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Frontiers in Surgery

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https://www.readbyqxmd.com/read/28224127/early-diagnosis-and-surgical-treatment-for-necrotizing-fasciitis-a-multicenter-study
#1
Evangelos P Misiakos, George Bagias, Iordanis Papadopoulos, Nickolaos Danias, Paul Patapis, Nickolaos Machairas, Theodore Karatzas, Nickolaos Arkadopoulos, Konstantinos Toutouzas, Nickolaos Alexakis, Manousos N Konstantoulakis, George Zografos, Vasilis Smyrniotis, Gregory Kouraklis, Anastasios Machairas
BACKGROUND: Necrotizing fasciitis (NF) is a group of relatively rare infections, usually caused by two or more pathogens. It affects the skin and subcutaneous tissues of lower and upper limbs, perineal area (Fournier's gangrene), and the abdominal wall. Early diagnosis and aggressive surgical management are of high significance for the management of this potentially lethal disease. METHODS: We conducted a retrospective study in patients who presented, during the last decade, at four University Surgical Departments in the area of Athens, Greece, with an admission diagnosis of NF...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28217690/iatrogenic-acute-ascending-aortic-dissection-with-intramural-hematoma-during-coronary-artery-stenting-a-case-report
#2
Mohamad El-Haress, Hicham Daadaa, Shima Shahjouei, Firas El-Bitar, Hisham Bahmad
BACKGROUND: Iatrogenic acute ascending aortic dissection during percutaneous coronary intervention (PCI) is an exceptionally rare and life-threatening sequel that requires early and accurate diagnosis along with rapid management. No guidelines have yet been established to direct decisions on the different treatment options that can be employed in the setting of acute aortic dissections caused by PCI. However, similar cases have been treated either by intracoronary stenting and conservative management as in localized aortocoronary dissections or by surgical intervention in cases of extensive aortic dissections...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28197403/network-plasticity-and-intraoperative-mapping-for-personalized-multimodal-management-of-diffuse-low-grade-gliomas
#3
REVIEW
Cristina Diana Ghinda, Hugues Duffau
Gliomas are the most frequent primary brain tumors and include a variety of different histological tumor types and malignancy grades. Recent achievements in terms of molecular and imaging fields have created an unprecedented opportunity to perform a comprehensive interdisciplinary assessment of the glioma pathophysiology, with direct implications in terms of the medical and surgical treatment strategies available for patients. The current paradigm shift considers glioma management in a comprehensive perspective that takes into account the intricate connectivity of the cerebral networks...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28194399/the-role-of-permissive-and-induced-hypotension-in-current-neuroanesthesia-practice
#4
Suren Soghomonyan, Nicoleta Stoicea, Gurneet S Sandhu, Jeffrey J Pasternak, Sergio D Bergese
BACKGROUND: Induced hypotension (IH) had been used for decades in neurosurgery to reduce the risk for intraoperative blood loss and decrease blood replacement. More recently, this method fell out of favor because of concerns for cerebral and other end-organ ischemia and worse treatment outcomes. Other contributing factors to the decline in its popularity include improvements in microsurgical technique, widespread use of endovascular procedures, and advances in blood conservation and transfusion protocols...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28168190/granulocytic-sarcoma-presenting-as-a-palpable-breast-lump
#5
Victor Fernandes Vieira, Quoc Duy Vo, Jean Bouquet de la Jolinière, Fathi Khomsi, Anis Feki, Henri-Marcel Hoogewoud
We report the case of a 45-year-old woman who palpated a voluminous painless lump in the superior outer quadrant of her left breast. Her past medical history revealed an acute myeloid leukemia (AML) treated and considered in remission 1 month prior to this discovery. Imaging work-up by mammogram, US, and MRI showed multiples masses suspect of malignancy in both breasts. US-guided needle biopsy was performed in the palpable mass and in one of the multiple lesions located in the right breast. Histologic findings were compatible with a granulocytic sarcoma in both breasts, which was considered as a relapse of the AML treated a few months earlier...
2016: Frontiers in Surgery
https://www.readbyqxmd.com/read/28018904/3d-volumetric-modeling-and-microvascular-reconstruction-of-irradiated-lumbosacral-defects-after-oncologic-resection
#6
Emilio Garcia-Tutor, Marco Romeo, Michael P Chae, David J Hunter-Smith, Warren Matthew Rozen
BACKGROUND: Locoregional flaps are sufficient in most sacral reconstructions. However, large sacral defects due to malignancy necessitate a different reconstructive approach, with local flaps compromised by radiation and regional flaps inadequate for broad surface areas or substantial volume obliteration. In this report, we present our experience using free muscle transfer for volumetric reconstruction, in such cases, and demonstrate three-dimensional (3D) haptic models of the sacral defect to aid preoperative planning...
