels in the tumor tissue of patients receiving neoadjuvant therapy. Another apoptosis-modulating marker, c-myc, in the tumor tissue of Group 2 patients showed similar pattern levels (high and low) as that of superoxide dismutase/catalase. The association of cyclooxygenase-2 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 infrarenalen Bauchaortenaneurysmas hat sich als Alternative zur ...
Objective:? Primary hyperparathyroidism (HPT) is characterised by autonomous secretion of PTH from enlarged parathyroid glands leading, in most patients, to asymptomatic hypercalcaemia. Familial hypocalciuric hypercalcaemia (FHH) is an autosomal dominant disorder caused by inactivating mutations in the calcium sensing receptor (CaSR) gene; it is characterised by lifelong and usually asymptomatic hypercalcaemia. Establishing the correct diagnosis is important because surgery can be curative in HPT, but ineffective in FHH. There is overlap in the diagnostic criteria for the two disorders and some patients carrying inactivating mutations in the CaSR gene, which is suggestive of FHH, also have HPT with hyperplastic parathyroid glands or adenomas. Design and Patients:? CaSR gene mutations were analyzed and clinical and biochemical parameters evaluated in 139 consecutive out-patients presenting with hypercalcaemia and suspected of having HPT. Results:? Six different ...
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 signs, 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 and complex organization). Therefore CT can presently be considered the method of choice in patients with suspected bowel infarction. [Italian] L'infarto intestinale rappresenta una malattia rara e tipica del soggeto anziano; nonostante il ...
Purpose: To examine the role of brachytherapy in the treatment of cholangiocarcinomas in a relatively large group of patients. Methods and Materials: Using the Surveillance, Epidemiology and End Results database, a total of 193 patients with cholangiocarcinoma treated with brachytherapy were identified for the period 1988-2003. The primary analysis compared patients treated with brachytherapy (with or without external-beam radiation) with those who did not receive radiation. To try to account for confounding variables, propensity score and sensitivity analyses were used. Results: There was a significant difference between patients who received radiation (n = 193) and those who did not (n = 6859) with regard to surgery (p < 0.0001), race (p < 0.0001), stage (p < 0.0001), and year of diagnosis (p <0.0001). Median survival for patients treated with brachytherapy was 11 months (95% confidence interval [CI] 9-13 months), compared with 4 months for patients ...
January, 1992, to October, 1995, sixty-four patients with advanced head and neck cancer underwent head and neck reconstructive surgery using myocutaneous or revascularized flaps; in the same period, all patients were consecutively examined with CT and MRI. Myocutaneous flaps were used in 26 patients: 12 flaps were tubular and 14 linear. Revascularized flaps were used in 38 patients: to repair a large defect in 26 patients (14 latissimus dorsi flaps and 12 temporal muscle flaps) and to repair an oral damage in 12 patients (5 revascularized radial and 7 jejunal flaps). CT and MR images of myocutaneous flaps showed the flaps as fatty areas, repairing large surgical defects, hypodense at CT and hyperintense at MRI, with no post-contrast enhancement. The appearance of revascularized flaps at CT and MRI depends on the characteristics of the structure used to repair the surgical defect: jejunal and radial flaps appeared as mostly fatty thickened layers with both imaging ...
January, 1992, to October, 1995, sixty-four patients with advanced head and neck cancer underwent head and neck reconstructive surgery using myocutaneous or revascularized flaps; in the same period, all patients were consecutively examined with CT and MRI. Myocutaneous flaps were used in 26 patients: 12 flaps were tubular and 14 linear. Revascularized flaps were used in 38 patients: to repair a large defect in 26 patients (14 latissimus dorsi flaps and 12 temporal muscle flaps) and to repair an oral damage in 12 patients (5 revascularized radial and 7 jejunal flaps). CT and MR images of myocutaneous flaps showed the flaps as fatty areas, repairing large surgical defects, hypodense at CT and hyperintense at MRI, with no post-contrast enhancement. The appearance of revascularized flaps at CT and MRI depends on the characteristics of the structure used to repair the surgical defect: jejunal and radial flaps appeared as mostly fatty thickened layers with both imaging ...
To illustrate frequently encountered anatomic variations on PNS computed tomography(CT) and to assess their clinical significance. CT findings of 1523 patients, who underwent PNS CT with no history of sinus surgery, were reviewed, and prevalence of each anatomic variation and its relationship with mucociliary clearance pathway was evaluated. Two categories of anatomic variations were encountered. The first group included variations of the turbinates, such as concha bullosa(28.6%), paradoxical middle turbinate(31.5%), of the uncinate process, such as medially bent or folded(36.3%), laterally bent(3.7%) or uncinate bulla(0.5%), of the ethmoidal sinus, such as Haller's cell(28.2%), large agger nasi cell(9.6%) or large ethmoidal bulla(23.5%) and nasal septal deviation(24.1%), which might cause obstruction of mucociliary clearance pathway and thus give rise to secondary obstructive sinusitis. The second group included Onodi cell(1.4%) and medial depression of ...
To illustrate frequently encountered anatomic variations on PNS computed tomography(CT) and to assess their clinical significance. CT findings of 1523 patients, who underwent PNS CT with no history of sinus surgery, were reviewed, and prevalence of each anatomic variation and its relationship with mucociliary clearance pathway was evaluated. Two categories of anatomic variations were encountered. The first group included variations of the turbinates, such as concha bullosa(28.6%), paradoxical middle turbinate(31.5%), of the uncinate process, such as medially bent or folded(36.3%), laterally bent(3.7%) or uncinate bulla(0.5%), of the ethmoidal sinus, such as Haller's cell(28.2%), large agger nasi cell(9.6%) or large ethmoidal bulla(23.5%) and nasal septal deviation(24.1%), which might cause obstruction of mucociliary clearance pathway and thus give rise to secondary obstructive sinusitis. The second group included Onodi cell(1.4%) and medial depression of the lamina ...
Total 125 patients with primary and metastatic Ewing's sarcoma were treated in various ways between 1963 to 1977. Patients were divided into 3 groups according to the treatment methods. Group 1 was nonprotocol patients with or without chemotherapy. Total 58 patients were entered. Group 1 was divided into 2 subgroups. 33 patients were treated locally without chemotherapy and 25 patients were treated with local therapy and nonprotocol chemotherapy. Group 2 was treated with local therapy and plus T-2 regimen multiagent chemotherapy. 29 patients were entered. Group 3 was treated with local therapy and T-6 regimen multiagent chemotherapy. 38 patients were entered. Local treatments for primary tumor were surgery and/or radiation therapy. Radiation dose ranged between 2,000 and 8,000 rad. Patients with pulmonary metastases received bilateral pulmonary RT. Local recurrence rate was analyzed according to treatment groups and was 16.8%. Total 15 yr survival was 33% and 8 yr ...
