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Functional surgery

Ryan D Sheldon, Kayla M Kanosky, Kevin D Wells, Lili Miles, James W Perfield, Stavra Xanthakos, Thomas H Inge, R Scott Rector
BACKGROUND: Mechanisms responsible for progression of nonalcoholic fatty liver disease (NAFLD) to steatohepatitis (NASH) remain poorly defined. METHODS: To examine the potential contribution of adipose tissue to NAFLD progression, we performed a complete transcriptomic analysis using RNA-sequencing (RNA-seq) on intra-abdominal adipose tissue (IAT) from severely obese adolescents (Mage 16.9±0.4 yrs; BMI z-score 2.7±0.1) undergoing bariatric surgery and liver biopsy categorized into 3 groups; No steatosis (Normal, n=8), steatosis only (n=13), or NASH (n=10) by liver histology...
October 7, 2016: Physiological Genomics
Ruijie Liu, Hadi Khalil, Suh-Chin J Lin, Michelle A Sargent, Allen J York, Jeffery D Molkentin
Nemo-like kinase (NLK) is an evolutionary conserved serine/threonine protein kinase implicated in development, proliferation and apoptosis regulation. Here we identified NLK as a gene product induced in the hearts of mice subjected to pressure overload or myocardial infarction injury, suggesting a potential regulatory role with pathological stimulation to this organ. To examine the potential functional consequences of increased NLK levels, cardiac-specific transgenic mice with inducible expression of this gene product were generated, as well as cardiac-specific Nlk gene-deleted mice...
2016: PloS One
Amir M Abtahi, Kade Shumway Lyman, Darrel S Brodke, Brandon D Lawrence, Chong Zhang, William Ryan Spiker
STUDY DESIGN: This is a retrospective review. OBJECTIVE: To evaluate the relationship between patient functional status and self-assessment of disability as measured by 3 commonly used clinical assessment instruments-the Oswestry Disability Index (ODI), the Neck Disability Index (NDI), and the EuroQol (EQ)-5D and patient satisfaction scores in a spine surgery clinic population. SUMMARY OF BACKGROUND DATA: Patient satisfaction surveys, which measure the "patient experience of care" are becoming an increasingly important measure of the quality of medical care...
October 19, 2016: Clinical Spine Surgery
Andrea Bowyer, Colin F Royse
PURPOSE OF REVIEW: Recovery after surgery is a complex interplay of the patient, the surgery, and the perioperative anaesthesia management. Assessment of recovery should address the needs of multiple stakeholders, including the institutions and healthcare providers, but primarily should be focused on the patients and their perception of quality of recovery and return to normalcy. This review will summarize the development of assessment of recovery to a multidimensional dichotomous construct that requires a real-time assessment tool validated for repeat measures and containing cognitive assessment...
October 18, 2016: Current Opinion in Anaesthesiology
Andreas Gravvanis, Despoina Kakagia, Nick Katsikeris, Dimosthenis Tsoutsos
BACKGROUND: This report aims to first present Integra as an adjunct to complex mandibular reconstruction for intraoral lining resurfacing, and to review the literature on the use of dermal matrices for mucosal resurfacing of the floor of the mouth. CLINICAL REPORT: A 62-year-old female patient with previous ablation surgery for squamous cell carcinoma of the floor of the mouth, presented with extrusion of the mandibular plate through the chin skin and serious tongue tethering...
October 2016: Journal of Craniofacial Surgery
Jacopo Celli, Gudrun Rappold, Beate Niesler
Serotonin type 3 (5-HT3 ) receptors are ligand-gated ion channels formed by five subunits (5-HT3 A-E), which are encoded by the HTR3A, HTR3B, HTR3C, HTR3D and HTR3E genes. Functional receptors are pentameric complexes of diverse composition. Different receptor subtypes confer a predisposition to nausea and vomiting during chemotherapy, pregnancy, and following surgery. In addition, different subtypes contribute to neurogastroenterologic disorders such irritable bowel syndrome (IBS) and eating disorders as well as comorbid psychiatric conditions...
October 20, 2016: Human Mutation
Ling Xue, Nick Holford, Xiao-Liang Ding, Zhen-Ya Shen, Chen-Rong Huang, Hua Zhang, Jing-Jing Zhang, Zhe-Ning Guo, Cheng Xie, Ling Zhou, Zhi-Yao Chen, Lin-Sheng Liu, Li-Yan Miao
AIMS: The aims of this study are to apply a theory based mechanistic model to describe the pharmacokinetics (PK) and pharmacodynamics (PD) of S- and R-warfarin. METHODS: Clinical data were obtained from 264 patients. Total concentrations for S- and R-warfarin were measured by ultra-high performance liquid tandem mass spectrometry. Genotypes were measured using pyrosequencing. A sequential population pharmacokinetic parameter with data method was used to describe the international normalized ratio (INR) time course...
