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Yeela Ben Naftali, Ori Samuel Duek, Ram Kalus, Marc Berns, Yaniv Zohar, Yehuda Ullmann
INTRODUCTION: Cutaneous squamous cell carcinoma (SCC) is a common skin cancer, second in incidence only to basal cell carcinoma (BCC). The incidence of SCC increases significantly with age; thus, it is rarely diagnosed in young patients. In this paper, we present two cases of young patients who presented clinically with purulent lesions that were later diagnosed as large primary SCCs. MATERIALS AND METHODS: A review of the medical records of two patients who were admitted to the department of plastic surgery with a final clinical diagnosis of cutaneous SCC was conducted...
August 8, 2018: International Journal of Surgery Case Reports
Aaron B Caughey, Stephen L Wood, George A Macones, Ian J Wrench, Jeffrey Huang, Mikael Norman, Karin Pettersson, William J Fawcett, Medhat M Shalabi, Amy Metcalfe, Leah Gramlich, Gregg Nelson, R Douglas Wilson
OBJECTIVE: This ERAS Guideline for intraoperative care in Cesarean Delivery (CD) will provide best practice, evidenced-based, recommendations for intra-operative care with primarily, a maternal focus. The 'focused' pathway process for scheduled and unscheduled CD, for this ERAS CD guideline will consider, from decision to operate (starting with the 30 - 60 minutes prior to skin incision) through the conduct of the surgery. METHODS: The literature search (1966-2017) used Embase and PubMed to search medical subject headings including "Cesarean Section", "Cesarean Section", "Cesarean Section Delivery" and all pre- and intra-operative ERAS® items...
August 14, 2018: American Journal of Obstetrics and Gynecology
Jose A Moreno Rodriguez, Raúl G Caffesse
A new surgical approach has been developed to optimize the preservation of the gingival margin and papillae when treating periodontal defects. The flap is raised by one mucosal incision far away from the marginal tissues. This case series reports on the effectiveness of a nonincised surgical approach (NIPSA) in conjunction with a hydroxyapatite-based graft biomaterial and enamel matrix derivative in treating intrabony defects. Ten defects in 10 patients were treated. The follow-up period ranged from 6 to 18 months (mean: 10...
2018: International Journal of Periodontics & Restorative Dentistry
Ping Liu, Jing Qin, Bin Duan, Qiong Wang, Xiaoyu Tan, Baoliang Zhao, Peneyra Libao Jonnathan, Chee-Kong Chui, Pheng-Ann Heng
BACKGROUND: We aimed at facilitating percutaneous radiofrequency ablation (RFA) for large tumors with accurate overlapping ablation planning and robot-assisted needle insertion from a single incision port (SIP). METHODS: We developed a personalized and quantitative RFA planning method to obtain multiple needle overlapping ablation planning through a single incision. A robot with a remote center of motion (RCM) mechanism was designed to perform needle insertions through a single incision port according to the planning...
August 16, 2018: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
Natalie N Merchant, Osita Onugha
We report a patient who presented with multiple rib fractures after falling off a horse and was initially managed medically. Several weeks later, the patient returned to the hospital complaining of dyspnea on exertion. Physical exam revealed severe chest wall malformation and imaging revealed moderate hemothorax and complete collapse of the right lower lobe. Considering the likelihood that this patient's multiple ribs fractures contributed to the hemothorax and trapped lung, the patient underwent surgical evacuation of the hemothorax followed by rib fixation of ribs three through six...
August 14, 2018: Surgical Technology International
Masataka Yamazaki, Akihiro Yoshitake, Tatsuo Takahashi, Tsutomu Ito, Naritaka Kimura, Akinori Hirano, Yasunori Iida, Shuichiro Takanashi, Hideyuki Shimizu
BACKGROUND: Trans-right axillary aortic valve replacement (TAX-AVR) remains uncommon. We developed a special method to pull the heart closer to the right chest wall to make the surgery as easy and safe as aortic valve replacement via median sternotomy. Because the retraction sutures lifting the ascending aorta and aortic root are arranged circularly around the wound, we named this technique "Stonehenge technique". METHODS: We examined 47 patients who underwent aortic valve replacement through a small right infra-axillary thoracotomy as the initial surgical therapy...