A large proportion of patients may develop chronic pain following cancer treatments such as surgery, radiotherapy, or chemotherapy. These patients can experience significant levels of physical and psychological morbidity. Our aim was to investigate a cognitive-behavioral pain management program (PMP) for cancer patients with chronic treatment-related pain. Thirteen patients (1 man, 12 women; mean age 52 yrs) completed the study, 9 of whom had a history of breast cancer and had received extensive medical treatment, including surgery. A combination of physical and psychological techniques were adapted from previous work in chronic benign pain and implemented by two therapists. Interventions included education, relaxation, exercise training, and goal setting. A variety of outcomes were examined to assess general fitness, psychological distress, coping success, activities of daily living, and pain report. The median number of interventions by each ...
An increase in forest production will be necessary in the future when wood becomes a major renewable source of energy and chemicals along with its traditional role of fibre source. This increase could eventually by achieved be proper selection and breeding of trees. Clonal forestry by vegetative propagation of cuttings is becoming a viable alternative to a seedling-based forestry with many advantages, and cutting could be used to quickly propagate large numbers of clones of control-pollinated seedlings. Most forest trees are propagated sexually and seed orchards were started in the US and Canada in the last 40-50 years for breeding purposes. Forests could ultimately be established with improved seedlings instead of from seed with unknown genetic potential, or by natural regeneration. Micropropagation is the term used to refer to the propagation of plants raised by tissue culture methods rather than from seeds or cuttings. Many clonal plantlets could be regenerated asexually in the ...
The purpose of this study is to evaluate the therapeutic efficacy of the liposome encaged with vinorelbine (VNB) and "1"1"1In-oxine on human colorectal adenocarcinoma (HT-29) using HT-29/luc mouse xenografts. HT-29 cells stably transfected with plasmid vectors containing luciferase gene (luc) were transplanted subcutaneously into the male NOD/SCID mice. Biodistribution of the drug was performed when tumor size reached 500-600 mm"3. The uptakes of "1"1"1In-VNB-liposome in tumor and normal tissues/organs at various time points postinjection were assayed. Multimodalities, including gamma scintigraphy, bioluminescence imaging (BLI) and whole-body autoradiography (WBAR), were applied for evaluating the therapeutic efficacy when tumor size was about 100 mm"3. The tumor/blood ratios of "1"1"1In-VNB-liposome were 0.044, 0.058, 2.690, 20.628 and 24.327, respectively, at 1, 4, 24, 48 and 72 h postinjection. Gamma scinitigraphy showed that the tumor/muscle ratios were 2.04, ...
Understanding prostate stem cells may provide insight into the origin of prostate cancer. Primary cells have been cultured from human prostate tissue but they usually survive only 15-20 population doublings before undergoing senescence. We report here that RC-170N/h/clone 7 cells, a clonal cell line from hTERT-immortalized primary non-malignant tissue-derived human prostate epithelial cell line (RC170N/h), retain multipotent stem cell properties. The RC-170N/h/clone 7 cells expressed a human embryonic stem cell marker, Oct-4, and potential prostate epithelial stem cell markers, CD133, integrin #alpha#2#beta#1"h"i and CD44. The RC-170N/h/clone 7 cells proliferated in KGM and Dulbecco's Modified Eagle Medium with 10% fetal bovine serum and 5 #mu#g/ml insulin (DMEM + 10% FBS + Ins.) medium, and differentiated into epithelial stem cells that expressed epithelial cell markers, including CK5/14, CD44, p63 and cytokeratin 18 (CK18); as well as the mesenchymal cell markers, vimentin, desmin; ...
In the use of doxorubicin and radiation for treatment of human malignant tumors in vivo, the relationship between treatment-induced apoptosis and Ki-67 labeling index was investigated. Four human tumor xenografts (ependymoblastoma, NNE; primitive neuroectodermal tumor, YKP; small cell lung carcinoma, GLS; glioblastoma, KYG) were transplanted under the skin of thigh of the nude mice (BALB/cA JcL-nu). The mice were given a single radiation dose of 1 Gy, or doxorubicin alone intraperitoneally at a dose of 8 mg/kg. After treatment, sections of tumor specimens were prepared from paraffin-embedded tissues. Hematoxylin and eosin staining, TUNEL staining, and immunohistochemical analysis of Ki-67 were performed. In NNE, apoptotic cells appeared most frequently after treatment compared with all other tumors, and the incidence of apoptosis in the radiation-treated group was much higher than in the doxorubicintreated group. As the incidence of apoptosis in NNE increased, the ...
Full text: The general population is daily exposed to chronic, low doses of ionizing radiation (IR) from both natural and artificial sources. The biological consequences of acute, high dose IR exposure can be readily determined; however, the nature and significance of low dose, low dose-rate IR effects are still the subject of debate. Confounding the issue, are the phenomena collectively referred to as the Radiation-induced Bystander Effect (RIBE). The RIBE describes a collection of in vitro observations that suggest the presence of a soluble, transmissible factor(s) released from irradiated cells that can induce a biological response in un-irradiated cells. The induction, nature and magnitude of the RIBE varies between cell culture systems, radiation sources and end-points measured. Efforts to confirm the presence of the RIBE in vivo have been confined to in vivo-like culture systems and limited work with tumour and bone-marrow transplantation models. Validation ...
Recently the association of a rare disease named ''nephrogenic systemic fibrosis'' (NSF) with the administration of gadolinium-containing contrast media, especially gadodiamide (Omniscan, GE-Healthcare), was described. NSF is a scleroderma-like disease characterised by widespread tissue fibrosis. Until now, NSF cases were observed only in patients with kidney disease. Almost all patients were suffering from chronic renal insufficiency, 90 % of them required renal replacement therapy. The true incidence of the disease is unknown. First retrospective analyses of selected collectives of patients with end-stage renal disease showed 2 - 5 % cases of NSF after administration of Gadolinium-containing contrast agents with an odds ratio of 20 - 50 in comparison to non-exposed controls. NSF is a serious adverse reaction, which may result in severe disabilities and even death. Therefore all radiologists applying gadolinium-based contrast agents should be ...
(Materials and Methods) (I) VX/sub 2/ carcinoma was transplanted to the rabbit tibia, sup(99m)Tc-MDP was intravenously injected when bone destruction was radiologically seen. Preoperative scintigraphs, postoperative one of the resected tibia and fibra and scintigraphs of sliced tumor were compared with each other. Tissue fragments were collected from the sliced tumor, and RI was measured to compare concentration rates at different parts together with histological investigations. (II) Tetracycline was given to the rabbit of Experiment (I) to compare with the concentration of sup(99m)Tc-MDP. (III) Microautoradiography method was done on the experimental animals for investigation of the concentration of sup(99m)Tc-MDP. (Results) (I) Localization of sup(99m)Tc-MDP was increased at the sites of tumorous bone formation, of reactive bone formation at tumor edges, and of cartilage calcification, with little concentration at tumor cells or necrotic tissue. (II) Deposition ...
