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magnetic sphincter

I Mohamed Iqbal, R Morris, M Hersch
We report a case of serious neurologic injury due to inadvertent epidural injection of 8 ml of the antiseptic 2% chlorhexidine in 70% alcohol during a procedure aimed to relieve the pain of labour. This resulted in immediate severe back pain, progressive tetraparesis and sphincter dysfunction caused by damage to the spinal cord and nerve roots. Subacute hydrocephalus necessitated drainage, but cranial nerve and cognitive function were spared. Magnetic resonance imaging documented marked abnormality of the spinal cord and surrounding leptomeninges...
November 2018: Anaesthesia and Intensive Care
Eric Knull, Aytekin Oto, Scott Eggener, David Tessier, Serkan Guneyli, Aritrick Chatterjee, Aaron Fenster
PURPOSE: Prostate cancer is the most common non-cutaneous cancer among men in the USA.[1] Focal laser thermal ablation (FLA) has the potential to control small tumours while preserving urinary and erectile function by leaving the neurovascular bundles and urethral sphincters intact. Accurate needle guidance is critical to the success of FLA. Multi-parametric magnetic resonance images (mpMRI) can be used to identify targets, guide needles, and assess treatment outcomes. In this study, we evaluated the location of ablation zones relative to targeted lesions in 23 patients who underwent FLA therapy in a phase II trial...
November 17, 2018: Medical Physics
Alan H Appelbaum, Jeffrey K Zuber, Roberto Levi-D'Ancona, Harris L Cohen
OBJECTIVES: To demonstrate and confirm the presence of three anatomic zones of the vagina (a superficial sphincteric zone; a central wedge shaped transition zone; and a deep, expanded forniceal zone) using pelvic magnetic resonance imaging with contrast distention of the vagina. METHODS: A total of 107 consecutive female pelvic magnetic resonance imaging scans using vaginal contrast distention were retrospectively reviewed. The images were observed for the three-zone configuration...
November 2018: Southern Medical Journal
James M Tatum, Evan Alicuben, Nikolai Bildzukewicz, Kamran Samakar, Caitlin C Houghton, John C Lipham
BACKGROUND: Recurrent or persistent symptoms of reflux, dysphagia, or device erosion can lead to removal of the magnetic sphincter augmentation (MSA aka Linx) device. Device removal has been previously reported, and outcomes of various surgical management strategies at the time of removal have not been well described. METHODS: This is a retrospective review of patients undergoing MSA removal from March 2009 to September 2017 in a single institution. Reason for removal, operative management, and short-term outcomes are reported...
November 1, 2018: Surgical Endoscopy
Paula Salgado, Ricardo Taipa, Joana Domingos, Daniel Dias, Manuel Melo Pires, Marina Magalhães
Background: Chorea may occur as a manifestation of an acute stroke. Patients with vascular-related chorea typically present with an acute or subacute onset of hemichorea, contralateral to the lesion. Methods and Findings: In this clinico-pathological case, we report a 90-year-old female who presented, at age 81, with a transient episode of generalized chorea. Over the years, the patient continued to have intermittent episodes of generalized chorea or hemichorea, followed by a progressive dementia syndrome with gait and sphincter disturbance...
November 2017: Movement Disorders Clinical Practice
Kazuhiko Morikawa, Shinsuke Takenaga, Koichi Masuda, Asami Kano, Takao Igarashi, Hiroya Ojiri, Kaoru Ueda, Mamoru Ishiyama, Nei Fukasawa
BACKGROUND: A solitary fibrous tumor (SFT) is a rare mesenchymal tumor that occurs mostly in pleural sites, and an SFT occurring in the ischiorectal fossa is extremely rare. Because of the rarity, there are few reports detailing an SFT in the ischiorectal fossa. CASE PRESENTATION: A pararectal tumor was incidentally found in a 42-year-old man during a routine medical examination. The patient had no symptoms and no previous medical history. In the physical examination, a smooth-margined and hard elastic mass was felt, and in a digital rectal examination, the rectal mucosa appeared normal...
October 3, 2018: Surgical Case Reports
Ali Konan, Mehmet Ruhi Onur, Mustafa Nasuh Özmen
PURPOSE: Anal fistula is an abnormal tract or cavity between the anal canal and perianal skin. Surgical treatment of anal fistulas requires the identification of the course of the primary and secondary tracts and their relation with the sphincter musculature in order to appropriately manage them and drain any abscess. Physical examination alone is not as accurate as imaging modalities in detecting these features of the fistula, and recurrences are usually due to missed or inadequately managed infective components...
