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Surgical endocrinology

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https://www.readbyqxmd.com/read/29317946/transient-adult-jejunojejunal-intussusception-a-case-of-conservative-management-vs-surgery
#1
Jonathan Lai, Daryl Ramai, Tyler Murphy, Fanny Kasher
Transient intussusception without any underlying lead is a rare clinical entity which can cause abdominal pain in adults. It has been associated with inflammatory bowel disease, cystic fibrosis, and endocrinological disorders. We present a case of transient jejunojejunal intussusception in a 42-year-old Hispanic male patient without any underlying pathological lead point. Surgical intervention yielded a negative laparotomy and resection was not undertaken. We discuss the clinical presentation, surgical procedure, risk factors leading to episodes of transient intussusception, and the use of surgery versus conservative management in such cases...
December 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/29288106/pituitary-apoplexy-should-endoscopic-surgery-be-the-gold-standard
#2
Joaquim Teixeira, José Lavrador, Diogo Simão, José Miguéns
BACKGROUND: Pituitary apoplexy is an uncommon, potentially fatal condition due to spontaneous ischemia or hemorrhage in a pituitary adenoma. The treatment of this disorder has long been a matter of debate. METHODS: Retrospective cohort study including all patients admitted with pituitary apoplexy in our Department between 2005 and 2015. Clinical symptoms and signs on admission, treatment (conservative vs surgical), neurological deficit on discharge and at 6 months follow-up, endocrinological evaluation at 6 months follow-up were analyzed...
December 26, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29248982/a-case-series-of-atypical-features-of-patients-with-biopsy-proven-isolated-igg4-related-hypophysitis-and-normal-serum-igg4-levels
#3
Kevin C J Yuen, Kelley J Moloney, Jennifer U Mercado, Steven Rostad, Brendan J McCullough, Zachary N Litvack, Johnny B Delashaw, Marc R Mayberg
BACKGROUND: IgG4-related hypophysitis is a rare clinical entity that forms part of an emerging group of multi-organ IgG4-related fibrosclerotic systemic diseases. The rare prevalence of the disease, presenting features that overlap with other sellar pathologies, and variable imaging features can make preoperative identification challenging. PURPOSE AND METHODS: We report three cases of isolated IgG4-related hypophysitis with atypical clinical and imaging features that mimicked those of pituitary apoplexy and other sellar lesions...
December 16, 2017: Pituitary
https://www.readbyqxmd.com/read/29238923/endoscopic-therapy-and-curative-effect-in-pituitary-adenoma-patients-complicated-by-acromegalic-cardiomyopathy
#4
Heping Zhou, Zhengjiang Zha, Xiangdong Li, Xinsheng Chen, Jing Wang, Zhongzhou Su
The study aimed to retrospectively analyze the clinical characteristics of patients with pituitary adenomas complicated by acromegalic cardiomyopathy and to evaluate the effect of endoscopic surgery. Eighty-six pituitary adenoma patients complicated by acromegalic cardiomyopathy who were treated with endoscopic surgery in the First Affiliated Hospital of Soochow University from January 2010 to December 2016 were enrolled. We noted patient clinical characteristics and explored the relationships with surgical treatment...
December 13, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/29230595/an-optimized-technique-of-endoscopic-third-ventriculocisternostomy-etv-for-children-with-occlusive-hydrocephalus
#5
Albert Akramovich Sufianov, Ekkehard M Kasper, Rinat Albertovich Sufianov
In this article, we present an optimized minimally invasive technique of ETV for children with occlusive hydrocephalus. The study comprises of 64 consecutive pediatric cases (34 boys and 30 girls aged from 1 month to 5 years) of occlusive hydrocephalus from various etiologies, which were treated with a modified technique of ETV. Mean clinical follow-up period after ETV was 24.2 ± 3.8 months. Application of the new technique made it possible to significantly reduce the length of the soft tissue incision for access, and the use of upgraded instruments allowed to perform a twist drill hole in the skull to less than half a usual size...