2016: Frontiers in Surgery
https://www.readbyqxmd.com/read/28018903/impact-of-lymph-node-burden-on-survival-of-high-risk-prostate-cancer-patients-following-radical-prostatectomy-and-pelvic-lymph-node-dissection
#7
Lisa Moris, Thomas Van den Broeck, Lorenzo Tosco, Anthony Van Baelen, Paolo Gontero, Robert Jeffrey Karnes, Wouter Everaerts, Maarten Albersen, Patrick J Bastian, Piotr Chlosta, Frank Claessens, Felix K Chun, Markus Graefen, Christian Gratzke, Burkhard Kneitz, Giansilvio Marchioro, Rafael Sanchez Salas, Bertrand Tombal, Henk Van Der Poel, Jochen Christoph Walz, Gert De Meerleer, Alberto Bossi, Karin Haustermans, Francesco Montorsi, Hendrik Van Poppel, Martin Spahn, Alberto Briganti, Steven Joniau
AIM: To determine the impact of the extent of lymph node invasion (LNI) on long-term oncological outcomes after radical prostatectomy (RP). MATERIAL AND METHODS: In this retrospective study, we examined the data of 1,249 high-risk, non-metastatic PCa patients treated with RP and pelvic lymph node dissection (PLND) between 1989 and 2011 at eight different tertiary institutions. We fitted univariate and multivariate Cox models to assess independent predictors of cancer-specific survival (CSS) and overall survival (OS)...
2016: Frontiers in Surgery
https://www.readbyqxmd.com/read/27995127/stereotactic-laser-ablation-for-medically-intractable-epilepsy-the-next-generation-of-minimally-invasive-epilepsy-surgery
#8
REVIEW
Michael J LaRiviere, Robert E Gross
Epilepsy is a common, disabling illness that is refractory to medical treatment in approximately one-third of patients, particularly among those with mesial temporal lobe epilepsy. While standard open mesial temporal resection is effective, achieving seizure freedom in most patients, efforts to develop safer, minimally invasive techniques have been underway for over half a century. Stereotactic ablative techniques, in particular, radiofrequency (RF) ablation, were first developed in the 1960s, with refinements in the 1990s with the advent of modern computed tomography and magnetic resonance-based imaging...
2016: Frontiers in Surgery
https://www.readbyqxmd.com/read/27921035/genetics-underlying-an-individualized-approach-to-adult-spinal-disorders
#9
REVIEW
Corey T Walker, Phillip A Bonney, Nikolay L Martirosyan, Nicholas Theodore
Adult spinal disorders are a significant cause of morbidity across the world and carry significant health and economic burdens. Genetic predispositions are increasingly considered for these conditions and are becoming understood. Advances in molecular technologies since the mid-1990s have made possible genetic characterizations of these diseases in many populations, and recent findings have provided insight into the underlying pathophysiologic mechanisms. These studies have made clear the genetic heterogeneity producing clinical phenotypes and suggest that individualized treatments are possible in the future...
2016: Frontiers in Surgery
https://www.readbyqxmd.com/read/27917384/genetic-alterations-in-intervertebral-disc-disease
#10
REVIEW
Nikolay L Martirosyan, Arpan A Patel, Alessandro Carotenuto, M Yashar S Kalani, Evgenii Belykh, Corey T Walker, Mark C Preul, Nicholas Theodore
BACKGROUND: Intervertebral disc degeneration (IVDD) is considered a multifactorial disease that is influenced by both environmental and genetic factors. The last two decades of research strongly demonstrate that genetic factors contribute about 75% of the IVDD etiology. Recent total genome sequencing studies have shed light on the various single-nucleotide polymorphisms (SNPs) that are associated with IVDD. AIM: This review presents comprehensive and updated information about the diversity of genetic factors in the inflammatory, degradative, homeostatic, and structural systems involved in the IVDD...
