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Surgical clinics

Min Gyu Kyung, Seung Hoo Lee, Min Bom Kim
Patellar fractures are characterized by injuries to the extensor and typically require surgical fixation. Among the methods used for fixation, the most common is the modified AO tension-band wiring technique. However, using this technique, implant migration occurs due to the lack of connections between the K-wires and the tension-band wire, which causes irritation and reduces fracture stability. Recently, new methods for tension-band wiring have been developed in which tension bands lock the K-wires through an attached "ring" to prevent migration...
October 24, 2016: Journal of Knee Surgery
Hideki Ushiku, Keishi Yamashita, Hiroshi Kawamata, Mina Waraya, Hiroshi Katoh, Keigo Yokoi, Toshimichi Tanaka, Satoru Ishii, Nobuyuki Nishizawa, Mariko Kikuchi, Naoko Minatani, Ken Kojo, Hiroshi Tajima, Ryo Nishiyama, Takashi Kaizu, Yusuke Kumamoto, Masahiko Watanabe
OBJECTIVES: We have identified homeobox-only protein (HOPX) as a tumor suppressor gene in various human cancer, and its expression was reduced by promoter DNA hypermethylation. Homeobox-only protein is strongly expressed on pancreatic islet cells; however, clinical relevance of HOPX expression has remained elusive in pancreatic neuroendocrine tumor (pNET). METHODS: We investigated 36 patients with pNET who undertook surgical resection between 1988 and 2012 for HOPX expression and DNA methylation to reveal its clinical significance...
October 2016: Pancreas
Clément Drouet, Olivier Morel, Hatem Boulahdour
FDG PET/CT has high sensitivity and specificity for the detection of distant metastases from cutaneous melanoma. Imaging is recommended for patients with clinical suspicion of metastasis and should be considered for those with confirmed sentinel lymph node metastasis. Metastatic melanoma bears a poor prognosis. Only a complete resection improves survival, which explains the need to detect potentially unresectable disease, and most metastatic patients are ineligible for a curative surgical procedure. Here, FDG PET/CT demonstrated isolated bilateral adrenal metastases from melanoma of unknown primary...
October 21, 2016: Clinical Nuclear Medicine
Z Hirjaková, H Šingliarová, D Bzdúšková, J Kimijanová, K Bučková, P Valkovič, F Hlavačka
The aim of the study was to evaluate the effect of surgical reconstruction of anterior cruciate ligament (ACL) on postural stability and responses to lower limb (LL) muscles vibrations. Centre of pressure (CoP) was measured in 17 subjects during stance on firm/foam surface with eyes open/closed and during unilateral vibrations of LL muscles (m. triceps surae - TS, m. quadriceps femoris - Q, m. quadriceps femoris and hamstrings simultaneously - QH). The measurements were performed: 1) preoperatively, 2) six weeks and 3) three months after the reconstruction...
October 24, 2016: Physiological Research
M Oviedo Gutiérrez, S Amat Valero, A Gómez Farpón, C Montalvo Ávalos, L Fernández García, D C Lara Cárdenas, S Barnes Marañón, C Granell Suárez, N Vega Mata, A J López López, M González Guerrero, V Álvarez Muñoz
PURPOSE: Gastrointestinal adenomyoma is a rare benign tumor most frequently located in the stomach. The differential diagnosis is wide because of its large clinical spectrum and unspecific radiological findings. Surgical excision is both diagnostic and therapeutic. CASE REPORT: A 49-days old girl presented with nonbilious vomiting of 48 hours of evolution. Infantile hypertrofic pyloric stenosis was suspected. Ultrasound showed a nonobstructive nodular lesion in the anterior pyloric wall...
April 20, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
P Bragagnini Rodríguez, N Álvarez García, Y González Ruiz, M Ruiz de Temiño, R Escartín Villacampa, N González Martínez-Pardo
OBJECIVE: Hypertrophy of labia minora in adolescence is a little known disease. However, the growing demand for the solution of this problem pushes us to include it in our clinical practice. We evaluated the aesthetic and functional results of labiaplasty using straight amputation of the protuberant tissue of the labial edges. METHODS: Patients treated by hypertrophy of labia minora were reviewed. We evaluated the results of aesthetic, functional and surgical complications...
October 10, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
S Castañeda, I Molina, P Jaimes, J Beltrán, J Valero, F Fierro
INTRODUCTION: The aim of the present study was to evaluate clinical presentation and management of sigmoid volvulus in children. Sigmoid volvulus is one of the three leading causes of acute obstruction of the colon and is between 50 and 90% of all large bowel volvulus. In the pediatric population only 3 to 5% of bowel obstructions are caused by volvulus and there are less than 100 cases reported in the literature. The presence of a redundant sigmoid with a narrow mesentery (dolicosigmoide) is a prerequisite for the volvulus formation...