December 11, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/29184714/clinical-significance-of-thickened-sphenoid-sinus-mucosa-in-rathke-s-cleft-cyst
#6
Hiroshi Takasuna, Taigen Sase, Hidemichi Ito, Hajime Ono, Kotaro Oshio, Yuichiro Tanaka
Background: To determine the clinical significance of thickening of the sphenoid sinus mucosa (TSSM) in Rathke's cleft cyst (RCC). Methods: We retrospectively reviewed patients with pituitary lesions. A total of 99 patients, who underwent surgery of pituitary lesions between 2008 and 2015, were analyzed to evaluate the clinical significance of TSSM using magnetic resonance imaging. The patients with TSSM were evaluated for their characteristics. Results: Of the 99 operations, 15 patients with paranasal sinusitis, direct invasion to the sellar floor, and/or a history of transsphenoidal surgery were excluded...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29171893/should-clinicians-set-limits-on-reproductive-autonomy
#7
Louise P King
As a gynecologic surgeon with a focus on infertility, I frequently hold complex discussions with patients, exploring with them the risks and benefits of surgical options. In the past, we physicians may have expected our patients to simply defer to our expertise and choose from the options we presented. In our contemporary era, however, patients frequently request options not favored by their physicians and even some they've found themselves online. In reproductive endocrinology and infertility, the range of options that may be offered or that patients may themselves seek out is continuously widening...
December 2017: Hastings Center Report
https://www.readbyqxmd.com/read/29155347/postoperative-gamma-knife-radiosurgery-for-cavernous-sinus-invading-growth-hormone-secreting-pituitary-adenomas
#8
Eui Hyun Kim, Min Chul Oh, Jong Hee Chang, Ju Hyung Moon, Cheol Ryong Ku, Won-Seok Chang, Eun Jig Lee, Sun Ho Kim
OBJECTIVE: We aimed to determine the long-term effects of Gamma knife radiosurgery (GKS) on remnants in the cavernous sinus (CS) after transsphenoidal surgery (TSS) for acromegaly and to identify its possible adverse effects. METHODS: Thirty patients who had remnant tumors only inside the CS after TSS and who consequently underwent GKS were included. They were followed for a median period of 47 months after GKS with regular hormonal and radiological examinations...
November 16, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29145468/the-effects-of-non-surgical-periodontal-treatment-on-glycemic-control-oxidative-stress-balance-and-quality-of-life-in-patients-with-type-2-diabetes-a-randomized-clinical-trial
#9
Hirofumi Mizuno, Daisuke Ekuni, Takayuki Maruyama, Kota Kataoka, Toshiki Yoneda, Daiki Fukuhara, Yoshio Sugiura, Takaaki Tomofuji, Jun Wada, Manabu Morita
AIM: The purpose of this study was to investigate the effects of non-surgical periodontal treatment on hemoglobinA1c (HbA1c) levels, oxidative stress balance and quality of life (QOL) in patients with type 2 diabetes mellitus (T2DM) compared to no periodontal treatment (simple oral hygiene instructions only). METHODS: The design was a 6-month, single-masked, single center, randomized clinical trial. Patients had both T2DM and chronic periodontitis. Forty participants were enrolled between April 2014 and March 2016 at the Nephrology, Diabetology and Endocrinology Department of Okayama University Hospital...
2017: PloS One
https://www.readbyqxmd.com/read/29122303/is-it-really-possible-to-predict-the-consistency-of-a-pituitary-adenoma-preoperatively
#10
A K Thotakura, M R Patibandla, M K Panigrahi, A Mahadevan
OBJECTIVES: To determine if the consistency of pituitary adenomas can be predicted based on a preoperative MRI study and to assess the surgical outcome of firm pituitary adenomas. MATERIALS AND METHODS: One hundred consecutive patients with pituitary adenomas and suprasellar extension were operated by a transsphenoidal approach from July 2003 to December 2006. In addition to the neurological examination, the patients were evaluated by ophthalmological, endocrinological and radiological workups...
November 6, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/29117664/pituitary-abscess-with-unusual-clinical-course
#11
Milica Medić Stojanoska, Duško Kozić, Mladen Bjelan, Petar Vuleković, Nada Vučković, Bojan Vuković, Branka Kovačev Zavišić
The aim is to present unusual clinical course and magnetic resonance imaging (MRI) features of pituitary abscess. A 59-year-old man presented with fever, polyuria, polydipsia and marked weight loss within the last two months. Basic endocrinology tests revealed the presence of anterior pituitary dysfunction, associated with central diabetes insipidus and increased levels of inflammatory markers. The presence of expansile sellar lesion, showing restricted diffusion signal pattern compatible with acute pituitary pyogenic abscess was found on MRI...