Tc-MDP 10mCi was intravenously given preoperatively to 20 patients with primary bone tumors and 1 with a metastatic bone tumor. Preoperative and postoperative scintigraphs of resected tumor and scintigraphs of sliced tumor were compared. Tissue fragments were collected from the sliced tumor, and RI measured to compare concentration rates at different areas. Histological investigations were also done. Localization of Tc-MDP was increased at sites of tumorous bone formation, of reactive bone formation at tumor edges, and of cartilage calcification, with little concentration at tumor cells or necrotic tissue. VX/sub 2/ carcinoma was transplanted into the rabbit tibia, Tc-MDP was intravenously injected when bone destruction was radiologically evident, and investigations were done as in the clinical cases. In experimental bone tumor, increased uptake localization of Tc-MDP was much the same as in clinical cases. Tetracycline was given to the rabbit of Experiment to ...
Background: In the German CESS-studies, Ewing's sarcoma patients with pulmonary metastases at diagnosis were considered as candidates for additional bilateral lung irradiation. We have retrospectively analyzed the impact of radiotherapy on survival. Material and methods: Out of 42 patients presenting with pulmonary metastases of Ewing's sarcoma between 1981 and June 1992, 30 were evaluable. One patient died of progressive disease prior to lung irradiation. The other patients had a complete radiographic remission either after chemotherapy (n=25) or chemotherapy plus resection of lung metastases (n=4). 22 patients received bilateral lung irradiation with doses of 12 to 21 Gy (once daily 1.5 Gy or twice daily 1.25 Gy), six had no further treatment and one had bone marrow transplantation for consolidation. Results: Ten patients are in complete remission, nine of them had received lung irradiation and one had a complete resection of three lung metastases. Two patients ...
Patients with Ewing's sarcoma who present with a central axis or proximal extremity primary and/or with metastatic disease have a poor prognosis despite aggressive combination chemotherapy and local irradiation. In this high risk group of patients, total body irradiation (TBI) has been proposed as a systemic adjuvant. To aid in the design of a clinical TBI protocol, the authors have studied in the in vitro radiation response of two established cell lines of Ewing's sarcoma and human bone marrow CFUc. The Ewing's lines showed a larger D_0 and anti-n compared to the bone marrow CFU. No repair of potentially lethal radiation damage (PLDR) was found after 4.5 Gy in plateau phase Ewing's sarcoma cells. A theoretical split dose survival curve for both the Ewing's sarcoma lines and human bone marrow CFUc using this TBI schedule shows a significantly lower surviving fraction (10"-"4-10"-"5) for the bone marrow CFUc. Based on these in vitro results, two 4.0 Gy fractions separated by 24 hours is ...
Changes in the phosphate metabolism of the transplanted SCCVII (squamous cell carcinoma VII) tumor were studied before and after irradiation using in vivo [sup 31]P-magnetic resonance spectroscopy (MRS). Phosphocreatine (PCr), [gamma]-, [alpha]-, [beta]-ATP, inorganic phosphate (Pi), phosphomonoester (PME), and phosphodiester (PDE) were detected in [sup 31]P-MR spectra of tumor tissues. The curve fitting method was employed for calculating each peak of [sup 31]P-MR spectra (PCr, [beta]-ATP, Pi, PME, PDE). The values of PCr, PCr/Pi, [beta]-ATP/Pi and pH decreased in proportion to the growth of tumor, whereas that of Pi, PME and PDE increased. But the changes of [beta]-ATP were minimal in degree. Based on the fact that the ratio of PCr/Pi highly correlated with tumor volume and showed the most remarkable change among various parameters, it might be the useful index for the tumor growth. Because the phospholipid metabolite PME was detected in the earlier stage of ...
Radiation chimeras in the early phase after bone marrow transplantation are a good model to study the efficiency of the body's nonspecific defense system represented by macrophages (M phi), polymorphonuclear cells (PMN), and NK cells. These cell types are present in large numbers in spleen and liver at that time, whereas the specific immune system represented by T and B cells is functionally deficient. We previously reported enhanced activities in vitro of M phi (and PMN) from recipient animals in an early phase after allogeneic bone marrow transfer. We here demonstrate that these activities result in enhanced spontaneous resistance against Listeria monocytogenes in vivo: CFU of L. monocytogenes in spleen and liver 48 h after infection were about 1 or 2 to 4 log steps less than in untreated control mice of donor or host haplotype. This enhanced resistance decreased over the 4-mo period after marrow transfer. Preactivated M phi were identified as the most important ...
Autoreactive cytotoxic CD8 T-cells (CTLs) play a key pathogenic role in the destruction of insulin-producing beta-cells resulting in type 1 diabetes. However, knowledge regarding their targets is limited, restricting the ability to monitor the course of the disease and immune interventions. In a multi-step discovery process to identify novel CTL epitopes in human preproinsulin (PPI), PPI was digested with purified human proteasomes, and resulting COOH-fragments aligned with algorithm-predicted HLA-binding peptides to yield nine potential HLA-A1, -A2, -A3 or -B7-restricted candidates. An UV-exchange method allowed the generation of a repertoire of multimers including low-affinity HLA-binding peptides. These were labeled with quantum dot-fluorochromes and encoded in a combinatorial fashion, allowing parallel and sensitive detection of specific, low-avidity T-cells. Significantly increased frequencies of T-cells against four novel PPI epitopes (PPI(4-13)/B7, PPI(29-38)/A2, PPI(76-84)/A3 ...
Colorectal carcinoma is a highly prevalent and common cause of cancer in Taiwan. There is still no available cure for this malignant disease. To address this issue, we applied the multimodality of molecular imaging to explore the efficacy of diagnostic and therapeutic nanoradiopharmaceuticals in an animal model of human colorectal adenocarcinoma [colorectal cancer (CRC)] that stably expresses luciferase (luc) as a reporter. In this study, an in vivo therapeutic efficacy evaluation of dual-nanoliposome (100 nm in diameter) encaged vinorelbine (VNB) and "1"1"1In-oxine on HT-29/luc mouse xenografts was carried out. HT-29/luc tumor cells were transplanted subcutaneously into male SCID mice. Multimodality of molecular imaging approaches including bioluminescence imaging (BLI), gamma scintigraphy, whole-body autoradiography (WBAR) and in vivo tumor growth tracing, histopathology and biochemistry/hematology analyses were applied on xenografted SCID mice to study the ...
