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Limb preservation

Joseph Morrison, Matthew David Alexander, Christopher F Dowd, Daniel L Cooke
A man aged 61 years with a history of a ruptured basilar fenestration aneurysm underwent unassisted coiling in 1997 and repeat intervention for a recurrence at the aneurysm mouth in 2011. At repeat intervention, the decision was made to intentionally leave some filling at the base to preserve the parent vessels. Stent-assisted coil embolization, although technically feasible, was not pursued given the relative risks of the procedure. In 2017, the patient returned for repeat surveillance and further coil compaction was found at the aneurysm base...
March 21, 2018: Journal of Neurointerventional Surgery
Yu V Chervyakov, I N Staroverov, A V Borisov, S Yu Smurov
AIM: To present own 10-year experience of abdominal aortic and great vessels aneurysms management. MATERIAL AND METHODS: There were 369 patients with abdominal aortic aneurysms (AAA) for the period 1995-2016 at the Yaroslavl Regional Clinical Hospital. 25% of patients suffered from abdominal aortic and great vessels aneurysms. Mean age was 70.3±7.5. There were 79 (86%) men and 13 (14%) women. 93 patients had 212 aneurysms of other sites besides AAA (from 1 to 6 aneurysms in each case)...
2018: Khirurgiia
Philip Jefferies, Pamela Gallagher, Mark Philbin
PURPOSE: Research on prosthesis use is largely focused on understanding how persons manage the loss of a limb and begin their prosthesis use. We sought to elaborate an important aspect of a common concern of prosthesis users as they live day to day with their artificial limbs; specifically, the nature and management of threats that have implications for staying "just normal". METHODS: Grounded Theory methodology was employed to collect and analyse data from 24 interviewees, 17 weblogs, 17 autobiographies, and posts from four internet discussion forums...
March 20, 2018: Disability and Rehabilitation. Assistive Technology
Sarel R van Amstel, David E Anderson, Ricardo Videla
CASE DESCRIPTION 3 Angus bulls, aged 2 to 3 years, with severe lameness of 2 to 4 weeks' duration and swelling proximal to the coronary band of the affected limb were evaluated after failing to respond to antimicrobial treatment. CLINICAL FINDINGS Septic arthritis of a distal interphalangeal joint (DIPJ) was diagnosed in all 3 bulls on the basis of results of a physical examination, radiographic and ultrasonographic evaluations of the affected foot, and cytologic evaluation of synovial fluid from the affected DIPJ...
April 1, 2018: Journal of the American Veterinary Medical Association
Lisa Gamsjaeger, Munashe Chigerwe
OBJECTIVE To characterize indications for and clinical outcomes of limb amputation in goats and sheep. DESIGN Retrospective case series and observational study. ANIMALS Goats (n = 15) and sheep (7) that underwent partial or complete limb amputation at the University of California-Davis Veterinary Medical Teaching Hospital from January 1, 1985, through December 31, 2015. PROCEDURES Medical records of qualifying goats and sheep were reviewed and data extracted regarding signalment, use of animal, characteristics of the amputated limb, duration of hospitalization, outcome, and surgery-associated complications...
April 1, 2018: Journal of the American Veterinary Medical Association
Nikita Woodhead, Kelly M Hare, Alison Cree
The existence of sex differences in digit-length ratio (especially between the second and fourth digits, 2D:4D) is well established for humans from fetal life onwards, and has been linked with later performance. In rodents, the ratio is affected prenatally by exposure to androgens and estrogens, with some research suggesting an influence from sex of the neighbouring intrauterine fetus. However, the ubiquity and ontogenetic development of sexual dimorphism in digit ratios is not well established among wild amniotes...
March 15, 2018: Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology
Katharine M Hinchcliff, Jessica Crockett, Steven W Thorpe, Christopher O Bayne
Long ischemia times adversely affect free flap survival, and large muscle flaps are particularly vulnerable. Hypothermic machine perfusion (HMP) is a well-established method of organ preservation, and recent literature has detailed the use of HMP to extend free flap ischemia times, predominantly in the laboratory setting. One limitation in the study and adoption of free flap HMP has been the availability of standardized perfusion machinery, as thus far institutions have built their own devices. We present a case of a 75-year-old woman with dedifferentiated chondrosarcoma of her right proximal femur...
March 14, 2018: Microsurgery
S Kabatas, C S Demir, E Civelek, I Yilmaz, A Kircelli, C Yilmaz, Y Akyuva, E Karaoz
OBJECTIVE: This study aimed to analyze the effect of human Dental Pulp-Neural Crest Stem Cells (hDP-NCSCs) delivery on lesion site after spinal cord injury (SCI), and to observe the functional recovery after transplantation. METHODS: Neural Crest Stem Cells (NCSCs) were isolated from human Dental Pulp (hDP). The experimental rat population was divided into four groups (n = 6/24). Their behavioral motility was scored regularly. After 4-weeks, rats were sacrificed, and their spinal cords were examined for Green Fluorescent Protein (GFP) labeled hDP-NCSCs by immunofluorescence (IF) staining...