November 2018: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
Akira Dobashi, Shu-Wei Wu, Jodie L Deters, Charles A Miller, Mary A Knipschield, Graham P Cameron, Lichun Lu, Elizabeth Rajan, Christopher J Gostout
BACKGROUND AND AIMS: Endolumenal therapies serve as a treatment option for gastroesophageal reflux disease (GERD). This study aimed to determine if magnets could be placed endoscopically using the adventitial layer creating a sub-adventitial space near the esophagogastric junction to augment the lower esophageal sphincter using the submucosal endoscopy. METHODS: This study consisted of 2 phases, ex vivo and in vivo, with domestic pig esophagus. A long submucosal tunnel was made at mid to lower esophagus...
September 24, 2018: Gastrointestinal Endoscopy
L Dormegny, S Chibbaro, M Ganau, Mdn Santin, L Kremer, F Proust
Spinal cord biopsy is a difficult procedure fraught with the risk of false-negative results or even misdiagnosis in up to 30% of cases. Differential diagnoses of spinal cord lesions include a wide range of inflammatory, infectious and neoplastic diseases. Given the importance of correctly managing these pathologies, it is crucial to avoid delays in making the correct diagnosis in order to improve the patient's outcome. We present here the case of a 21-year-old male with rapidly progressing sphincter and lower limb motor dysfunctions up to complete paraplegia with evidence of thoracic spinal cord lesion on magnetic resonance imaging...
September 19, 2018: Neuro-Chirurgie
Soumya Jagannath, Pramod Kumar Garg
PURPOSE OF REVIEW: There have been significant developments in the diagnosis, clinical approach, and management of patients with recurrent acute pancreatitis (RAP) in the last decade. This review systematically summarizes our current understanding of RAP. NEW FINDINGS: Gallstones and alcohol are common causes of RAP. Non-alcohol non-biliary RAP (nAnB RAP) is a difficult group of patients after excluding these two causes because extensive workup is required to elucidate the etiology...
December 2018: Current Treatment Options in Gastroenterology
Jonathan Zadeh, Anthony Andreoni, Daniela Treitl, Kfir Ben-David
Background: The initial approach to gastroesophageal reflux disease (GERD) management typically involves lifestyle modification and medical therapy utilizing acid reducing agents such as histamine blockers and proton pump inhibitors. In severe cases refractory to such treatments, surgical therapy may be indicated. The gold standard for surgical treatment of GERD is the laparoscopic Nissen fundoplication. In recent years, a new technique known as magnetic sphincter augmentation (MSA) has been developed using the Linx™ Reflux Management System...
2018: Medical Devices: Evidence and Research
Xuelian Xiang, Tanisa Patcharatrakul, Amol Sharma, Rachael Parr, Shaheen Hamdy, Satish S C Rao
BACKGROUND & AIMS: The neuropathophysiology of fecal incontinence (FI) is incompletely understood. We examined the efferent brain-anorectal and spino-anorectal motor-evoked potentials (MEP) to characterize the locus of neuronal injury in patients with FI. METHODS: We performed bilateral transcranial, translumbar, and transsacral magnetic stimulations in 27 patients with FI (19 female) and 31 healthy individuals (controls, 20 female) from 2015 through 2017. MEPs were recorded simultaneously from the rectum and anus using 4 ring electrodes...
September 10, 2018: Clinical Gastroenterology and Hepatology
Tianyi Niu, Carol J Bennett, Tina L Keller, J C Leiter, Daniel C Lu
Patients with chronic spinal cord injury (SCI) cannot urinate at will and must empty the bladder by self-catheterization. We tested the hypothesis that non-invasive, transcutaneous magnetic spinal cord stimulation (TMSCS) would improve bladder function in individuals with SCI. Five individuals with American Spinal Injury Association Impairment Scale A/B, chronic SCI and detrusor sphincter dyssynergia enrolled in this prospective, interventional study. After a two-week assessment to determine effective stimulation characteristics, each patient received sixteen weekly TMSCS treatments and then received "sham" weekly stimulation for six weeks while bladder function was monitored...
August 22, 2018: Scientific Reports
Sebastian H Doeltgen, Lakkari Rigney, Charles Cock, Taher Omari
BACKGROUND: Anodal transcranial direct current stimulation (tDCS) has demonstrated effects on corticobulbar excitability and swallowing function as assessed via clinical rating scales in stroke cohorts. Biomechanical effects of anodal tDCS on swallowing remain largely unexplored. We investigated how anodal tDCS applied over the floor of mouth (FOM) representation on the primary motor cortex affects swallowing biomechanics in healthy participants. METHODS: Anodal and sham tDCS were applied for 20 minutes at 1...