January 15, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
H Delgado Bartra, F M Lapouble Ramírez, J Bonilla Pabón, S T Vega Centeno
INTRODUCTION: The Rubinstein-Taybi syndrome and pancreas divisum are uncommon diseases in children. The Rubinstein-Taybi syndrome diagnosis is only clinical, and mental retardation and dysmorphic features mainly characterize it. The PD relates to idiopathic pancreatitis in 7.5% of patients suffering from this disorder. It has not been found any cases reported where these diseases are associated and the management of patients with pancreatitis associated with PD is still a challenge. CLINICAL CASE: A patient diagnosed with Rubinstein-Taybi syndrome has recurrent abdominal pain of six months and elevated pancreatic enzymes, he underwent a magnetic resonance imaging where pancreas divisum is suspected...
January 15, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
J Rojas-Ticona, M Fernández-Ibieta, L Nortes Cano, O Girón-Vallejo, P Reyes Ríos, I Martínez Castaño, V Villamil, J I Ruiz Jiménez
OBJECTIVES: To describe our experience in testicular and paratesticular tumors during the prepubertal stage, focusing especially on its character of benignity/malignancy and surgical treatment used. MATERIAL AND METHODS: Retrospective review of all testicular tumors in children under 12 years diagnosed and treated in our clinical setting from 1998-2015. Data on their presentation, study and management were collected. RESULTS: 17 children with prepubertal testicular tumors were identified...
January 15, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
Song-Jun Liu, Wen Lv, Wu Li
AIM: The aim of this study was to investigate the clinical data of laparoscopic repair with hysteroscopy of cesarean scar diverticulum (CSD). METHODS: We retrospectively evaluated 49 patients with CSD in our hospital who had undergone laparoscopic repair with hysteroscopy from January 2014 to June 2015. All patients had a history of cesarean section deliveries and prolonged postmenstrual spotting (duration 16.1 ± 3.4 days). The diagnosis of CSD was established by using 2-D transvaginal ultrasound...
October 24, 2016: Journal of Obstetrics and Gynaecology Research
Zhao-Qing Du, Li-Na Zhang, Qiang Lu, Yi-Fan Ren, Yi Lv, Xue-Min Liu, Xu-Feng Zhang
The standard therapeutic protocols of pyogenic liver abscess (PLA) have not been well established yet. We investigated the clinical characteristics, disease progression, choices of treatments and outcomes of PLA with different size. 410 cases of patients with PLA were enrolled retrospectively from 2000 to 2014, and were grouped as small abscess (≤5 cm, n = 125), large abscess (5 cm to 10 cm, n = 218) and giant abscess (>10 cm, n = 36). The most common bacteria were Klebsiella pneumonia (22%) and Escherichia coli (11%) by pus culture, and Escherichia coli (36...
October 24, 2016: Scientific Reports
M M F Aubuchon, L J J Bolt, M L G Janssen-Heijnen, S T H P Verleisdonk-Bolhaar, A van Marion, C L H van Berlo
BACKGROUND: Malignant melanoma (MM) is the most aggressive type of skin cancer, accounting for 90% of all the skin cancer mortality. The objective of this study was providing an overview of current patient- and tumour characteristics, treatment strategies, complications and survival in patients with MM over the past ten years. Hereby, an up-to-date view of every day clinical practice is obtained. METHODS: Files of patients treated for primary cutaneous melanoma (n = 686) in the VieCuri Medical Centre in the Netherlands between January 2002 and December 2013 were retrospectively reviewed...
October 23, 2016: Acta Chirurgica Belgica
Sean D McGarry, Sarah L Hurrell, Amy L Kaczmarowski, Elizabeth J Cochran, Jennifer Connelly, Scott D Rand, Kathleen M Schmainda, Peter S LaViolette
Magnetic resonance imaging (MRI) is used to diagnose and monitor brain tumors. Extracting additional information from medical imaging and relating it to a clinical variable of interest is broadly defined as radiomics. Here, multiparametric MRI radiomic profiles (RPs) of de novo glioblastoma (GBM) brain tumors is related with patient prognosis. Clinical imaging from 81 patients with GBM before surgery was analyzed. Four MRI contrasts were aligned, masked by margins defined by gadolinium contrast enhancement and T2/fluid attenuated inversion recovery hyperintensity, and contoured based on image intensity...