2018: Bratislavské Lekárske Listy
Luis A Aponte-Tinao, Jose I Albergo, Miguel A Ayerza, D Luis Muscolo, Federico Milano Ing, German L Farfalli
BACKGROUND: Preservation of limb function after resection of malignant bone tumors in skeletally immature children is challenging. Resection of bone sarcomas and reconstruction with an allograft in patients younger than 10 years old is one reconstructive alternative. However, long-term studies analyzing late complications and limb length discrepancy at skeletal maturity are scarce; this information would be important, because growth potential is altered in these patients owing to the loss of one physis during tumor resection...
March 2018: Clinical Orthopaedics and related Research
Thomas S Maldonado, Nilo J Mosquera, Peter Lin, Raffaello Bellosta, Michael Barfield, Albeir Moussa, Robert Rhee, Marc Schermerhorn, Jeffrey Weinberger, Marald Wikkeling, Jan Heyligers, Frank J Veith, Ross Milner, Michel P J Reijnen
OBJECTIVE: The Gore Iliac Branch Endoprosthesis (IBE; W. L. Gore & Associates, Flagstaff, Ariz) has recently been approved by the Food and Drug Administration for treatment of common iliac artery (CIA) aneurysms. Despite early excellent results in clinical trial, none of 63 patients were treated for bilateral iliac aneurysms. The goal of this study was to examine real-world experience using the Gore IBE for bilateral CIA aneurysms. METHODS: A retrospective review of an international multicenter (16 U...
March 8, 2018: Journal of Vascular Surgery
Shunichiro Fujioka, Shigeru Hosaka, Hayato Morimura, Ken Chen, Zhi Chao Wang, Koji Toguchi, Shoji Fukuda, Koki Takizawa, Hiroshi Osawa
Objective : Patients of aorto-iliac aneurysms who undergo endovascular aortic repair (EVAR) require internal iliac artery (IIA) occlusion with coil embolization and its coverage with the stent graft to prevent type II endoleak after extending the endograft into the external iliac artery. However, it has become well recognized that IIA occlusion cause buttock claudication and other various sequelae due to pelvic ischemia. We retrospectively analyzed IIA occlusion outcomes. Methods : From October 2008 to February 2015, 71 patients with aorto-iliac aneurysms underwent IIA occlusion prior to EVAR...
December 25, 2017: Annals of Vascular Diseases
Minxun Lu, Yongjiang Li, Yi Luo, Wenli Zhang, Yong Zhou, Chongqi Tu
BACKGROUND: Currently, it is challenging to treat massive bone defects of proximal tibia. Although numerous methods are available for reconstruction with epiphysis preservation, limitations in knee function and complications are noted with these methods. Our paper describes our attempt to reconstruct a marked defect in the proximal tibia with an uncemented three-dimensional (3D)-printed prosthesis and to evaluate the prosthesis design and short-term outcomes. CASE PRESENTATION: A 15-year-old boy with metaphyseal osteosarcoma of the tibia underwent intercalary allograft reconstruction following wide tumour resection with epiphysis preservation...
March 6, 2018: World Journal of Surgical Oncology
Artem Rabtsun, Andréi Karpenko, D G Zoloev, Vladimir Starodubtsev, Pavel Ignatenko, Anne Lejay, Nabil Chakfe
OBJECTIVES: Superficial femoral artery (SFA) remote endarterectomy offers the advantage of preserving anatomy and geometry of the native artery but the risk of restenosis still exists. The particular role of the adductor canal (AC) in mechanical constraints has been highlighted. The aim of this study was to assess if a surgical protocol associating remote SFA endarterectomy and AC freeing would modify the SFA geometrical changes during physiological limb flexion. METHODS: From January 2015 to March 2015, 10 patients (Rutherford 3-5) with unilateral SFA occlusion were included...
February 27, 2018: Annals of Vascular Surgery
Łukasz Szelerski, Radosław Górski, Sławomir Żarek, Karol Mochocki, Paweł Małdyk
BACKGROUND: Distal femoral fractures constitute a type of lower limb injuries that is rare and difficult to treat. Despite advances in surgical technique and development of implants used for internal fixation of fracture fragments, the treatment continues to result in numerous complications. The Ilizarov External Fixator reduces the risk of complications and allows for bone union. MATERIAL AND METHODS: Six men with distal femoral fractures resulting from multisite and multiorgan injuries were treated at the Department of Orthopaedics and Musculoskeletal Traumatology of the Medical Uni-versity of Warsaw between 2008 and 2016...