December 2016: Acta Clinica Croatica
https://www.readbyqxmd.com/read/29094072/endoscopic-unilateral-transethmoid-paraseptal-approach-to-the-central-skull-base
#12
Márton Eördögh, Hans Rudolf Briner, Daniel Simmen, Nicholas Jones, Robert Reisch
Objectives: The endoscopic technique in transnasal skull base surgery offers optimal visualization and free manipulation in the surgical field. However, it may cause approach-related sinonasal injury, influencing patients' quality of life (QOL). To minimize rhinological morbidity without restrictions in surgical manipulation and tumor resection, we introduced the unilateral transethmoidal-paraseptal approach. In this article, we analyzed the long-term results and sinonasal outcome of this technique...
October 2017: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/29081161/-surgery-versus-conservative-management-for-subclinical-cushing-s-syndrome-in-adrenal-incidentalomas
#13
L L Li, L Zhao, J T Dou, G Q Yang, W J Gu, Z H Lü, J M Ba, Y M Mu, J M Lu, C Y Pan
Objective: To determine the effect of the surgical and conservative approaches on the metabolic profiles in patients with subclinical Cushing's syndrome (SCS) in adrenal incidentalomas (AI). Methods: A hundred and thirty AI patients with SCS in Department of Endocrinology, PLA General Hospital between January 2008 and December 2016 were studied, surgery was performed in 88 patients (surgical group), and the rest received conservative approach (conservative group). The improvement/worsening of blood pressure, blood glucose, lipid profiles and body weight after a duration of >18 months follow-up were analyzed, respectively...
October 31, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29076466/-a-supraorbital-trans-eyebrow-approach-in-surgery-of-chiasmatic-sellar-and-anterior-cranial-fossa-tumors
#14
A G Alekseev, A A Pichugin, V I Danilov
OBJECTIVE: to analyze 31 resections of chiasmatic-sellar region (CSR) and anterior cranial fossa (ACF) tumors using the supraorbital trans-eyebrow approach (STA). MATERIAL AND METHODS: We analyzed medical histories of 31 patients who underwent tumor resection using STA in the period between October 2013 and April 2017. We analyzed the age and gender of patients, size and location of the tumor, presence of a neurological deficit, vision and olfactory functions before and after surgery, surgery duration, amount of intraoperative blood loss, rate of frontal sinus trephination and nasal liquorrhea, hemorrhagic and ischemic complications after surgery, Simpson grade of tumor resection, patient's condition before and after surgery (Glasgow Outcome Scale and Karnofsky Scale), and degree of patient satisfaction with the cosmetic result of surgery...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/29050119/-feasibility-of-domestic-18-f-dopa-pet-ct-scanning-in-the-differential-diagnosis-of-pancreatic-lesions-in-children-with-hyperinsulinemic-hypoglycemia
#15
M Y Zhang, J J Ge, Z Pei, K R Dong, L Chen, X Wang, Z W Zhang, X J Li, L Xi, R Q Cheng, G P Lu, Y H Guan, F H Luo
Objective: To study the feasibility of (18)F-fluoro-L-dihydroxyphenylalanine positron emission tomography/Computed tomography ((18)F-DOPA PET/CT) scanning in the localization and differential diagnosing of focal versus diffuse form of pancreas lesions in patients with hyperinsulinemic hypoglycemia (HH). Method: Twenty-four patients were diagnosed with HH between January, 2016 and February, 2017 in the Department of Pediatric Endocrinology and Inherited Metabolic Diseases, Children's Hospital of Fudan University using an integrated clinical and biochemical diagnostic protocol, domestic (18)F-DOPA PET/CT imaging technique were applied after MRI and ultrasound failed to detect pancreas lesions...