August 16, 2018: General Thoracic and Cardiovascular Surgery
Nirmal R Gosalia, Mark S Dikopf, Jennifer I Lim, Amy Y Lin, Elmer Y Tu, Ahmad A Aref
INTRODUCTION: To present a case of an epithelial inclusion cyst masquerading as an inadvertent bleb in a patient with Marfan syndrome. CASE REPORT: A woman with Marfan syndrome presented with a subluxed crystalline lens in her right eye, which progressively subluxed over the following 2 years. A lensectomy was performed with placement of an anterior chamber intraocular lens (IOL); however, the patient experienced blurred vision and photopsias and preferred IOL explantation...
August 16, 2018: Ophthalmology and Therapy
Vasilios F Diakonis, Apostolos G Anagnostopoulos, Angeliki Moutsiopoulou, Nilufer Yesilirmak, Florence Cabot, Daniel P Waren, Terrence P O'Brien, Sonia H Yoo, Robert J Weinstock, Kendall E Donaldson
Purpose: To assess aqueous humor concentration of prostaglandin E2 (PGE2 ) after capsulotomy creation using a femtosecond laser (FLAC) in patients pretreated with short-term topical ketorolac versus patients without pretreatment. Methods: This prospective study comprised consecutive patients scheduled to undergo cataract surgery using a femtosecond laser platform to perform only capsulotomies. An identical protocol for preoperative mydriasis was used for all the eyes included in the study, while aqueous humor was extracted from the anterior chamber of all patients immediately after the initial side port incision...
2018: Journal of Ophthalmology
Shunhui He, Xuehua Liu, Guoping Du, Wenzhi Chen, Weiqing Ruan
Clinical value and safety of the use of gastroscopy as oral choledochoscopy in the treatment of biliary diseases was explored. Clinical data of 55 patients with biliary diseases who underwent gastroscopy were retrospectively analyzed. The types of gastroscopy, size of duodenal papilla incision, balloon dilatation, the success rate of gastroscopy entry, depth of gastroscopy entering into bile duct, endoscopic diagnosis and postoperative complications were recorded. Simple insertion-by-hand was performed, and insertion into common bile duct was successfully achieved in 53 cases, and the overall technical success rate was 96...
August 2018: Experimental and Therapeutic Medicine
Changsong Xu, Bing Chen, Liujun Xue, Lei Xia, Xiu Yang, Ming Wei, Xiaobo Hui, Quan Chen, Jinlong Zheng, Zhengming Li, Xiangyang Tian, Guanliang Cheng, Feng Xiao, Min Lu
The present randomized controlled study investigated the differences in the curative effects of twist-drill craniotomy (TDC) and burr-hole craniotomy (BHC) in the treatment of chronic subdural hematoma (CSDH). A total of 40 patients diagnosed with CSDH via head computed tomography (CT) who required surgical decompression from January 2016 to January 2017 were enrolled in the present study, and were randomly divided into a TDC group (n=20) and a BHC group (n=20). The modified Rankin scale (mRS) scores of patients were recorded prior to the operation, and at 48 h and 3 months after the operation...
August 2018: Experimental and Therapeutic Medicine
Jian Liu, Yong Han, Kai Cheng, Xiao-Hong Wang, Fengli Guo, Zhen-Lin Yang
Gynecomastia is a common benign condition of the male breast, frequently observed in newborns, adolescents and the elderly. Surgical excision remains one of the most effective methods for the management of patients with gynecomastia, particularly those with fibrosis or a course of >1 year. The present study describes two cases of patients with gynecomastia and presents a novel method of treatment, combining endoscopic surgery and liposuction using a TriPort, which may effectively remove breast tissue and shorten hospitalization time compared with a direct excision method...
August 2018: Experimental and Therapeutic Medicine
Tsontcho Ianchulev, David F Chang, Edward Koo, Susan MacDonald
We describe a new technique for nucleus disassembly using a microinterventional approach. This is the first report of a microinterventional phacoemulsification-free endocapsular lens fragmentation using a superelastic memory-shaped nickel and titanium (nitinol) microfilament (miLOOP). After standard capsulorhexis and hydrodissection, the microinterventional loop is inserted through the 2.3 mm clear corneal incision. An actuation mechanism is used to unfold the microloop, which glides horizontally on the anterior surface of the lens, expands below the anterior capsule, and then rotates vertically while traveling in the hydrodissection plane to encircle the entire nucleus...
August 2018: Journal of Cataract and Refractive Surgery
Jenna E Stoddard, Athanasios G Marneris, Matthew J Borr, Michael L Keil
PURPOSE: To demonstrate a safe and effective method of optimizing a femtosecond laser upon installation or for a new procedure before use on patients. In this case, specifically for optimizing settings for intrastromal corneal pocket creation for the presbyopic small-aperture corneal inlay (Kamra) and deep laser in situ keratomileusis (LASIK) flaps for the presbyopic hydrogel corneal inlay (Raindrop). SETTING: Keil LASIK Vision Center, Grand Rapids, Michigan, USA...
