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https://www.readbyqxmd.com/read/29217900/pulmonary-function-after-lobectomy-video-assisted-thoracoscopic-surgery-versus-muscle-sparing-mini-thoracotomy
#1
Katsuo Usuda, Sumiko Maeda, Nozomu Motomo, Makoto Tanaka, Masakatsu Ueno, Yuichiro Machida, Motoyasu Sagawa, Hidetaka Uramoto
Although pulmonary function was better after video-assisted thoracoscopic surgery (VATS) lobectomy than after open thoracotomy lobectomy, it is unclear whether postoperative pulmonary function after VATS lobectomy is better than that after mini-thoracotomy lobectomy. The aim of this study is to determine whether the former is better than the latter. VATS lobectomies were performed using endoscopic techniques through a 3-4-cm skin incision spread by a silicon rubber retractor and two or three trocars. Mini-thoracotomy lobectomies were performed through a 7-12-cm skin incision spread by rib retractors made of metal and one or two trocars...
December 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/29213346/safe-plastic-surgery-of-the-breast-ii-saving-nipple-sensation
#2
Steven Schulz, Matthew R Zeiderman, J Stephen Gunn, Charles A Riccio, Saeed Chowdhry, Ronald Brooks, Joshua H Choo, Bradon J Wilhelmi
Background: Since its inception, reduction mammoplasty has matured considerably. Primary evolution in clinical research and practice initially focused on developing techniques to preserve tissue viability; breast parenchyma, skin, and nipple tissue that has expanded to include sensation and erectile function play a large role in the physical intimacy of women. Studies regarding primary innervation to the nipple are few and often contradictory. Our past anatomical study demonstrated that primary innervation to the nipple to come from the lateral branch of the fourth intercostal nerve...
2017: Eplasty
https://www.readbyqxmd.com/read/29209826/volumetric-modulated-arc-therapy-vmat-to-deliver-nodal-irradiation-in-breast-cancer-patients
#3
Giuseppe Carlo Iorio, Pierfrancesco Franco, Elena Gallio, Stefania Martini, Francesca Arcadipane, Sara Bartoncini, Nadia Rondi, Francesca Romana Giglioli, Ada Ala, Mario Airoldi, Michela Donadio, Corrado De Sanctis, Isabella Castellano, Umberto Ricardi
To evaluate feasibility, safety, toxicity profile and dosimetric results of volumetric modulated arc therapy (VMAT) to deliver regional nodal irradiation (RNI) after either mastectomy or breast conservation (BCS) in high-risk breast cancer patients. Between January 2015 and January 2017, a total of 45 patients were treated with VMAT to deliver RNI together with whole breast or post-mastectomy radiotherapy. The fractionation schedule comprised 50 Gy in 25 fractions given to supraclavicular and axillary apex nodes and to whole breast (after BCS) or chest wall (after mastectomy)...
November 24, 2017: Medical Oncology
https://www.readbyqxmd.com/read/29200772/sclerema-neonatorum-in-a-full-term-infant-showing-favorable-prognosis
#4
Seh Hyun Park, Soo-Chan Kim
Sclerema neonatorum (SN) is a rare disease characterized by firm, indurated, waxy skin lesions extending throughout the body, sparing the fat-free soles, palms, and genitalia. The prognosis of SN is generally very poor, with a high fatality rate. We report the case of a full-term infant with delayed onset of SN showing good prognosis. A 4-month-old Korean male infant presented with diffuse waxy, sclerotic skin lesions on the whole body, sparing the face, nipples, and genital area, which began developing at 2 months of age...
December 2017: Annals of Dermatology
https://www.readbyqxmd.com/read/29187806/absorption-ratio-of-treatment-couch-and-effect-on-surface-and-build-up-region-doses
#5
Taylan Tuğrul
Aim: In this study, at different fields, energies and gantry angles, treatment couch and rails dose absorption ratio and treatment couch effect on surface and build-up region doses were examined. Background: It is assumed that radiation attenuation is minimal because the carbon fiber couches have low density and it is not generally accounted for during treatment planning. Consequently, it leads to a major dosimetric mistake. Materials and methods: Solid water phantom was used for relative dose measurement...