October 20, 2016: British Journal of Clinical Pharmacology
Sylwia Szotek, Joanna Dawidowicz, Brian Eyden, Natalia Matysiak, Aleksander Czogalla, Grzegorz Dudzik, Anna Leśniewicz, Krzysztof Maksymowicz
Fascia lata is an important element of the fascial system, which forms the continuum of connective tissue throughout the body. This deep fascia envelops the entire thigh and hip area and its main function is to transmit mechanical forces generated by the musculoskeletal system of the lower extremities. Fascia lata is also known as a useful and easily harvested graft material. Despite its crucial role in lower extremity biomechanics and wide-ranging applications in plastic and reconstructive surgery, both the structure of fascia lata and particularly the cells populating this tissue are relatively unexplored and therefore poorly understood...
October 20, 2016: Ultrastructural Pathology
Bao-Lin Li, Wei Li, Jia-Qi Bi, Qing-Gang Meng, Jian-Feng Fei
OBJECTIVES: To identify frail and pre-frail patients in a group of patients older than 60 years. METHODS: The phenotype model of Fried's method was used to identify frailty and pre-frailty in total of 78 participants. Cognitive ability and psychosocial function tests were also given to 59 of the 78 patients. RESULTS: Prevalence of frailty and pre-frailty was 14.1% (11/78) and 46.2% (36/78), respectively. Of the 5 phenotype variables, weak grip strength was the most commonly seen variable with 53...
October 20, 2016: Physician and Sportsmedicine
F Creamer, A Balfour, S Nimmo, I Foo, J D Norrie, L J Williams, K C Fearon, H M Paterson
BACKGROUND: Combined oral modified-release oxycodone-naloxone may reduce opioid-induced postoperative gut dysfunction. This study examined the feasibility of a randomized trial of oxycodone-naloxone within the context of enhanced recovery for laparoscopic colorectal resection. METHODS: In a single-centre open-label phase II feasibility study, patients received analgesia based on either oxycodone-naloxone or oxycodone. Primary endpoints were recruitment, retention and protocol compliance...
October 20, 2016: British Journal of Surgery
Joceline S Liu, Matthew I Bury, Natalie J Fuller, Renea M Sturm, Nida Ahmad, Arun K Sharma
Substitution urethroplasty for the treatment of male stricture disease is often accompanied by subsequent tissue fibrosis and secondary stricture formation. Patients with pre-existing morbidities are often at increased risk of urethral stricture recurrence brought upon in-part by delayed vascularization accompanied by overactive inflammatory responses following surgery. Within the context of this study, we demonstrate the functional utility of a cell/scaffold composite graft comprised of human bone marrow-derived mesenchymal stem cells (MSC) combined with CD34+ hematopoietic stem/progenitor cells (HSPC) to modulate inflammation and wound healing in a rodent model of substitution urethroplasty...
October 20, 2016: Scientific Reports
Candice Morrissey
Diastolic dysfunction ranging from impaired relaxation of the left ventricle to heart failure with preserved ejection fraction (HFpEF) is a common finding in the cardiac surgery population. It is important for the peri-operative echocardiographer to have a developed understanding of the pathophysiology of diastolic dysfunction and the echocardiographic features that determine where on the spectrum of diastolic function and dysfunction a patient lies.
October 2016: Annals of Cardiac Anaesthesia
Theodore Pincus
An MDHAQ/RAPID3 (multidimensional health assessment questionnaire/routine assessment of patient index data) was developed from the HAQ over 25 years, based on observations made from completion by every patient (with all diagnoses) at every routine rheumatology visit since 1980. Modification of the HAQ was viewed as similar to improving a laboratory test, with a primary focus on clinical value for diagnosis, prognosis, and/or management, as well as feasibility for minimal effect on clinical workflow. Rigorous attention, was also directed to validity, reliability, other methodologic and technological considerations, but after clinical value and feasibility were established...
September 2016: Clinical and Experimental Rheumatology
Markus Hoffmann, Asita Fazel, Kai-Gerrit Mews, Petra Ambrosch
OBJECTIVES: To underline the value of the microendoscopic CO2 -Laser assisted treatment (MEDCO2 ) of Zenker's diverticulum by investigating a large patient cohort treated in a single medical center. DESIGN: Retrospective Cohort Study of consecutive patients. SETTING: Dept. of Otorhinolaryngology, Head & Neck Surgery, Christian-Albrechts-University Kiel, Germany. PARTICIPANTS: 227 patients with Zenkers' diverticulum were treated by MEDCO2 and the results were compared with those reported in the literature for the open transcervical approach (OTA) and the endoscopic staple-assisted esophagodiverticulostomy (ESED)...
