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Alvaro Vidal, Nicolas Arnold, Mihai Dorin Vartolomei, Bernhard Kiss, Fiona Burkhard, George N Thalmann, Beat Roth
OBJECTIVES: To prospectively evaluate the long-term oncological and functional outcomes of postoperative total parenteral nutrition after radical cystectomy. METHODS: A total of 157 consecutive patients (≤cT3, cN0, cM0) who underwent extended pelvic lymph node dissection, radical cystectomy and ileal urinary diversion from September 2008 to March 2011 at a single center were randomized to receive either postoperative total parenteral nutrition (group A; n = 74) or oral nutrition alone (group B; n = 83)...
October 21, 2016: International Journal of Urology: Official Journal of the Japanese Urological Association
Shin-Rong Lee, Georgios Gemenetzis, Michol Cooper, Ammar A Javed, John L Cameron, Christopher L Wolfgang, Frederick E Eckhauser, Jin He, Matthew J Weiss
PURPOSE: The goal of this study was to assess the outcomes and characteristics of patients who underwent pancreatectomy for metastatic disease to the pancreas. METHODS: Patients who underwent surgical resection of metastatic disease to the pancreas from 1988 to 2016 were identified using a prospectively maintained database. Data on clinicopathological features and outcomes of these patients were analyzed. Cox proportional hazard models were employed to identify patient-specific risk factors that influence survival...
October 21, 2016: Annals of Surgical Oncology
Angelo M Dell'Aquila, Francesco Pollari, Khalil Fattouch, Giuseppe Santarpino, Julia Hillebrand, Stefan Schneider, Jan Landwerht, Giuseppe Nasso, Renato Gregorini, Mauro Del Giglio, Elisa Mikus, Alberto Albertini, Heinz Deschka, Theodor Fischlein, Sven Martens, Alina Gallo, Giovanni Concistrè, Giuseppe Speziale, Tommaso Regesta
This study provides early results of re-operations after the prior surgical treatment of acute type A aortic dissection (AAD) and identifies risk factors for mortality. Between May 2003 and January 2014, 117 aortic re-operations after an initial operation for AAD (a mean time from the first procedure was 3.98 years, with a range of 0.1-20.87 years) were performed in 110 patients (a mean age of 59.8 ± 12.6 years) in seven European institutions. The re-operation was indicated due to a proximal aortic pathology in ninety cases: twenty aortic root aneurysms, seventeen root re-dissections, twenty-seven aortic valve insufficiencies and twenty-six proximal anastomotic pseudoaneurysms...
October 21, 2016: Heart and Vessels
Christos Karagiannopoulos, Michael Sitler, Susan Michlovitz, Carole Tucker, Ryan Tierney
STUDY DESIGN: Prospective cohort study. INTRODUCTION: The active wrist joint position sense (JPS) test has been determined to be a clinically useful test for assessing wrist sensorimotor (SM) status after distal radius fracture (DRF). Its responsiveness is yet to be determined. PURPOSE OF THE STUDY: Primary study aim was to determine the active wrist JPS test responsiveness to detect change in wrist SM status at 8 and 12 weeks after DRF treatment intervention...
October 18, 2016: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
Jae Hoon Lee, Duke Whan Chung, Jong Hun Baek, Young Jun Kim, So Young Park
Background Although proximal fibular flaps have been widely applied in wrist arthroplasty, controversy remains regarding which side of the proximal fibula is better for reconstruction of the distal radius. If the articular surface of the proximal fibula shows dorsal tilting, the ipsilateral (right) proximal fibula should be harvested in right wrist arthroplasty because the articular surface of the distal radius normally has volar tilt. This study investigated anatomical similarities between the proximal fibular articular surface and the distal radius articular surface based on morphologic analysis of the proximal fibula using computed tomography (CT)...
October 21, 2016: Journal of Reconstructive Microsurgery
Devin Ganesh, Ben Service, Brian Zirgibel, Kenneth Koval
OBJECTIVES: To assess the utility of the dorsal tangential view (DTV) in detecting intraoperative dorsal screw penetration in distal radius fractures treated with volar locked plating. DESIGN: Retrospective cohort study. SETTING: Academic level 1 trauma center. PATIENTS/PARTICIPANTS: Skeletally mature patients where open reduction internal fixation with volar locked plating was the definitive treatment. A total of twenty-six patients were evaluated...
November 2016: Journal of Orthopaedic Trauma
Yong-Sik Bong, Shahin Assefnia, Therese Tuohy, Deborah W Neklason, Randall W Burt, Jaeil Ahn, Hao-Wen J Jiang, Stephen W Byers
Vitamin D is implicated in the etiology of cancers of the gastrointestinal tract, usually characterized by alteration in the APC/β-catenin/TCF tumor suppressor pathway. The vitamin D receptor (VDR) is also implicated in cardiovascular and skin diseases as well as in immunity. Activated VDR can indirectly alter β-catenin nuclear localization and directly suppress β-catenin/TCF mediated transcriptional activity. We treated VDR null mice with the carcinogen azoxymethane (AOM) and generated mice bearing a mutated APC (hypomorph) on a VDR null background (Apc1638N/+Vdr-/-)...