January 2018: Reports of Practical Oncology and Radiotherapy
https://www.readbyqxmd.com/read/29180895/postoperative-pain-management-in-the-postanesthesia-care-unit-an-update
#6
REVIEW
Jie Luo, Su Min
Acute postoperative pain remains a major problem, resulting in multiple undesirable outcomes if inadequately controlled. Most surgical patients spend their immediate postoperative period in the postanesthesia care unit (PACU), where pain management, being unsatisfactory and requiring improvements, affects further recovery. Recent studies on postoperative pain management in the PACU were reviewed for the advances in assessments and treatments. More objective assessments of pain being independent of patients' participation may be potentially appropriate in the PACU, including photoplethysmography-derived parameters, analgesia nociception index, skin conductance, and pupillometry, although further studies are needed to confirm their utilities...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/29167674/a-new-immunosuppressive-molecule-emodin-induces-both-cd4-foxp3-and-cd8-cd122-regulatory-t-cells-and-suppresses-murine-allograft-rejection
#7
Feifei Qiu, Huazhen Liu, Chun-Ling Liang, Golay D Nie, Zhenhua Dai
Due to vigorous alloimmunity, an allograft is usually rejected without any conventional immunosuppressive treatment. However, continuous global immunosuppression may cause severe side effects, including tumors and infections. Mounting evidence has shown that cyclosporine (CsA), a common immunosuppressant used in clinic, impedes allograft tolerance by dampening regulatory T cells (Tregs), although it inhibits allograft rejection at the same time. Therefore, it is necessary to seek an alternative immunosuppressive drug that spares Tregs with high efficiency in suppression but low toxicity...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/29166342/important-considerations-for-performing-prepectoral-breast-reconstruction
#8
Hani Sbitany
Prepectoral breast reconstruction has emerged as an excellent technique for postmastectomy reconstruction, as it allows for full preservation of a patient's pectoralis major muscle and chest wall function. This reduces pain, eliminates animation deformity, and results in high patient satisfaction. Safely performed prepectoral breast reconstruction requires a careful patient selection process before committing to the procedure, taking into account comorbidities, radiation status, and oncologic criteria such as tumor location and breast cancer stage...
December 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29158365/phase-ii-trial-using-a-combination-of-oxaliplatin-capecitabine-and-celecoxib-with-concurrent-radiation-for-newly-diagnosed-resectable-rectal-cancer
#9
Emilio P Araujo-Mino, Yehuda Z Patt, Cristina Murray-Krezan, Joshua A Hanson, Pranshu Bansal, Ben J Liem, Ashwani Rajput, M Houman Fekrazad, Glenory Heywood, Fa Chyi Lee
LESSONS LEARNED: Colorectal cancers exhibit a high level of cyclooxygenase-2 (COX-2) expression with strong preclinical rationale for improved clinical outcomes with COX-2 inhibition. Celecoxib is a COX-2 inhibitor and we have shown that it can be safely combined with capecitabine and oxaliplatin as part of neoadjuvant treatment with radiation therapy (RT) in rectal cancer.There was a significant improvement in skin toxicity with this combination as compared with historical data. Considering the field has moved on to single-agent capecitabine, we believe future trials with capecitabine and celecoxib hold potential...
November 20, 2017: Oncologist
https://www.readbyqxmd.com/read/29141048/microcirculation-in-open-vs-minimally-invasive-dorsal-stabilization-of-thoracolumbar-fractures
#10
Bergita Ganse, Miguel Pishnamaz, Philipp Kobbe, Christian Herren, Gertraud Gradl-Dietsch, Franziska Böhle, Bernd Johannes, Bong-Sung Kim, Klemens Horst, Matthias Knobe
Standard open and percutaneous minimally invasive surgical procedures co-exist in the treatment of fractures of the thoracolumbar spine. Shorter skin incisions just above the pedicles are used in minimally invasive procedures. Full-length skin incisions and invasive preparations are applied in the standard open approach. While both methods show equivalent rates of intraoperative surgical complications and comparable clinical and radiological outcomes, blood loss and operation time have shown to be decreased in minimally invasive treatment...