2016: Frontiers in Surgery
https://www.readbyqxmd.com/read/27900320/the-golden-spiral-flap-a-new-flap-design-that-allows-for-closure-of-larger-wounds-under-reduced-tension-how-studying-nature-s-own-design-led-to-the-development-of-a-new-surgical-technique
#11
Sharad P Paul
This paper details the study of biodynamic excisional skin tension lines on the scalp and the development of a new flap technique for closure of scalp wounds. Recently, a study by this author, on pigskin, replicated whorls by placing tissue under rapid stretch using saline tissue expanders, by recreating rapid dermo-epidermal shear of skin - thereby concluding that the golden spiral pattern is nature's own pattern for rapid expansion. Given the relationship between tissue expansion and stretch has been shown to cause deformation gradients that have both elastic and growth factors, the author set out to test the hypothesis that a golden spiral pattern therefore would be more efficient at closing wounds under less tension when compared with standard semicircular rotational flap patterns...
2016: Frontiers in Surgery
https://www.readbyqxmd.com/read/27896269/cerebral-cavernous-malformations-review-of-the-genetic-and-protein-protein-interactions-resulting-in-disease-pathogenesis
#12
REVIEW
Jacob F Baranoski, M Yashar S Kalani, Colin J Przybylowski, Joseph M Zabramski
Mutations in the genes KRIT1, CCM2, and PDCD10 are known to result in the formation of cerebral cavernous malformations (CCMs). CCMs are intracranial lesions composed of aberrantly enlarged "cavernous" endothelial channels that can result in cerebral hemorrhage, seizures, and neurologic deficits. Although these genes have been known to be associated with CCMs since the 1990s, numerous discoveries have been made that better elucidate how they and their subsequent protein products are involved in CCM pathogenesis...
2016: Frontiers in Surgery
https://www.readbyqxmd.com/read/27891504/thoracic-aorta-aneurysm-repair-in-a-patient-with-a-solitary-kidney-hybrid-surgery-as-a-bailout-procedure
#13
Chris Bakoyiannis, Demetrios Moris, George Karaolanis, Nikolaos Patelis, Dimitrios Schizas, Sotirios Georgopoulos, Theodoros Liakakos
Thoracic endovascular aortic repair (TEVAR) is an emerging treatment option for thoracic aorta aneurysms (TAA). Endovascular access is a challenge. We present a novel TEVAR technique in a patient with single kidney and a 6.4 cm TAA. Attempting to place a sheath through iliac arteries was unsuccessful. The decision to proceed to hybrid TEVAR was made. The protection of the solitary kidney was achieved through axillo-femoral bypass, followed by an end-to-side anastomosis between the aorta and a bifurcated graft...
2016: Frontiers in Surgery
https://www.readbyqxmd.com/read/27878119/the-role-of-microrna-markers-in-the-diagnosis-treatment-and-outcome-prediction-of-spinal-cord-injury
#14
REVIEW
Nikolay L Martirosyan, Alessandro Carotenuto, Arpan A Patel, M Yashar S Kalani, Kaan Yagmurlu, G Michael Lemole, Mark C Preul, Nicholas Theodore
Spinal cord injury (SCI) is a devastating condition that affects many people worldwide. Treatment focuses on controlling secondary injury cascade and improving regeneration. It has recently been suggested that both the secondary injury cascade and the regenerative process are heavily regulated by microRNAs (miRNAs). The measurement of specific biomarkers could improve our understanding of the disease processes, and thereby provide clinicians with the opportunity to guide treatment and predict clinical outcomes after SCI...
2016: Frontiers in Surgery
https://www.readbyqxmd.com/read/27853733/pedagogic-approach-in-the-surgical-learning-the-first-period-of-assistant-surgeon-may-improve-the-learning-curve-for-laparoscopic-robotic-assisted-hysterectomy
#15
Angeline Favre, Stephanie Huberlant, Marie Carbonnel, Julie Goetgheluck, Aurelie Revaux, Jean Marc Ayoubi
BACKGROUND: Hysterectomy is the most frequent surgery done with robotic assistance in the world and has been widely studied since its emergence. The surgical outcomes of the robotic hysterectomy are similar to those obtained with other minimally invasive hysterectomy techniques (laparoscopic and vaginal) and appear as a promising surgical technique in gynecology surgery. The aim of this study was to observe the learning curve of robot-assisted hysterectomy in a French surgical center, and was to evaluate the impact of the surgical mentoring...
2016: Frontiers in Surgery
https://www.readbyqxmd.com/read/27826549/point-of-view-recording-devices-for-intraoperative-neurosurgical-video-capture
#16
Jose L Porras, Syed Khalid, Brandon K Root, Imad S Khan, Robert J Singer
INTRODUCTION: The ability to record and stream neurosurgery is an unprecedented opportunity to further research, medical education, and quality improvement. Here, we appraise the ease of implementation of existing point-of-view devices when capturing and sharing procedures from the neurosurgical operating room and detail their potential utility in this context. METHODS: Our neurosurgical team tested and critically evaluated features of the Google Glass and Panasonic HX-A500 cameras, including ergonomics, media quality, and media sharing in both the operating theater and the angiography suite...