October 19, 2016: Oncotarget
Hiroaki Matsuno
BACKGROUND AND OBJECTIVES: Recently, the osteoporosis treatment has attracted attention, and several drugs have been developed. Among these, bisphosphonates (BPs), parathyroid hormone (PTH) and anti-receptor activator of nuclear factor kappa B ligand (RANKL) monoclonal (MAb) denosumab (DMAb) are the major osteoporosis agents. Several studies demonstrated that the effect of osteoporosis agents is evaluated by lumar or hip dual energy X-ray absorptiometry (DXA). However, private clinic commonly use the radial DXA...
October 20, 2016: Drugs in R&D
Nirav H Amin, Alex Volpi, T Sean Lynch, Ronak M Patel, Douglas L Cerynik, Mark S Schickendantz, Morgan H Jones
BACKGROUND: Anatomic reinsertion of the distal biceps is critical for restoring flexion and supination strength. Single- and double-incision surgical techniques have been reported, analyzing complications and outcomes measures. Which technique results in superior clinical outcomes and the lowest associated complications remains unclear. HYPOTHESIS: We hypothesized that rerupture rates would be similar between the 2 techniques, while nerve complications would be higher for the single-incision technique and heterotopic ossification would be more frequent with the double-incision technique...
October 2016: Orthopaedic Journal of Sports Medicine
Ryan C Shelstad, Justin G Reeves, Katsuhiro Yamanaka, T Brett Reece
We review the operative techniques of aortic arch replacement. Aortic arch replacement presents several formidable challenges, as it requires arresting the circulation to the body and replacement of the brachiocephalic vessels with special consideration for protecting the central nervous system. Perfusion strategies, selective antegrade cerebral perfusion, and operative graft selection are key elements in aortic arch replacement surgery. Standard approaches include the island technique, the branched graft technique, and the "Spielvogel" trifurcated graft technique-each having its own advantages...
October 7, 2016: Seminars in Cardiothoracic and Vascular Anesthesia
Sunguk Jang, Tyler Stevens, Mansour A Parsi, Rocio Lopez, John J Vargo
BACKGROUND & AIMS: Biliary self-expandable metallic stents (SEMSs) are widely used to treat malignant and benign conditions of bile duct. Despite their lower rate of occlusion and longer patency than plastic stents, SEMSs still have significant rates of occlusion. We aimed to identify factors associated with occlusion of biliary SEMS. METHODS: We performed a retrospective study of consecutive patients who underwent endoscopic retrograde cholangiopancreatography with biliary SEMS placement at the Cleveland Clinic Foundation from March 2011 to April 2016...
October 17, 2016: Clinical Gastroenterology and Hepatology
Bo Xu, Björn Redfors, Yuejin Yang, Shubin Qiao, Yongjian Wu, Jilin Chen, Haibo Liu, Jue Chen, Liang Xu, Yanyan Zhao, Changdong Guan, Runlin Gao, Philippe Généreux
OBJECTIVES: The aim of this study was to assess the impact of operator experience on prognosis after left main coronary artery (LM) percutaneous coronary intervention (PCI). BACKGROUND: LM PCI can be technically challenging and potentially risky considering the amount of supplied myocardium. METHODS: Consecutive patients who underwent unprotected LM PCI at a single institution were included and compared according to whether the primary operator was an experienced, high-volume LM operator (defined as an operator who performed at least 15 LM PCIs per year for at least 3 consecutive years) or not...
October 24, 2016: JACC. Cardiovascular Interventions
Min Hyun Cho, Sung Han Kim, Weon Seo Park, Jae Young Joung, Ho Kyung Seo, Jinsoo Chung, Kang Hyun Lee
BACKGROUND: Sarcomatoid urothelial carcinoma (SUC) is a rare malignant neoplasm of the urinary bladder comprising 0.2-0.6 % of all histological bladder tumor subtypes. It presents as a high-stage malignancy and exhibits aggressive biological behavior, regardless of the treatment employed. It is defined as histologically indistinguishable from sarcoma and as a high-grade biphasic neoplasm with malignant epithelial and mesenchymal components. The mean age of patients presenting with SUC is 66 years, and the male-to-female ratio is 3:1...
October 20, 2016: World Journal of Surgical Oncology
Tongzhi Wu, Cong Xie, Hang Wu, Karen L Jones, Michael Horowitz, Christopher K Rayner
In rodents, metformin slows intestinal glucose absorption, potentially increasing exposure of the distal gut to glucose to enhance postprandial glucagon-like peptide-1 (GLP-1) secretion. We evaluated the effects of metformin on serum 3-O-methylglucose (3-OMG, a marker of glucose absorption) and plasma total GLP-1 concentrations during a standardised intraduodenal infusion of glucose and 3-OMG in patients with type 2 diabetes. 12 patients, treated with metformin 850 mg bd or placebo each for 7 days in a double-blind, randomised, crossover design (14 days 'washout' between treatments), were evaluated on days 5 or 8 of each treatment (6 each)...