2017: PloS One
https://www.readbyqxmd.com/read/29129153/skin-biopsy-for-diagnosis-of-ullrich-congenital-muscular-dystrophy-an-observational-study
#11
Biswaroop Chakrabarty, M C Sharma, Sheffali Gulati, Chitra Sarkar
The gold standard diagnostic test for Ullrich congenital muscular dystrophy (UCMD) is molecular testing for COL6 mutation. The facility for genetic testing is sparingly available and it is usually diagnosed by muscle biopsy. The latter is an invasive procedure requiring expertise and sedation. Skin biopsy has shown promise as a simpler diagnostic modality. Eleven and 7 cases, respectively, of phenotypically suspected Ullrich congenital muscular dystrophy and dystrophinopathy underwent simultaneous skin and muscle biopsies, which were subjected to hematoxylin and eosin (H&E) and immunohistochemistry staining for collagen VI and dystrophin 1, 2, and 3...
December 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/29126044/medial-forefoot-fillet-flap-for-primary-closure-of-transmetatarsal-amputation-a-series-of-four-cases
#12
Eliezer Sidon, Shai Shemesh, Yoav Rosenthal, Snir Heller, Steven Velkes, Alon Burg
Amputation of the forefoot is a salvage procedure for several forefoot acute or chronic infection. A good, sensate and durable skin cover is important for quicker and better rehabilitation. The use of filleted flaps (or "spare parts technique") has been published in the past as a creative technique. The purpose of this article is to introduce a reproducible, pre-planned, technique that requires less creativity for the use of the "spare parts". The authors describe a case series of 4 patients with deep infection and osteomyelitis of the forefoot, without involvement of the medial skin that underwent two staged procedure for transmetatarsal amputation with medial forefoot fillet flap...
December 2017: Foot
https://www.readbyqxmd.com/read/29121782/imaging-in-cutaneous-surgery
#13
Amanda Levine, Daniel Siegel, Orit Markowitz
Skin cancer is the most commonly diagnosed cancer in the USA. Mohs micrographic surgery is a microscopically controlled surgical technique that excises lateral and deep surgical margins while also sparing function and achieving a good cosmetic outcome. Given the increasing incidence in skin cancer worldwide and its associated treatment costs, techniques are being developed to improve the time and cost efficacy of this procedure. The use of noninvasive imaging, both in vivo and ex vivo, has the potential to increase efficiency of diagnosis and surgical management of skin cancers...
November 10, 2017: Future Oncology
https://www.readbyqxmd.com/read/29109028/enhancing-immunogenicity-of-antigens-through-sustained-intradermal-delivery-using-chitosan-microneedles-with-a-patch-dissolvable-design
#14
Mei-Chin Chen, Kuan-Ying Lai, Ming-Hung Ling, Chun-Wei Lin
Reducing the dosage required for vaccination is highly desirable, particularly in cases of epidemic emergencies. This study evaluated the potential of a chitosan microneedle (MN) system with a patch-dissolvable design for low-dose immunization. This system comprises antigen-loaded chitosan MNs and a hydrophilic polyvinyl alcohol/polyvinyl pyrrolidone supporting array patch, which provides extra strength to achieve complete MN insertion and then quickly dissolves in the skin to reduce patch-induced skin irritation...
November 3, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/29107625/activation-of-erk-creb-pathway-in-noradrenergic-neurons-contributes-to-hypernociceptive-phenotype-in-h4-receptor-knockout-mice-after-nerve-injury
#15
Maria Domenica Sanna, Tommaso Mello, Emanuela Masini, Nicoletta Galeotti
G-protein coupled receptor H4 (H4R) is a histamine receptor subtype that is involved in a condition of pathological chronic pain, but its pathophysiological function is unknown. Here, we investigate the role of H4R in a model of traumatic nerve injury. H4R knockout (H4R(-)/(-)) mice exposed to spared nerve injury (SNI) developed a more prominent mechanical and thermal hypersensitivity than wild type mice. Western blotting and immunofluorescence were used to characterize the cellular mechanisms. Nerve injury increased phosphorylated pERK MAPK expression in the spinal cord that was further promoted in H4R(-)/(-) genotype...