PURPOSE OF REVIEW: To review the recent literature on the prognostic value of biomarkers of liver fibrosis and impaired liver function in patients with chronic hepatitis C with or without HIV coinfection. RECENT FINDINGS: A combination of standard blood tests seems to be useful in identifying patients at risk of liver-related complications. Findings from studies investigating the validity of the Model for End-Stage Liver Disease (MELD) score in HIV-infected liver transplant candidates are conflicting. Two large studies of HIV/hepatitis C virus (HCV) coinfected patients have shown that plasma levels of the fibrosis marker hyaluronic acid are a strong predictor of clinical complications. A smaller study found hyaluronic acid and two other fibrosis tests, aspartate aminotransferase-to-platelet ratio index (APRI) and Fib-4, to be independent predictors of mortality when included in models with the MELD or the Child-Pugh-Turcotte scores. SUMMARY: Although the data are ...
Glioblastoma multiforme is the most aggressive form of human brain tumor, which has no effective cure. Previously, we have demonstrated that overexpression of the C-terminal fragment of the human telomerase reverse transcriptase (hTERTC27) inhibits the growth and tumorigenicity of human cervical cancer HeLa cells. In this study, the therapeutic effect and molecular mechanisms of hTERTC27-mediated cancer gene therapy were further explored in vivo in established human glioblastoma xenografts in nude mice. We showed that intratumoral injection of adeno-associated virus carrying hTERTC27 (rAAV-hTERTC27) is highly effective in reducing the growth of the subcutaneously transplanted glioblastoma tumors. Histological analyses showed that rAAV-hTERTC27 treatment leads to profound necrosis, apoptosis, infiltration of polymorphonuclear neutrophils and reduced microvessel density in the tumor samples. To study the molecular mechanism of rAAV-hTERTC27-mediated antitumor ...
The family of natriuretic peptides consists of the atria natriuretic peptide (ANP), the cerebral natriuretic peptide (BNP), the type C natriuretic peptide (CNP) and the peptide isolated from the dendroaspis snakes' poison (DNP), whose presence in humans has not been confirmed. The physiological function of ANP is in the control of arterial blood pressure by regulation of systemic vascular resistance of blood vessels. BNP is produced as one of the factors in the acute response to inflammatory tissue damage, mainly in coronary vessels. Increased serum concentrations of natriuretic peptides have been found in stress situations, such as trauma or major surgery, systemic hypotension, and in intrinsic myocardial dysfunction. High concentrations of natriuretic peptides were observed in severe sepsis, septic shock and in multiple organ failure, probably due to increased secretion by mediators of the inflammatory process.The highest concentrations of ANP and BNP were found ...
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 ...
Tetracycline is an antibiotic that absorbs ultraviolet light at 355 nm and preferentially binds to atherosclerotic plaque both in vitro and in vivo. Tetracycline-treated human cadaveric aorta was compared with untreated aorta using several techniques: absorptive spectrophotometry; and tissue uptake of radiolabeled tetracycline, which showed 4-fold greater uptake by atheroma than by normal vessel. In addition, intravenous tetracycline administered to patients undergoing vascular surgery demonstrated characteristic fluorescence in surgically excised diseased arteries. Because of tetracycline's unique properties, the authors exposed tetracycline-treated and untreated aorta to ultraviolet laser radiation at a wavelength of 355 nm. They found enhanced ablation of tetracycline-treated atheroma compared with untreated atheroma. The plaque ablation caused by ultraviolet laser radiation was twice as extensive in tetracycline-treated vs nontreated plaque. This study ...
Purpose: to evaluate the efficacy and advantages of the snare systems in the retrieval of foreign bodies from vascular system. Materials and methods: the snare technique has been used for intravascular foreign body retrieval. We performed percutaneous extraction of intravascular foreign bodies using combination multipurpose catheters and a nitinol snare loop. In this report, we evaluated the patients who had performed endovascular device reposition or foreign body retrieval from 1998 to 2001. Results: foreign body retrieval was performed in 15 patients. The foreign bodies consisted of seven fractured port catheters, one sheath fragment, one embolization coil, four wire fragments, one pace-maker transducer and one dislocated endovascular stent. In no case were surgical procedures required, and no complications were encountered. Conclusion: the snare technique is a useful and a safe method as an alternative procedure to surgery. This technique is highly effective ...
Severe damage to the pelvic viscera is a complication of irradiation therapy that, unfortunately, cannot always be avoided. Resulting rectal and rectocolonic strictures, rectovaginal fistulas, and shortening and stenosis of the vagina present very difficult problems that frequently require a colostomy for relief and may permanently impair sexual function. The authors present a new approach to correction of these unfortunate lesions based on the use of proximal nonirradiated colon which serves as a vascular pedicle graft to correct the defect without a complicated and massive resection. Twenty-two such operations have been done with 19 satisfactory to excellent results and two total failures (one death from small bowel complications). All patterns and combinations of irradiation injury have been found amenable to this technique of repair. These have included both web and linear strictures with and without fistulas. In half of the patients, it was possible to make use of normal colon ...
Seventeen eyes of patients who were being followed by their ophthalmologists for aphakic (8 eyes) or pseudophakic (9 eyes) cystoid macular edema (CME) were examined on referral. All eyes showed retinal detachment (RD), and eight eyes had CME with RD. Most RDs were inferior and shallow. Proliferative vitreoretinopathy (PVR) was noted in 15 eyes (88.2%). There was history of vitreous loss during the last intraocular surgery in 88.2% eyes. Visual acuity ranged from 20/40 to hand movements. Fundus view was hazy in most eyes, and indirect ophthalmoscopy was most useful in detecting RD. Retinal reattachment with scleral buckling and/or vitrectomy was achieved in 16 eyes (94.1%). Postoperative visual recovery was jeopardized due to longstanding macular detachment of greater than 1 month in 11 eyes (64.7%). Eight eyes (47%) achieved 20/50 vision whereas 25% did not improve to better than 20/400. Factors leading to failure in making the correct diagnosis and their ...
Gonadal function was studied in two groups of children previously treated for medulloblastoma with surgery followed by postoperative craniospinal irradiation. In group 1 but not in group 2, the children also received adjuvant chemotherapy for one to two years. All children in group 1 received a nitrosourea (BCNU or CCNU), plus vincristine in four and procarbazine in three patients. The nine children in group 1 showed clinical and biochemical evidence of gonadal damage with elevated serum FSH concentrations and, in the boys, small testes for their stage of pubertal development. In group 2 (n . 8), each child had completed pubertal development normally, the boys had adult sized testes and the girls regular menses. Gonadotropin values were normal in all eight children. We conclude that nitrosoureas were responsible for the gonadal damage in the children in group 1, with procarbazine also contributing to the damage in the three children who received this drug. In view ...