November 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Sarah B Cairo, George Ventro, Ellene Sandoval, David H Rothstein
BACKGROUND: The purpose of this study is to describe a cohort of pediatric patients undergoing cholecystectomy for biliary dyskinesia (BD) and characterize postoperative resource utilization. METHODS: Single-institution, retrospective chart review of pediatric patients after cholecystectomy for BD was done. Patient demographics and clinical characteristics as well as operative details and postoperative interventions were abstracted. Telephone follow-up was performed to identify persistent symptoms, characterize the patient experience, and quantify postoperative resource utilization...
October 2018: Journal of Surgical Research
Madhusmita, Rohini G Ghasi, M K Mittal, Deepak Bagga
Purpose: To evaluate the spectrum of magnetic resonance imaging (MRI) findings in pediatric patients with anorectal malformation (ARM) and compare the accuracy of MRI and distal cologram (DC) findings using surgery as reference standard. Materials and Methods: Thirty pediatric patients of age less than 14 years (19 boys and 11 girls) with ARM underwent preoperative MRI. MRI images were evaluated for the level of rectal pouch in relation to the pelvic floor, fistula, and development of sphincter muscle complex (SMC)...
April 2018: Indian Journal of Radiology & Imaging
Evan T Alicuben, James M Tatum, Nikolai Bildzukewicz, Kamran Samakar, Jamil S Samaan, Einav N Silverstein, Kulmeet Sandhu, Caitlin C Houghton, John C Lipham
BACKGROUND: Intestinal metaplasia represents an esophageal mucosal transformation due to uncontrolled gastroesophageal reflux disease. Fundoplication has been shown to lead to regression of disease. Magnetic sphincter augmentation is an alternative to fundoplication that effectively treats reflux disease. Initially, patients with intestinal metaplasia were not considered candidates for device placement, so outcomes in these patients are unknown. METHODS: A retrospective review of all patients who underwent magnetic sphincter augmentation device placement between 2007 and 2017 was performed...
July 25, 2018: Surgical Endoscopy
Reginald Bell, John Lipham, Brian Louie, Valerie Williams, James Luketich, Michael Hill, William Richards, Christy Dunst, Dan Lister, Lauren McDowell-Jacobs, Patrick Reardon, Karen Woods, Jon Gould, F Paul Buckley, Shanu Kothari, Leena Khaitan, C Daniel Smith, Adrian Park, Christopher Smith, Garth Jacobsen, Ghulam Abbas, Philip Katz
BACKGROUND AND AIMS: GERD patients frequently complain of regurgitation of gastric contents. Medical therapy with proton-pump inhibitors (PPIs) is frequently ineffective in alleviating regurgitation symptoms, because PPIs do nothing to restore a weak lower esophageal sphincter. Our aim was to compare effectiveness of increased PPI dosing with laparoscopic magnetic sphincter augmentation (MSA) in patients with moderate-to-severe regurgitation despite once-daily PPI therapy. METHODS: One hundred fifty-two patients with GERD, aged ≥21 years with moderate-to-severe regurgitation despite 8 weeks of once-daily PPI therapy, were prospectively enrolled at 21 U...
July 18, 2018: Gastrointestinal Endoscopy
Fabrizio Rebecchi, Marco Ettore Allaix, Lorenzo Cinti, Milica Nestorović, Mario Morino
A total laparoscopic fundoplication has become the procedure of choice for the surgical treatment of gastroesophageal reflux disease in patients with normal esophageal motility, with reduced postoperative pain, faster recovery and similar long-term outcomes compared to conventional open total fundoplication. Most controversial surgical aspects are the division of the short gastric vessels and the insertion of a bougie to calibrate the wrap. The anterior 180° and the posterior partial fundoplications lead to similar control of heartburn when compared to total fundoplication with lower risk of dysphagia...
September 2018: Updates in Surgery
Emanuele Asti, Alberto Aiolfi, Veronica Lazzari, Andrea Sironi, Matteo Porta, Luigi Bonavina
Use of the magnetic sphincter augmentation (MSA) device for the laparoscopic treatment of gastroesophageal reflux disease is increasing since the first clinical implant performed a decade ago. The MSA procedure is a minimally invasive and highly standardized surgical option for patients who are partially responders to proton-pump inhibitors, which have troublesome regurgitation or develop progressive symptoms despite continuous medical therapy. The procedure has proven to be highly effective in improving typical reflux symptoms, reducing the use of proton-pump inhibitors, and decreasing esophageal acid exposure...
September 2018: Updates in Surgery
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