2016: Frontiers in Surgery
https://www.readbyqxmd.com/read/27800481/intraoperative-fluorescence-imaging-for-personalized-brain-tumor-resection-current-state-and-future-directions
#17
REVIEW
Evgenii Belykh, Nikolay L Martirosyan, Kaan Yagmurlu, Eric J Miller, Jennifer M Eschbacher, Mohammadhassan Izadyyazdanabadi, Liudmila A Bardonova, Vadim A Byvaltsev, Peter Nakaji, Mark C Preul
INTRODUCTION: Fluorescence-guided surgery is one of the rapidly emerging methods of surgical "theranostics." In this review, we summarize current fluorescence techniques used in neurosurgical practice for brain tumor patients as well as future applications of recent laboratory and translational studies. METHODS: Review of the literature. RESULTS: A wide spectrum of fluorophores that have been tested for brain surgery is reviewed. Beginning with a fluorescein sodium application in 1948 by Moore, fluorescence-guided brain tumor surgery is either routinely applied in some centers or is under active study in clinical trials...
2016: Frontiers in Surgery
https://www.readbyqxmd.com/read/27730124/cancer-stem-cells-in-moderately-differentiated-buccal-mucosal-squamous-cell-carcinoma-express-components-of-the-renin-angiotensin-system
#18
Therese Featherston, Helen H Yu, Jonathan C Dunne, Alice M Chibnall, Helen D Brasch, Paul F Davis, Swee T Tan, Tinte Itinteang
AIM: We have recently identified and characterized cancer stem cell (CSC) subpopulations within moderately differentiated buccal mucosal squamous cell carcinoma (MDBMSCC). We hypothesized that these CSCs express components of the renin-angiotensin system (RAS). METHODS: 3,3'-Diaminobenzidine (DAB) immunohistochemical (IHC) staining was performed on formalin-fixed paraffin-embedded MDBMSCC samples to investigate the expression of the components of the RAS: (pro)renin receptor (PRR), angiotensin converting enzyme (ACE), angiotensin II receptor 1 (ATIIR1), and angiotensin II receptor 2 (ATIIR2)...
2016: Frontiers in Surgery
https://www.readbyqxmd.com/read/27730123/glioblastoma-multiforme-cancer-stem-cells-express-components-of-the-renin-angiotensin-system
#19
Amy Ruth Bradshaw, Agadha Crisantha Wickremesekera, Helen D Brasch, Alice M Chibnall, Paul F Davis, Swee T Tan, Tinte Itinteang
AIM: To investigate the expression of the renin-angiotensin system (RAS) in cancer stem cells (CSCs), we have previously characterized in glioblastoma multiforme (GBM). METHODS: 3,3-Diaminobenzidine (DAB) immunohistochemical (IHC) staining for the stem cell marker, SOX2, and components of the RAS: angiotensin converting enzyme (ACE), (pro)renin receptor (PRR), angiotensin II receptor 1 (ATIIR1), and angiotensin II receptor 2 (ATIIR2) on 4 μm-thick formalin-fixed paraffin-embedded sections of previously characterized GBM samples in six patients was undertaken...
2016: Frontiers in Surgery
https://www.readbyqxmd.com/read/27725931/prevention-of-incisional-hernias-with-biological-mesh-a-systematic-review-of-the-literature
#20
REVIEW
Filip E Muysoms, An Jairam, Manuel López-Cano, Maciej Śmietański, Guido Woeste, Iris Kyle-Leinhase, Stavros A Antoniou, Ferdinand Köckerling
BACKGROUND: Prophylactic mesh-augmented reinforcement during closure of abdominal wall incisions has been proposed in patients with increased risk for development of incisional hernias (IHs). As part of the BioMesh consensus project, a systematic literature review has been performed to detect those studies where MAR was performed with a non-permanent absorbable mesh (biological or biosynthetic). METHODS: A computerized search was performed within 12 databases (Embase, Medline, Web-of-Science, Scopus, Cochrane, CINAHL, Pubmed publisher, Lilacs, Scielo, ScienceDirect, ProQuest, Google Scholar) with appropriate search terms...
2016: Frontiers in Surgery
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