September 2016: Tomography: a Journal for Imaging Research
A Gabriella Wernicke, Stefanie P Lazow, Shoshana Taube, Menachem Z Yondorf, Ilhami Kovanlikaya, Dattatreyudu Nori, Paul Christos, John A Boockvar, Susan Pannullo, Philip E Stieg, Theodore H Schwartz
BACKGROUND: Cesium-131 (Cs-131) brachytherapy is used to reduce local recurrence of resected brain metastases. In order to ensure dose homogeneity and reduce risk of radiation necrosis, inter-seed distance and cavity volume must remain stable during delivery. OBJECTIVE: To investigate the efficacy of the "seeds-on-a-string" technique with intracavitary fibrin glue in achieving cavity volume stability. METHODS: We placed intra-operative Cs-131 brachytherapy in 30 cavities post-resection of brain metastases...
March 2016: Oper Neurosurg (Hagerstown)
Valentine Nfonsam, Hassan Aziz, Viraj Pandit, Mazhar Khalil, Jana Jandova, Bellal Joseph
INTRODUCTION: Optimization of surgical outcomes after colectomy continues to be actively studied, but most studies group right-sided and left-sided colectomies together. The aim of our study was to determine whether the complication rate differs between right-sided and left-sided colectomies for cancer. METHODS: We identified patients who underwent laparoscopic colectomy for colon cancer between 2005 and 2010 in the American College of Surgeons National Surgical Quality Improvement Program database and stratified cases by right and left side...
2016: Cancer Treatment Communications
Bo Wang, Shannon J Walsh, Muhammad W Saif
5-Fluorouracil (5-FU) is one of the most commonly used chemotherapeutic agents in solid tumors, including colon, gastric and breast cancers. The pharmacogenetic syndrome of dihydropyrimidine dehydrogenase (DPD) deficiency leading to severe toxicity after administration of 5-flourouracil (5-FU) and capecitabine has been well-recognized. However, the data about the association of the target enzyme, thymidylate synthase (TYMS) with the toxicity of these agents is limited. A 50-year-old Caucasian woman with T2N2M0 Stage IIIB squamous cell rectal cancer after local surgical excision initiated 5-FU therapy with mitomycin-C and radiation therapy in the adjuvant setting...
September 21, 2016: Curēus
Nicholas Brandmeir, Elena Nehrbass, James McInerney
INTRODUCTION:  Deep brain stimulator (DBS) infections are a persistent problem for patients undergoing this procedure. They may require further surgery, treatment with antibiotics, or even removal of the device. To date, no consensus exists on the best practices to avoid DBS infections or what factors predispose patients to an eventual infection. The goal of this study was to examine several patient factors for association with DBS infection. METHODS:  A single-center, single-surgeon quality improvement database was queried...
September 20, 2016: Curēus
Lukas Andereggen, Janine Frey, Robert H Andres, Marwan El-Koussy, Jürgen Beck, Rolf W Seiler, Emanuel Christ
OBJECTIVE: In men with prolactinomas, an impaired bone density is the principle consequence of hyperprolactinemia-induced hypogonadism. While dopamine (DA-) agonists are the first-line approach in prolactinomas, surgery can be considered in selected cases. In the present study, we aimed to investigate on the long-term control of hyperprolactinemia, hypogonadism and bone health comparing primary medical and surgical therapy in men who had not had prior DA-agonist treatment. METHODS: Retrospective case-note study of 44 consecutive men with prolactinomas and no prior DA-agonists managed in a single tertiary referral center...
October 20, 2016: World Neurosurgery
Amanda M Casabella, Timur M Urakov, Gregory Basil, Jacques J Morcos
Foramen magnum meningiomas are very rare and challenging lesions. Their presentation in female patients during pregnancy tremendously complicates the course of gestation. Conservative management is always the first choice but in cases of a deteriorating clinical picture there are currently no clear guidelines on best management. We looked closely at a case of foramen magnum meningioma presenting at 30 weeks of gestation. Successful surgical resection was performed with intraoperative fetal heart monitoring and ¾ prone position of the patient...
October 20, 2016: World Neurosurgery
Ian S Metzler, Rebecca Smith-Bindman, Michelle Moghadassi, Ralph C Wang, Marshall L Stoller, Thomas Chi
PURPOSE: In the emergency department (ED), ultrasonography (US) is emerging as an alternative to computed tomography (CT) for diagnosing patients with nephrolithiasis. In this multi-center randomized clinical trial, we examined rates of urologic referral and intervention to elucidate if initial diagnostic imaging modality affected management of nephrolithiasis. MATERIALS AND METHODS: Patients ages 18-76 years who presented to the ED with renal colic across 15 diverse treatment centers were randomized to receive either an abdominal US by an ED physician, a radiologist or an abdominal CT...
October 20, 2016: Journal of Urology
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