The anatomical patterns of anorectal malformations have so far been studied according to the principles which inspire Pena's technique for the surgical treatment of anorectal anomalies. Thus, the diagnostic study of anorectal malformation has by the authors been considered a work of classification, but of identification. Among the diagnostic procedures in use in author's Institute, preoperative CT of pelvis is performed to assess the presence and to define the development of muscular sphincteric structure towards prognostic evaluation of continence, the major long-term goal. Seven patients, aged 1-30 months, with anorectal anomalies were studied with preoperative CT of the pelvis. CT scans showed well-developed sphinteric muscles in 3 patients (2 with recto-ureteral and 1 with recto-vestibular fistulas), poorly-developed muscular structure in 3 patients (with recto-vaginal, cloacal and prostatic fistulas), absence of muscular structure in 1 case (with recto-vesical fistula). CT ...
The Zollinger-Ellison syndrome (ZES) is taken as an example of the diagnostic and therapeutic strategy in gastro-entero-pancreatic endocrine tumours, given the standard characteristics of this procedure, whatever the nature of the primitive tumour. Management of ZES includes: anatomical localization of gastrinoma and of possible metastases, in 60 % of cases this step conditioning therapeutic indications and chances of cure; search of a type 1-multiple endocrine neoplasia (MEN A), in 25 % of cases; therapeutic indications: ablative surgery with curative intent in case of gastrinoma and of resectable liver metastases, palliative treatment otherwise: anti-secretory drugs, somatostatin analogues, chemotherapy and interferon {alpha}; long-term follow-up of patients with resected tumour. At each step, somatostatin receptor scintigraphy with indium 111-pentetreotide does play a pivotal role. (author). 110 refs.
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 MRI can be applied to ...
A new miniature high-frequency (HF) plasma source intended for bio-medical applications is studied using nitrogen/oxygen mixture at atmospheric pressure. This plasma source can be used as an element of a plasma source array for applications in dermatology and surgery. Nitric oxide and ozone which are produced in this plasma source are well-known agents for proliferation of the cells, inhalation therapy for newborn infants, disinfection of wounds and blood ozonation. Using optical emission spectroscopy, microphotography and numerical simulation, the gas temperature in the active plasma region and plasma parameters (electron density and electron distribution function) are determined for varied nitrogen/oxygen flows. The influence of the gas flows on the plasma conditions is studied. Ozone and nitric oxide concentrations in the effluent of the plasma source are measured using absorption spectroscopy and electro-chemical NO-detector at variable gas flows. Correlations ...
Purpose To analyze the clinical profile, management and outcome of non-hematological tumors in head and neck region in children less than 18?years of age. Patients and methods Medical records of patients (0?18?years) presenting with non-hematological tumors of head and neck region from 2000 to 2010 were reviewed. Result Out of the 78 patients identified, 50 were males with median age of 14?years (3?months to 18?years). Histologically, 58 out of the 78 patients had malignant tumors and 20 were metastatic at presentation. Common site of tumor origin was noted as thyroid (23/78), salivary glands (21/78) and nasopharynx (13/78). Out of 78 patients, 44 patients were treated by surgery, 26 patients received radiation and 13 patients received chemotherapy, while 9 patients received radio-iodine (...
Bone metastases at the thoracic and lumbar segment of the spine are usually presented with painful sensation and medullar compression. The treatment is based on the clinical and neurological conditions of the patient and the degree of tumor invasion. In the present study, 32 patients with spinal metastasis of thoracic and lumbar segment were prospectively analyzed. These patients were treated by decompression and internal stabilization followed by radiotherapy or irradiation with external immobilization. The election of the groups was in accordance with the tumor radiotherapy sensitivity, clinical conditions, spinal stability, medullar or nerve compression and patient's decision. The Frankel scale and pain visual test were applied at the moment of diagnosis and after 1 and 6 months. The surgical group had better results with preserving the ambulation longer and significant reduction of pain.(author)
MRT criteria have been developed to distinguish between tumour and implant material following examination of 50 patients who had transsphenoidal hypophysectomies for tumours. Judgements were based on the postoperative hormonal status and the operation notes. Following contrast injection of Gd-DTPA and using T[sub 1] weighted spin-echo sequences, implant material appeared as sandwich-like, linear or circular structures. Residual recurrent tumour produced homogenous or non-homogenous aspects without marginal enhancement in 84% of cases. Postoperative displacement of the infundibulum to the opposite side was observed in 73% of patients with tumour remnants. Sensitivity of MRT was 70%, specificity 95%. There was a positive predictive value of 94% and a negative predictive value of 72% with an accuracy of 81%. This provides assistance in differentiating between tumour remnants and implant material. MRT is recommended as a method of examination for hypophyseal tumours to evaluate the success ...
MRT criteria have been developed to distinguish between tumour and implant material following examination of 50 patients who had transsphenoidal hypophysectomies for tumours. Judgements were based on the postoperative hormonal status and the operation notes. Following contrast injection of Gd-DTPA and using T_1 weighted spin-echo sequences, implant material appeared as sandwich-like, linear or circular structures. Residual recurrent tumour produced homogenous or non-homogenous aspects without marginal enhancement in 84% of cases. Postoperative displacement of the infundibulum to the opposite side was observed in 73% of patients with tumour remnants. Sensitivity of MRT was 70%, specificity 95%. There was a positive predictive value of 94% and a negative predictive value of 72% with an accuracy of 81%. This provides assistance in differentiating between tumour remnants and implant material. MRT is recommended as a method of examination for hypophyseal tumours to evaluate the success of ...
Purpose: To determine the value of MRI in the preoperative evaluation of chronic paranasal sinusitis and to compare the results with CT and intraoperative findings. Method/Materials: 42 patients with clinical signs of chronic paranasal sinusitis underwent MRI after CT evaluation on one day, with subsequent functional endoscopic sinus surgery on the next day. Coronary CT was obtained with 5-mm slices and table-feed in the prone position, while MRI was performed in the supine position with coronary T_2-TSE+pd and coronary and transverse HASTE, each with 5-mm slice thickness. Aquisition time in MRI was less than 8 minutes. Two radiologists reviewed the CT and MRI scans for signs of sinusitis and detection of anatomical landmarks. The results were correlated with the intraoperative findings. Results: MRI offered no artifacts of dental work and showed more often high quality pictures than CT. CT and MRI demonstrated a good correlation in the detection of mucosal ...