October 19, 2016: Clinical Otolaryngology
Michitaka Honda, Takashi Akiyoshi, Hisashi Noma, Atsushi Ogura, Toshiya Nagasaki, Tsuyoshi Konishi, Yoshiya Fujimoto, Satoshi Nagayama, Yosuke Fukunaga, Masashi Ueno
BACKGROUND: For patients with low-lying rectal cancer, the feasibility of anus-preserving surgery in combination with neoadjuvant chemoradiotherapy (NACRT) has been not well established from the perspective of patient-centered outcomes. METHODS: We investigated 278 patients with low-lying rectal adenocarcinoma from 2005 to 2012. We compared their symptoms and QOL scores of patients who underwent anus-preserving surgery with (n = 88) and without (n = 143) NACRT according to the Wexner scale, EORTC QLQ C-30, CR29, and the modified fecal incontinence quality life scale (mFIQL)...
October 2016: Journal of Surgical Oncology
H Borgmann, M Rodríguez Socarrás, J Salem, I Tsaur, J Gomez Rivas, E Barret, L Tortolero
PURPOSE: To assess the feasibility, safety and usefulness of augmented reality-assisted urological surgery using smartglass (SG). METHODS: Seven urological surgeons (3 board urologists and 4 urology residents) performed augmented reality-assisted urological surgery using SG for 10 different types of operations and a total of 31 urological operations. Feasibility was assessed using technical metadata (number of photographs taken/number of videos recorded/video time recorded) and structured interviews with the urologists on their use of SG...
October 19, 2016: World Journal of Urology
Philipp Lingohr, Jonas Dohmen, Hanno Matthaei, Timo Schwandt, Kathy Stein, Gun-Soo Hong, Julia Steitz, Thomas Longerich, Edwin Bölke, Sven Wehner, Jörg C Kalff
PURPOSE: Laparoscopic surgery (LS) has proved superior compared to conventional surgery (CS) regarding morbidity, length of hospital stay, rate of wound infection and time until recovery. An improved preservation of the postoperative immune function is assumed to contribute to these benefits though the role of the local peritoneal immune response is still poorly understood. Our study investigates the peritoneal immune response subsequent to abdominal surgery and compares it between laparoscopic and conventional surgery to find an immunological explanation for the clinically proven benefits of LS...
October 19, 2016: Langenbeck's Archives of Surgery
Michael C Glanzmann, Christoph Kolling, Hans-Kaspar Schwyzer, Matthias Flury, Laurent Audigé
PURPOSE: This study compared clinical and radiographic outcomes of patients undergoing resurfacing total shoulder arthroplasty (TSA) with those treated with a stemmed TSA. METHODS: Patients with primary osteoarthritis who underwent humeral resurfacing (RES) or stemmed (STA) TSA were identified in our shoulder arthroplasty register for retrospective analysis. Standard radiographs and clinical/patient-rated assessments were made up to 24 months post-surgery. Implant revisions were assessed...
October 19, 2016: International Orthopaedics
Sen Li, Wenhui Gong, Quan Qi, Zezhe Yuan, Anqing Chen, Jun Liu, Junfeng Cai, Mi Zhou, Zhe Wang, Xiaofeng Ye, Qiang Zhao
BACKGROUND: Currently, off-pump coronary artery bypass (OPCAB) grafting has been the standard procedure for surgical revascularization in patients with coronary artery disease (CAD). This study aimed to examine the safety and applicability of OPCAB compared with on-pump coronary artery bypass (ONCAB) in patients with severely dilated left ventricle. METHODS: A retrospective study of giant left ventricle patients [left ventricular end diastolic diameter (LVEDD) ≥ VE mm] undergoing coronary bypass grafting from 2009 through 2015 at a single center was conducted...
September 2016: Annals of Translational Medicine
J Do Cao, A Wiedemann, T Quinaux, S F Battaglia-Hsu, L Mainard, R Froissart, C Bonnemains, S Ragot, B Leheup, P Journeau, F Feillet
: Patients under 5 years were not evaluated in the phase-3 study for enzyme replacement therapy (ERT) in MPS IV A. Here we describe the evolution of a severe Morquio A pediatric patient who was diagnosed at 19 months old and treated by ERT at 21 months old for the next 30 months. Applying the standard ERT protocol on this very young patient appeared to reduce his urinary excretion of glycosaminoglycans (GAGs); the improvements in both the 6 minute-walk test (6MWT) and the stair climb test, however, were no different than those reported in the nature history study...
December 2016: Molecular Genetics and Metabolism Reports
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