August 2018: Journal of Cataract and Refractive Surgery
Feinberg Joshua, Flynn Lorna, Woodward Matthew, Pennell Christopher, Higham Helen, Morgan Lauren, Holman Lance, Tully Patrick, McCulloch Peter
INTRODUCTION: Methods to improve clinical systems safety suffer from significant difficulties in implementation and scaling up. We used an upscaling implementation strategy entitled Supported Champions in a quality and safety improvement programme for emergency surgery at regional level, focusing on patients with right iliac fossa pain. METHODS: A before-after study was conducted across four acute NHS Trusts: A 6 month intervention phase was preceded and followed by 3 months of data collection...
August 13, 2018: International Journal of Surgery
Yiannis Philippou, Eli Harriss, Lucy Davies, Ibrahim Jubber, Tom Leslie, Richard W Bell, Richard J Bryant, Freddie C Hamdy, Clare Verill, Alastair D Lamb
INTRODUCTION: Capsular Incision (CapI) is an iatrogenic breach of the prostatic capsule during radical prostatectomy that can cause positive surgical margins (PSM) in organ-confined (pT2) prostate cancer (PCa), or the retention of benign prostatic tissue. We systematically interrogated the literature in order to clarify the definition of CapI, and the implications of this event for rates of PSM and biochemical recurrence (BCR). METHODS: A literature search was conducted according to PRISMA criteria using the search terms 'CapI' AND 'prostatectomy' and variations of each...
August 16, 2018: BJU International
Yuta Nakajima, Shoji Kondoh, Hiroshi Nishioka, Wataru Kasuga
Several operative techniques for inframammary fold (IMF) reconstruction have been described and have resolved the shortcomings of conventional methods. However, there are still difficulties with IMF reconstruction, that is, performance through small mastectomy scars, creation of a smooth IMF curve, transfer of external IMF markings to the interior chest wall, or determining correct IMF without an implant in place. We have used a type of anchor suture with a completely percutaneous approach, the vertical pendulum suture (VP suture), to reconstruct the IMF easily in implant-based breast reconstruction...
August 2018: Medicine (Baltimore)
ZuoXia Zhang, Hao Wu, Yue Liu, XiaoPing Gu, Wei Zhang, ZhengLiang Ma
BACKGROUND: Patients undergoing surgery often feel anxious. Accumulating evidence indicated that presurgical anxiety was related to the more severe postsurgical pain. An animal model was established that exposed Sprague-Dawley rats to a single-prolonged stress (SPS) procedure to induce presurgical anxiety-like behaviors. The experiment revealed that presurgical anxiety not only aggravated but also prolonged postsurgical pain. However, the underlying mechanisms were unknown. METHODS: The rats in group C + Cort, group I + Cort, group A + Cort, and group AI + Cort were injected with corticosterone...
August 14, 2018: Anesthesia and Analgesia
Mihri Amasyalı, Fidan Alakuş Sabuncuoğlu, Şeniz Karaçay, Mehmet Doğru, Handan Altuğ
Objective: Our objective was to investigate and quantify the treatment of micro-implant-aided retraction and torque (R&T) arch on dentofacial structures. Methods: Twelve patients (mean age 21.2 years) who required orthodontic camouflage treatment were included in the study. Following the canine distalization, mini-screws were placed between maxillary first molars and second premolars, and R&T arch was applied for the retraction of incisors. The vertical retraction arms of the arch were adjusted between the apex of the lateral incisor and the alveolar bone so that the retraction force passed through the center of resistance of four incisors and forced the incisors to bodily retraction...
March 2018: Turkish journal of orthodontics
Guoxin Fan, Chaobo Feng, Wangcheng Xie, Dongdong Wang, Fei Liu, Chun Yuan, Zhi Zhou, Shisheng He
Background: Percutaneous endoscopic transforaminal discectomy (PETD) is usually chosen for lumbar disc herniation due to its obvious advantages such as small incision and absence of nerve or muscular traction. However, learning PETD is a great challenge for inexperienced surgeons. Objective: The study aimed to investigate whether isocentric navigation would be beneficial in PETD training. Methods: A total of 117 inexperienced surgeons were trained with PETD at L2/3, L3/4, L4/5, and L5/S1 on the cadavers without (Group A n=58) or with (Group B n=59) isocentric navigation...
2018: BioMed Research International
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