December 30, 2017: Ortopedia, Traumatologia, Rehabilitacja
Michael Koutouzis, George S Sfyroeras, Christos Maniotis, Konstantinos Kintis, Sotirios Patsilinakos, Panagiotis Tsiverdis, Giannis Giannikouris, Ioannis Tsiafoutis, Efstathios Lazaris, Michalis Hamilos
BACKGROUND: End-stage renal disease (ESRD) is considered a relative contraindication for forearm (radial or ulnar) cardiac catheterization. However, in everyday practice, many ESRD patients are catheterized from the forearm. The aim of this study was to compare femoral and forearm approach for cardiac catheterization in ESRD patients. METHODS: All cardiac catheterization procedures performed in ESRD patients in three Greek hospitals in a 2-year period (2014-2015) were retrospectively evaluated...
March 2018: Journal of Invasive Cardiology
Takashi Higuchi, Norio Yamamoto, Katsuhiro Hayashi, Akihiko Takeuchi, Kensaku Abe, Yuta Taniguchi, Yoshihiro Araki, Kaoru Tada, Hiroyuki Tsuchiya
BACKGROUND: The wrist joint is an extremely rare site for osteosarcoma. Joint structure preservation to maintain good limb function is well described in case of knee osteosarcoma, whereas it is not described in case of wrist joint osteosarcoma. In this report, we present the first case of joint preservation surgery to treat distal radius osteosarcoma using a tumor bearing autograft treated with liquid nitrogen. CASE PRESENTATION: A 46-year-old male presented with swelling and pain in the right wrist and was diagnosed with conventional osteosarcoma of the distal radius...
March 1, 2018: BMC Surgery
Chih-Chien Yen, Chih-Hong Kao, Chien-Sung Tsai, Shin-Han Tsai
OBJECTIVE: Application of extracorporeal membrane oxygenation (ECMO) for life support has been widely used in various fields of resuscitation. When the common femoral artery (CFA) is used during cannulation for ECMO support in adults, it is often complicated by limb ischemia. Placement of distal perfusion catheter (DPC) can reduce the incidence of limb ischemia and increases the likelihood of limb preservation, but selection criteria is uncertain. METHODS: This is a retrospective study...
January 16, 2018: Heart Surgery Forum
I G Stanistreet, H Stollhofen, J K Njau, P Farrugia, M C Pante, F T Masao, R M Albert, M K Bamford
Archaeological excavations at the DK site in the eastern Olduvai Basin, Tanzania, age-bracketed between ∼1.88 Ma (Bed I Basalt) and ∼1.85 Ma (Tuff IB), record the oldest lahar inundation, modification, and preservation of a hominin "occupation" site yet identified. Our landscape approach reconstructs environments and processes at high resolution to explain the distribution and final preservation of archaeological materials at the DK site, where an early hominin (likely Homo habilis) assemblage of stone tools and bones, found close to hominin specimens OH24 and OH56, developed on an uneven heterogeneous surface that was rapidly inundated by a lahar and buried to a depth of 0...
March 2018: Journal of Human Evolution
Marco Fiore, Samuel Ford, Dario Callegaro, Claudia Sangalli, Chiara Colombo, Stefano Radaelli, Anna Maria Frezza, Salvatore L Renne, Paolo G Casali, Alessandro Gronchi
BACKGROUND: Established practice for the management of soft tissue sarcoma (STS) of the extremity and trunk wall combines perioperative radiotherapy (RT) with limb-preserving surgery. OBJECTIVE: The aim of this study was to explore whether high-quality surgery at high-volume centers may offer equivalent local control in selected cases, when RT needs to be avoided. METHODS: All consecutive adult cases of primary, high-risk STSs treated in a high-volume reference center over a 12-year timeframe were included, and, on retrospective analysis, were divided into two groups...
February 22, 2018: Annals of Surgical Oncology
Ola A Hussein, Amel M M Abdel-Hafez, Ayat Abd El Kareim
Limb ischemia reperfusion (I/R) injury is associated with serious local and systemic effects. Reperfusion may augment tissue injury in excess of that produced by ischemia alone. The hippocampus has been reported to be vulnerable to I/R injury. Alpha lipoic acid (ALA) is an endogenous antioxidant with a powerful antioxidative, anti-inflammatory, and antiapoptotic properties. We studied the probable restorative effect of ALA on limb I/R-induced structural damage of rat hippocampus. Forty adult male albino rats were divided equally into four groups: group I (sham); group II (I/R-1 day) has undergone bilateral femoral arteries occlusion (3 h), then reperfusion for 1 day; group III (I/R-7 days) has undergone reperfusion for seven days; group IV (I/R-ALA) has undergone I/R as group III and received an intraperitoneal injection of ALA (100 mg/kg) for 7 days...
March 2018: Ultrastructural Pathology
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