October 28, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/29101685/short-term-feed-and-light-deprivation-reduces-voluntary-activity-but-improves-swimming-performance-in-rainbow-trout-oncorhynchus-mykiss
#16
J R Khan, C C Lazado, C Methling, P V Skov
Rainbow trout Oncorhynchus mykiss (~ 180 g, 16 °C and < 5 kg m(-3)) that were feed deprived and kept in total darkness showed a significant increase in critical swimming speed (U crit) between 1 and 12 days of deprivation (from 3.35 to 4.46 body length (BL) s(-1)) with no increase in maximum metabolic rate (MMR). They also showed a significant decrease in the estimated metabolic rate at 0 BL s(-1) over 12 days which leads to a higher factorial aerobic metabolic scope at day 12 (9.38) compared to day 1 (6...
November 3, 2017: Fish Physiology and Biochemistry
https://www.readbyqxmd.com/read/29097860/necrotizing-fasciitis-how-reliable-are-the-cutaneous-signs
#17
REVIEW
Ho Jun Kiat, Yap Hui En Natalie, Lateef Fatimah
Necrotizing fasciitis (NF) is a surgical emergency. It is often aggressive and characterized by the rapidly progressive inflammatory infection of the fascia that causes extensive necrosis of the subcutaneous tissue and fascia, relatively sparing the muscle and skin tissue. As the disease progresses, thrombosis of the affected cutaneous perforators subsequently devascularizes the overlying skin. The course indeed can be a fulminant one. The diagnosis of NF, especially in the early stages, is extremely challenging, and it can be very close in presentation to other skin and subcutaneous tissue infections...
October 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29089810/training-oncoplastic-breast-surgeons-the-canadian-fellowship-experience
#18
J Maxwell, A Arnaout, R Hanrahan, M Brackstone
BACKGROUND: Oncoplastic breast surgery combines traditional oncologic breast conservation with plastic surgery techniques to achieve improved aesthetic and quality-of-life outcomes without sacrificing oncologic safety. Clinical uptake and training remain limited in the Canadian surgical system. In the present article, we detail the current state of oncoplastic surgery (ops) training in Canada, the United States, and worldwide, as well as the experience of a Canadian clinical fellow in ops...
October 2017: Current Oncology
https://www.readbyqxmd.com/read/29089533/proton-minibeam-radiation-therapy-spares-normal-rat-brain-long-term-clinical-radiological-and-histopathological-analysis
#19
Yolanda Prezado, Gregory Jouvion, David Hardy, Annalisa Patriarca, Catherine Nauraye, Judith Bergs, Wilfredo González, Consuelo Guardiola, Marjorie Juchaux, Dalila Labiod, Remi Dendale, Laurène Jourdain, Catherine Sebrie, Frederic Pouzoulet
Proton minibeam radiation therapy (pMBRT) is a novel strategy for minimizing normal tissue damage resulting from radiotherapy treatments. This strategy partners the inherent advantages of protons for radiotherapy with the gain in normal tissue preservation observed upon irradiation with narrow, spatially fractionated beams. In this study, whole brains (excluding the olfactory bulb) of Fischer 344 rats (n = 16) were irradiated at the Orsay Proton Therapy Center. Half of the animals received standard proton irradiation, while the other half were irradiated with pMBRT at the same average dose (25 Gy in one fraction)...
October 31, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29082219/an-update-of-couch-effect-on-the-attenuation-of-megavoltage-radiotherapy-beam-and-the-variation-of-absorbed-dose-in-the-build-up-region
#20
T Sedaghatian, M Momennezhad, S H Rasta, Y Makhdoomi, S Abdollahian
PURPOSE: Fiber carbon is the most common material used in treating couch as it causes less beam attenuation than other materials. Beam attenuation replaces build-up region, reduces skin-sparing effect and causes target volume under dosage. In this study, we aimed to evaluate beam attenuation and variation of build-up region in 550 TxT radiotherapy couch. MATERIALS AND METHODS: In this study, we utilized cylindrical PMMA Farmer chamber, DOSE-1 electrometer and set PMMA phantom in isocenter of gantry and the Farmer chamber on the phantom...
September 2017: Journal of Biomedical Physics & Engineering
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