Penile rehabilitation has been an area of intense study and debate over the last decade. Interest in this topic was stimulated by the observation that erectile dysfunction remained a significant problem after radical prostatectomy despite meticulous nerve-sparing technique. Smooth muscle alterations and fibrotic changes in the penis were identified as the underlying causes of penile atrophy, veno-occlusive dysfunction, and Peyronie's-like changes that were observed after surgery. Initial observations that intracavernous injection therapies used on a regular basis postoperatively resulted in improvements in the return of spontaneous erectile function led to the development of penile rehabilitation protocols. Chronic dosing of oral type V phosphodiesterase inhibitors is now commonly used by urologists after radical prostatectomy despite a lack of convincing evidence from randomized, placebo-controlled clinical trials. Use of local therapies to heal the penis may have ...
In 1981, the German Society of Pediatric Oncology initiated a multi-institutional study for the treatment of Ewing's sarcoma. The protocol (Cooperative Ewing's Sarcoma Study, CESS 81) consisted of four courses of a four-drug-regimen (VACA), each course taking nine weeks. Local therapy (radical surgery or resection plus irradiation or radiotherapy alone) was performed after the second course. The results of CESS 81 can be summarized as follows: VACA-chemotherapy is effective in controlling systemic disease. Initial tumor mass and response to initial chemotherapy are of major prognostic value for local control and survival. Permanent local control is a problem, especially in irradiated patients. The high local failure rate in irradiated patients in CESS 81 could be attributable to the following reasons: Late start of local therapy (after 18 weeks of chemotherapy), uneven distribution of prognostic parameters: Large tumors were more often irradiated than operated, ...
Correct ortopedic therapy for traumas of the cervical rachis requires perfect knowledge of the spatial balance of the fracture focus. The authors belive Computed Tomography (CT) to be the most suitable, and often indispensable, method for this purpose. Twenty-four patients were examined for traumatic pathology of the cervical rachis. In 7 cases with clinically minor traumas, the negative outcome of the traditional traumas, the negative outcome of the traditional exam was considered reliable and sufficient for therapeutic purposes. The extant 17 patients were examined also by means of CT, either to better dermine the characteristics of skeletal lesions already ascertained with traditional techniques or to asses the presence of clinically-suspected osteo-articular lesions, even with negative conventional X-rays. For 9 of these patients orthopedic treatment was considered sufficient, whereas 8 patients underwent surgery and were subsequently examined with CT, which ...
Efficient and precise ablation of soft tissue is needed for non-invasive dermatological and corneal surgeries. Previous research has revealed that smooth and efficient cutting of certain soft tissues and gelatin is possible using a Free Electron Laser (FEL) with a wavelength of #lambda#=6.45 #mu#m, tuned to the amide-II band of protein. Gelatin ablation experiments have been carried out using a mid-infrared FEL within the waveband #lambda#=5.6-6.7 #mu#m by changing the primary absorbers such as water (#lambda#=6.1 #mu#m) and protein (#lambda#=6.45 #mu#m). The gelatin with 80 wt% water was efficiently ablated by FEL irradiation with the waveband #lambda#=#approx#5.95-6.19 #mu#m. On the other hand, using irradiation within #lambda#=#approx#6.4-6.6 #mu#m, many small bubbles were observed in the irradiated volume, and the gelatin was not ablated but significantly melted. Thus, it was found that the most effective wavelength was #approx#6.1 #mu#m, not #approx#6.45 ...
To analyze and review the most common focal lesions of the external auditory canal (EAC), describing the computed tomography (CT) findings. The CT images of EAC were reviewed in a series of 167 patients. Abnormal findings were recorded in 13 cases. The CT images were correlated with otoscopic and/or intraoperative findings. There were four cases of osteoma (one located outside the EAC); all of which were treated surgically, as was the one case of exostosis. Six patients presented debris in EAC, coinciding with clinical evidence of external otitis. There were two cholesteatomas derived from EAC, one of them secondary to survery to treat osteoma. On patient was diagnosed as having a basal cell carcinoma of the ear, extending to EAC, but refused to undergo surgery. Five patients presented small triangular laminae of dense bone arising from the upper wall of the EAC which were defined as abnormal variants of the fusion of the temporal squamous epithelium to the ...
This study concerns our experiences with abdominal gamma imaging using Tc-99m colloid and with abdominal angiography using Tc-99m-pyrophosphate labelled erythrocytes ''in vivo'' based on the modified technique described by Callahan. The dynamic or perfusion phase was first performed, then the static phase during which for the first two hours scans were taken every 15 minutes and thereafter every 4-6 hours. The routine image corresponds to the first, although it was necessary at times to take oblique projections. The study was felt to be accomplished after 48 hours upon observing no extravasation of radioactive material in the abdominal region, or upon detecting a bleeding site. The investigation was performed on 11 patients, 8 having positive scans of abdominal extravasation, later confirmed in 6 by endoscopy and by surgery. In 2, the presence of salmonelosis was shown by laboratory analysis. Endoscopy and angiography XR are both invasor methods. Various authors ...
The purpose of this study was to determine the feasibility of virtual endoscopy, named as ''virtual CT laparoscopy'', in the hepatobiliary system prior to laparoscopic cholecystectomy. We applied this technique to 28 patients suspected of having biliary disease. These images were compared and analyzed qualitatively based on visualization of the structures critical to operative cholangiography and surgical findings. Twenty-four patients, who underwent laparoscopic cholecystectomy, were evaluated as follows: the common bile duct and the hepatic duct were adequately visualized in 23 (96%) of the 24 patients, the cystic duct in 21 (88%), the gallbladder opacification in 20 (83%), the liver inferior surface in 20 (83%). Four patients had anatomic variations detected virtual CT laparoscopy and were proven by operative cholangiography and surgical findings. We emphasize that our new technique may contribute to the laparoscopy during ...
Objective: To investigate the value of MRI in the diagnosis of hepatic hilar cholangiocarcinoma. Methods: Sixty-four patients with hepatic hilar cholangiocarcinomas confirmed by surgery or pathology underwent MRI using a 1.5-T superconductive MR system including conventional unenhanced MRI, MRCP and dynamic contrast-enhanced MRI with Gd-DTPA. Results: Dilatation of the intrahepatic biliary tree with narrowing, occlusion or filling defects in the hepatic hilar bile ducts was noted in all 64 cases. Unenhanced MR[ showed T_1- and T_2-hyperintense hilar masses in 42 patients and was normal in the remaining 22 patients. The hilar masses demonstrated slow, progressive and delayed enhancement patterns. There was enhancement of the thickened bile duct wall with luminal narrowing in the 22 patients without hilar masses. Conclusion: The characteristic MRI findings of enhancing hepatic hilar mass and bile duct wall thickening together with MRCP are valuable for diagnosing ...