October 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/29042391/korean-obesity-surgical-treatment-study-kobess-protocol-of-a-prospective-multicentre-cohort-study-on-obese-patients-undergoing-laparoscopic-sleeve-gastrectomy-and-roux-en-y-gastric-bypass
#16
Young Suk Park, Do Joong Park, Joo Ho Lee, Hyuk-Joon Lee, Tae Kyung Ha, Yong-Jin Kim, Seung-Wan Ryu, Sang-Moon Han, Moon-Won Yoo, Sungsoo Park, Sang-Uk Han, Yoonseok Heo
INTRODUCTION: Bariatric surgery effectively induces long-term weight loss in Western populations. However, its effectiveness in Asians remains to be confirmed objectively. The Korean Society for Metabolic and Bariatric Surgery proposes the first prospective cohort study on Koreans undergoing bariatric surgery. METHODS AND ANALYSIS: The Korean OBEsity Surgical treatment Study (KOBESS) is a prospective, multicentre, single-arm, observational, cohort study on morbidly obese patients who undergo primary sleeve gastrectomy or Roux-en-Y gastric bypass in Korea...
October 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/29025202/clinical-manifestations-of-rathke-s-cleft-cysts-and-their-natural-progression-during-2-years-in-children-and-adolescents
#17
Jo Eun Jung, Juhyun Jin, Mo Kyung Jung, Ahreum Kwon, Hyun Wook Chae, Duk Hee Kim, Ho-Seong Kim
PURPOSE: Rathke's cleft cyst (RCC) is an asymptomatic benign lesion. With increased interest in pediatric endocrinology, the prevalence of RCCs in children is also increasing. However, the clinical relevance and proper management of RCC is not well defined in children. Therefore, we investigated the clinical manifestations and radiologic features of RCC in children and adolescents, as well as the natural progression of RCC. METHODS: We retrospectively reviewed the medical records of 91 children and adolescents with RCC diagnosed with magnetic resonance imaging (MRI) in Severance Children's Hospital from January 2006 to December 2015...
September 2017: Annals of Pediatric Endocrinology & Metabolism
https://www.readbyqxmd.com/read/29016532/kcnj5-mutation-as-a-predictor-for-resolution-of-hypertension-after-surgical-treatment-of-aldosterone-producing-adenoma
#18
Takumi Kitamoto, Masao Omura, Sachiko Suematsu, Jun Saito, Tetsuo Nishikawa
OBJECTIVE: To investigate the effect of KCNJ5 mutations on the cure of hypertension in patients with aldosterone-producing adenoma (APA) after unilateral adrenalectomy. METHODS: Our study included 142 patients with APA, who were detected with an endocrinological abnormality and diagnosed with hypertension, as confirmed by pathological analysis. We sequenced KCNJ5, ATP1A1, ATP2B3, CACNA1D, and CTNNB1 from APA tissue samples, and performed a retrospective analysis to determine correlations between wild-type or mutated KCNJ5 and patient clinical characteristics...
October 7, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28987834/subtemporal-approach-for-gross-total-resection-of-retrochiasmatic-craniopharyngiomas-our-experience-on-30-cases
#19
Grzegorz Zieliński, Emir Ahmed Sajjad, Łukasz Robak, Andrzej Koziarski
BACKGROUND: Surgical treatment of retrochiasmatic craniopharyngiomas is associated with higher rates of complications, mortality, failure of complete removal, and recurrence when compared to craniopharyngiomas located elsewhere. These tumors lie behind the optic chiasm and, when large, can extend upward into the third ventricle and downward along the brain stem making their adequate exposure challenging. Most of the proposed techniques either employ a trans lamina terminalis route or require wide bony exposures...
October 4, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28986229/analysis-of-survival-prognosis-for-children-with-symptomatic-optic-pathway-gliomas-who-received-surgery
#20
Yuhan Liu, Xiaolei Hao, Wei Liu, Chunde Li, Jian Gong, Zhenyu Ma, Yongji Tian
OBJECTIVE: The feasibility and prognosis of surgical treatment for children with optic pathway gliomas (OPGs) is controversial. Therefore this study attempted to evaluate the effects of surgery and discuss prognostic factors related to the survival of children with symptomatic OPGs. MATERIALS AND METHODS: One-hundred twenty-five children diagnosed with OPGs underwent surgery in the Department of Neurosurgery, Beijing Tiantan Hospital from 2003-2016. In this retrospective study, their demographics, clinical characteristics, treatments, and survival outcomes were investigated and summarized...
October 3, 2017: World Neurosurgery
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