October 20, 2016: Diabetes, Obesity & Metabolism
Kerem Öztürk, Sercan Göde, Servet Çelik, Mustafa Orhan, Okan Bilge, Cem Bilgen, Tayfun Kirazlı, Canan Y Saylam
BACKGROUND: The exposure of the round window (RW) through the facial recess (FR) is sometimes partial. The anatomic variations that alter RW exposure during cochleostomy have not been clearly defined to date. AIMS: The aim of this study was to assess the best FR position in which to achieve the widest exposure of the RW niche and to define the topographic relationship between two other important anatomical structures, the facial nerve (FN) and the chorda tympani (CT)...
September 2016: Balkan Medical Journal
Kazuki Kano, Tsutomu Sato, Yukio Maezawa, Kenki Segami, Tetsushi Nakajima, Kousuke Ikeda, Tsutomu Hayashi, Takanobu Yamada, Naoto Yamamoto, Takashi Ohshima, Norio Yukawa, Yasushi Rino, Munetaka Masuda, Takashi Ogata, Haruhiko Cho, Takaki Yoshikawa
We report a case of advanced esophageal and gastric cancer that was successfully treated via multimodal therapy. A 65- year-old man with hoarseness was referred to our hospital. He was diagnosed with clinical T4aN2M0, Stage IV esophageal squamous cell carcinoma and clinical T3N1M0, Stage II B gastric adenocarcinoma. He was treated with 3 courses of chemotherapy, administered over 4weeks, with S-1(80mg/m / / 2: day 1-14), cisplatin(60mg/m2: day 1), and docetaxel(40mg/m2: day 1). Computed tomography(CT)revealed shrinkage of the primary esophageal tumor, gastric tumor, and lymph node metastases...
October 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Sebastien F Barre, David Haberthür, Tiziana P Cremona, Marco Stampanoni, Johannes C Schittny
The pulmonary airways are subdivided into conducting and gas-exchanging airways. The small tree of gas-exchanging airways which is fed by the most distal conducting airway represents an acinus. Very little is known about the development of the number of acini. The goal of this study was to estimate their number throughout rat postnatal development. Right middle rat lung lobes were obtained at postnatal day 4-60, stained with heavy metals, paraffin embedded, and scanned by synchrotron radiation based X-ray tomographic microscopy or imaged using micro computed tomography after critical point drying...
October 19, 2016: American Journal of Physiology. Lung Cellular and Molecular Physiology
Daniel Haselbach, Wassim Raffoul, Lorenz Larcher, Mathias Tremp, Daniel F Kalbermatten, Pietro G di Summa
INTRODUCTION: Hindlimb autophagy is common after rat sciatic total axotomy and is considered as a sign of neuropathic pain. We applied adult stem cells in a fibrin conduit in a total sciatic axotomy model to improve nerve regeneration, investigating whether a correlation could be detected between stem cells effects on regeneration and limb autophagy. MATERIAL AND METHODS: After sciatic nerve section, a 1-cm sciatic gap was crossed using fibrin conduits. EXPERIMENTAL: groups included empty fibrin conduits, fibrin conduits seeded with primary Schwann cells, and fibrin conduits seeded with Schwann cell-like differentiated mesenchymal or adipose-derived stem cells (dMSCs and dASCs)...
October 16, 2016: Neuroscience Letters
Cristiana Cipriani, Alice Abraham, Barbara C Silva, Natalie E Cusano, Mishaela R Rubin, Donald J McMahon, Chengchen Zhang, Didier Hans, Shonni J Silverberg, John P Bilezikian
Restoration of the euparathyroid state is associated with improvement of bone dynamics both in hypoparathyroidism and primary hyperparathyroidism. To date, no study has directly compared these two groups following correction of parathyroid hormone excess or deficiency. The study was designed to investigate changes in bone mineral density and trabecular bone score with restoration of the euparathyroid state by parathyroidectomy in primary hyperparathyroidism or recombinant parathyroid hormone [rhPTH(1-84)] replacement in hypoparathyroidism...
October 18, 2016: Endocrine
Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek
The concept of complete mesocolic excision and central vascular ligation for colonic cancer has been recently introduced. The paper describes a technique of right-sided complete mesocolic excision and intracorporeal anastomosis by using a single-port robotic approach with an additional conventional robotic port. We performed a single-port plus an additional port robotic surgery using the Da Vinci Single-Site platform via the Pfannenstiel incision and the wristed robotic instruments via an additional robotic port in the left lower quadrant...
October 2016: Annals of Surgical Treatment and Research
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