Introduction: There are many problems in the radiological diagnosis of aseptic loosening in total hip arthroplasty. Computed tomography (CT) and magnetic resonance tomography (MRT) are not usable for metallic implants (stainless steel, cobalt alloy, titanium alloy). Material and Methods: From April 1993 to December 1993 15 CFRP non-cemented hip prostheses have been implanted. In a prospective clinical study plane radiographs, CT and MRT have been analysed. Results: Three stems were revised (1 femoral fracture, 1 severe thigh pain, 1 aseptic loosening). CFRP are not visible in plane radiographs. There was a complete (two-third of the cases) or nearly complete (one-third of the cases) small sclerotic interface between the prosthesis and the bone, these were apparent in CT and MRT in stable implant cases and did not have any clinical correlations. Discussion: The small sclerotic interface is quite different in comparison to so called 'Reactive lines'. In one case of aseptic loosening ...
The purpose was to compare the findings of multi-detector computed tomography (MDCT) in prosthetic valve disorders using the operative findings as a gold standard. In a 3-year period, we prospectively enrolled 25 patients with 31 prosthetic heart valves. MDCT and transthoracic echocardiography (TTE) were done to evaluate pannus formation, prosthetic valve dysfunction, suture loosening (paravalvular leak) and pseudoaneurysm formation. Patients indicated for surgery received an operation within 1 week. The MDCT findings were compared with the operative findings. One patient with a Bjoerk-Shiley valve could not be evaluated by MDCT due to a severe beam-hardening artifact; thus, the exclusion rate for MDCT was 3.2% (1/31). Prosthetic valve disorders were suspected in 12 patients by either MDCT or TTE. Six patients received an operation that included three redo aortic valve replacements, two redo mitral replacements and one Amplatzer ductal occluder occlusion of a ...
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 ...
BACKGROUND AND PURPOSE Human K2P3.1 (TASK1) channels represent potential targets for pharmacological management of atrial fibrillation. K2P channels control excitability by stabilizing membrane potential and by expediting repolarization. In the heart, inhibition of K2P currents by class III antiarrhythmic drugs results in action potential prolongation and suppression of electrical automaticity. Carvedilol exerts antiarrhythmic activity and suppresses atrial fibrillation following cardiac surgery or cardioversion. The objective of this study was to investigate acute effects of carvedilol on human K2P3.1 (hK2P3.1) channels. EXPERIMENTAL APPROACH Two-electrode voltage clamp and whole-cell patch clamp electrophysiology was used to record hK2P3.1 currents from Xenopus oocytes, Chinese hamster o...
The authors present a comparison between the diagnostic accuracy of Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) in the articular pathologies of the knee. CT and MRI were performed in 30 patients who subsequently underwent surgery. CT and MRI results were compared on three bases: technique, definition of normal anatomy, and diagnostic accuracy. CT allowed a standardization of the technique, while MRI was superior in defining normal anatomy - especially in the study of capsulo-ligamentous structures. In all cases the use of both CT and MRI allowed a correct diagnosis, showing the site, extent and gravity of the lesion. CT proved to be superior to MRI in 4 cases, while MRI corrected CT diagnosis in 11 cases; in 15 patients both techniques had the same diagnostic accuracy. Meniscal tears were better identified by CT, while MRI was superior in the detection of ligamentous lesions and in the characterization of PVNS and tendinitis of the patellar ...
In cases of obstructive colorectal cancer (CRC), preoperative diagnosis of the proximal lesion is often difficult when the primary lesion impedes the passage of the endoscope. The aim of this study was to evaluate the usefulness of fluorine-18-fluorodeoxyglucose positron emission tomography (FDG-PET) in such cases. A total of 52 obstructive CRC patients who underwent preoperative FDG-PET and subsequent surgical resection were retrospectively reviewed. The correlation between characteristics of the proximal lesion and FDG-PET findings was analyzed statistically. There was a significant correlation between the proximal lesion size and the maximum standardized uptake value (P=0.00016). Abnormal FDG accumulation in the proximal colon indicated the existence of proximal cancer or adenoma with a sensitivity of 50% and a specificity of 100%. There was a significant difference in the distribution of tumor size between the cases with proximal abnormal accumulation and those with no proximal ...
Ewing's sarcoma classically presents as a hot spot on bone scan as a result of increased vascularity of the tumor and new bone formation. Purpose We report and analyze an uncommon pattern of a 'cold' lesion in Ewing's sarcoma on bone scan and its pathophysiologic significance. Case report A 15-year-old boy complaining of thigh pain. CT scan evoked Ewing's sarcoma or osteitis. MRI evoked chronic osteitis. Scintigraphy showed a fairly intense and heterogeneous uptake on the femoral lesion and no abnormal uptake elsewhere. Biopsy showed none pathologic pattern. Three months later, a second biopsy concluded to Ewing's sarcoma. Bone scan showed a larger lesion with peripheral intense uptake centered by enlarged 'cold' area in the left femoral diaphysis and no evident bone metastasis. The patient underwent chemotherapy and surgery. Three months later, bone scan showed extensive skeletal metastasis. Conclusion Ewing's sarcoma appears usually as an intense lesion on bone ...
Background: Some former retrospective studies have suggested that patients with Ewing's sarcoma might have a very high risk for developing secondary sarcomas if treated with radiotherapy. We have evaluated the risk of second malignancies (SM) in patients treated in the German Cooperative Ewing's Sarcoma Studies CESS 81 and CESS 86. Materials and methods: From January 1981 through June 1991, a total number of 674 patients was registered in the two multicentric Ewing's sarcoma trials CESS 81 (1981 through 1985) and CESS 86 (1986 through June 1991). The systemic treatment consisted in both studies of a four-drug-chemotherapy (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 was either complete surgery or surgery plus postoperative radiotherapy with 36-46Gy or ...
Purpose: Small suspicious breast lesions that are only visible at MR imaging were preoperatively marked with a hook wire under MR-guidance to allow the removal of the lesion with tissue-sparing surgery. Method: In all patients the suspicious lesions were marked preoperatively under MR guidance with a hook wire using a commercially available stereotactic device. Interventions were performed with MR guidance on a 1.0 T and on a 1.5 T system. Results: In 19 patients 22 lesions were localized. One lesion was missed and removed in a second procedure. The mean duration for localization was 66{+-}20 min (range 38-119 min). In two patients two lesions were localized. The mean deviation of the wire tip to the lesion was 2,0{+-}2,6 mm. In this series, 6 of 22 lesions were malignant. The mean diameter of the lesion was 7.6{+-}2.6 mm (range 3-14 mm). Conclusion: Suspicious breast lesions detectable only in MR imaging can be accurately localized with a hook wire preoperatively ...
In this article is reviewed the role of Computed Tomography (CT) in thoracic complications following ortho topic liver transplantation (OLT). In a post-OLT population of 567 patients transplanted in the Italian institutions, 100 patients (17.6%) were examined with chest CT. It was reviewed data relative to the total number of examinations, clinical and/or radiographic indications, the CT technique-i.e., conventional (with (out) intravenous, i.v., contrast material) or high-resolution (HRCT). It also reviewed the radiologic patterns and their correlation with the other clinical, bronchoscopic and/or laboratory results. Of 152 chest CT examinations, 45 (29.6%) were performed because of clinical indications, 31 (20.4%) because of a radiographic abnormality, 64 (42.1%) because of clinical and radiographic abnormality, 64 (42.1%) because of clinical and radiographic indications, while in 12 cases (7.9%) the reasons were unknown; 133/152 (87.5%) ...
Mucociliary transport so critical in nasal, paranasal sinus, and middle ear physiology is impaired in chronic sinsusitis and otitis media by factors such as increased mucus viscoelasticity, decreased ciliary area, and primary or secondary ciliary immotility. We reviewed the pathophysiology of primary ciliary dyskinesia, otitis media with effusion, chronic sinusitis, and allergic rhinitis in terms of mucociliary transport. Subjects with primary ciliary dyskinesia may experience recurrent middle ear infection, chronic airway infection, predominantly lower-lobe bronchiectasis, male sterility, or situs inversus. Primary ciliary dyskinesia is sometimes difficult to diagnose in cases without situs inversus. Nasal nitric oxide concentration in such patients decreases, although why is unclear. Mutations may involve dynein arm intermediate chain 1 (DNAI1) or dynein arm heavy chain 5 (DNAH5). Mucociliary clearance decreases more in those with otitis media with effusion than in those without, due ...
Background and Purpose: In an earlier phase II study, irradiation together with razoxane was shown to improve local control in recurrent rectal cancer. Therefore, the Austrian Society of Radiooncology (OeGRO) initiated a randomized controlled trial in 1992 to compare this combined treatment versus radiation therapy alone. Patients and Methods: Between 1992 and 1999, 36 patients with localized recurrences of rectal cancer were randomized to receive radiotherapy without (group A) or with razoxane (group B). The prognostic variables of the two groups were similar except for a longer median latency period from initial surgery to local recurrence in group A. High-energy photons with daily fractions between 170 and 200 cGy were used. The median total radiation dose was 60 Gy in each group. The patients in group B received a median razoxane dose of 9.6 g (range, 5-12 g). Main outcome measures were local control, overall survival, and toxicity. Results: The combined ...
Background and purpose: In order to investigate the feasibility, toxicity and antitumor efficacy of hyperfractionated radiation therapy, 37 adult patients with incompletely resected supratentorial low-grade glioma were entered into a phase II study. Materials and methods: The radiation therapy dose was 55 Gy in 50 fractions in 25 treatment days over 5 weeks to the tumor plus a 2-cm margin, with an additional 17.6 Gy given in 16 fractions in 8 treatment days over 1.5 weeks to the tumor plus a 1-cm margin, using 1.1 Gy b.i.d. fractionation with a 6 h interfraction interval. The total tumor dose was 72.6 Gy in 66 fractions in 33 treatment days over 6.5 weeks. Results: The median survival time (MST) for all 37 patients has not yet been attained, while 5- and 7-year survival rates were 75% and 69%, respectively. The median time to tumor progression (MTP) has also not yet been attained, while 5- and 7-year progression-free survival (PFS) rates were both 70%. There was no difference in ...
Objective: Solid pseudopapillary tumor of the pancreas (SPTP tumor) is a rare pancreatic neoplasm with low malignant potential, which usually affects female patients in the second or third decades of life. It is a non-functional, slow-growing neoplasm that very often reaches considerable size before the first symptoms appear. Symptomatology is frequently related to tumor size. Surgical excision is usually curative in most cases. Infrequently the tumor can appear in male patients or in aged women, which can make the diagnosis more difficult. Some patients develop liver metastases in the follow-up that can be resected. Our purpose is to review the radiological and pathological findings of SPTP with emphasis on these infrequent cases. Subjects and methods: The medical records and radiological findings of patients who underwent surgery for SPTP between 2000 and 2005 were retrospectively reviewed. Study eligibility required that patients had undergone surgical resection ...
Objective: Solid pseudopapillary tumor of the pancreas (SPTP tumor) is a rare pancreatic neoplasm with low malignant potential, which usually affects female patients in the second or third decades of life. It is a non-functional, slow-growing neoplasm that very often reaches considerable size before the first symptoms appear. Symptomatology is frequently related to tumor size. Surgical excision is usually curative in most cases. Infrequently the tumor can appear in male patients or in aged women, which can make the diagnosis more difficult. Some patients develop liver metastases in the follow-up that can be resected. Our purpose is to review the radiological and pathological findings of SPTP with emphasis on these infrequent cases. Subjects and methods: The medical records and radiological findings of patients who underwent surgery for SPTP between 2000 and 2005 were retrospectively reviewed. Study eligibility required that patients had undergone surgical resection ...
Cardiac Malposition refers to any position of the heart other than a left-sided heart in a situs solitus individual. Associated cardiac malformations are so complex that even angiocardiographic and autopsy studies may not afford an accurate information. Although the terms and classifications used to describe the internal cardiac anatomy and their arterial connections in cardiac malpositions differ and tend to be confusing, common agreement exists on the need for a segmental approach to diagnosis. Authors present 18 cases of cardiac malpositions in which cardiac catheterization and angiocardiography were done at the Department of Radiology, Seoul National University Hospital between 1971 and 1979. Authors analyzed the clinical, radiographic, operative and autopsy findings with the emphasis on the angiocardiographic findings. The results are as follows: 1. Among 18 cases with cardiac malpositions, 6 cases had dextrocardia with situs inversus, 9 cases had dextrocardia with situs solitus ...
Asymptomatic cholelithiasis is increasingly diagnosed today, mainly as a result of the widespread use of abdominal ultrasonography for the evaluation of patients for unrelated or vague abdominal complaints. About 10-20% of people in most western countries have gallstones, and among them 50-70% are asymptomatic at the time of diagnosis. Asymptomatic gallstone disease has a benign natural course; the progression of asymptomatic to symptomatic disease is relatively low, ranging from 10-25%. The majority of patients rarely develop gallstone-related complications without first having at least one episode of biliary pain ("colic"). In the prelaparoscopy era, (open) cholecystectomy was generally performed for symptomatic disease. The minimally invasive laparoscopic cholecystectomy refueled the discussion about the optimal management of asymptomatic cholelithiasis. Despite some controversy, most authors agree that the vast majority of subjects should be managed by observation alone (expectant ...