The role of operative procedure in the etiology of psychosis

1943 ◽  
Vol 17 (3) ◽  
pp. 405-422 ◽  
Author(s):  
Jane E. Oltman ◽  
Samuel Friedman
Keyword(s):  
Operative Procedure

GASTRIC ACIDITY BEFORE AND AFTER OPERATIVE PROCEDURE WITH SPECIAL REFERENCE TO THE ROLE OF THE PYLORUS AND ANTRUM*

1940 ◽  
Vol 112 (4) ◽  
pp. 626-670 ◽  
Author(s):  
Owen H. Wangensteen ◽  
Richard L. Varco ◽  
Lyle Hay ◽  
Stewart Walpole ◽  
Benedict Trach
Keyword(s):  
Special Reference ◽  
Gastric Acidity ◽  
Operative Procedure ◽  
Before And After

Operative Treatment of Ingrown Toenail by Nail Fold Resection Without Matricectomy

2015 ◽  
Vol 105 (4) ◽  
pp. 295-301 ◽  
Author(s):  
Michael B. DeBrule
Keyword(s):  
Operative Procedure ◽  
Inclusion Criteria ◽  
Operative Techniques ◽  
Recurrence Rates ◽  
Ingrown Toenail ◽  
Satisfactory Outcome ◽  
Skin Excision ◽  
Ingrown Toenails

Background Many operative techniques have been studied for correction of ingrown toenails, yet the role of nail fold resection without matricectomy is poorly defined. Current literature on this topic is sparse, and previous systematic reviews are absent. Methods A MEDLINE/Cumulative Index to Nursing and Allied Health Literature/Scopus search was performed and a systematic review was undertaken for articles discussing surgical treatment of ingrown toenail by nail fold resection without matricectomy. Outcome measures were systematically reported, and variations in operative technique were identified. Results Of the 14 articles that fit the inclusion criteria, 2 were level V evidence, 11 were level IV, and 1 was level III. Minimum follow-up time and the criteria for a satisfactory outcome were not consistently defined. Recurrence rates varied from 0% to 20%. The postsurgical infection rate was 0% for all nine studies reporting infection. Ten different operative techniques were identified. Three studies used partial or total nail avulsion as an adjunctive operative procedure. Triangular-, crescent-, elliptical-, semi-elliptical–, and radical-shaped skin excision strategies were identified. Primary and secondary intentions were used for closure. Conclusions Operative algorithms for the treatment of ingrown toenail are still unclear regarding nail fold resection without matricectomy and are supported by almost entirely level IV evidence. Future prospective comparative studies and randomized trials are necessary to support and strengthen current practice.

Is Routine Frozen Section Necessary for Parathyroid Surgery?

2005 ◽  
Vol 133 (6) ◽  
pp. 857-862 ◽  
Author(s):  
Anil K. Dewan ◽  
Silloo B. Kapadia ◽  
Christopher S. Hollenbeak ◽  
Brendan C. Stack
Keyword(s):  
Frozen Section ◽  
Operative Procedure ◽  
Effective Means ◽  
Parathyroid Tissue ◽  
Cost Effective ◽  
Parathyroid Surgery ◽  
Tissue Identification ◽  
Radionuclide Scanning ◽  
Gross Examination

OBJECTIVE: Successful parathyroidectomy requires identification and excision of 1 or more abnormal parathyroid glands. The pathologist confirms or refutes the intraoperative presence of parathyroid tissue in excised material. With the advent of radionuclide scanning and rapid parathyroid hormone assays, the role of routine frozen section (FS) has once again been called into question. Our aim was to assess the need for routine FS in tissue identification during parathyroidectomy in a series of 50 consecutive cases. METHODS: We analyzed 50 consecutive parathyroidectomies performed by a single surgeon from December 2002 to August 2003. Diagnoses on gross examination (GE) of both the surgeon and the pathologist were recorded, cytologic smears made, and FSs performed. A cost analysis was also performed. RESULTS: Of the 50 parathyroidectomies performed (35 adenoma and 15 hyperplasia), both surgeon and pathologist's opinions on GE were concordant. Incorrect gross identification occurred by both in 6% (3) of the cases. GE is a cost-effective means of identifying parathyroid tissue. CONCLUSIONS: Experienced parathyroid surgeons need not routinely request FS examination. The decision to omit intraoperative FS examination must be balanced against the potential implications of misdiagnosis and a repeat operative procedure. EBM RATING: C

scholarly journals The Role of MRI Pancreatic Protocol in Assessing Response to Neoadjuvant Therapy for Patients With Borderline Resectable Pancreatic Cancer

2022 ◽  
Vol 11 ◽  
Author(s):  
Nervana Hussien ◽  
Rasha S. Hussien ◽  
Darine Helmy Amin Saad ◽  
Mohamed El Kassas ◽  
Walid F. Elkhatib ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Neoadjuvant Therapy ◽  
Operative Procedure ◽  
Resectable Pancreatic Cancer ◽  
Borderline Resectable ◽  
Borderline Resectable Pancreatic Cancer ◽  
Number Of Patients ◽  
Magnetic Resonance Imaging Mri ◽  
Post Therapy

BackgroundBorderline Resectable Pancreatic Cancer (BRPC) remains a unique entity that is difficult to categorize due to variance in definitions and the small number of patients. The ultimate goal is to achieve a free resection (R0) after a favorable response to neoadjuvant therapy that is somewhat difficult to assess by current radiological parameters.AimTo evaluate the role of Magnetic Resonance Imaging (MRI) pancreatic protocol, including Diffusion-Weighted Imaging (DWI), in patients with BRPC receiving neoadjuvant therapy, and further compare it to RECIST criteria and outcome.MethodsHistologically confirmed BRPC patients were prospectively included. DWI-MRI was performed pre- and post-therapy. Clinical characteristics with ensuing operability were recorded and correlated to radiological RECIST/apparent diffusion coefficient (ADC) change, preoperative therapy administrated, surgical resection status, and survival.ResultsOut of 30 BRPC cases, only 11 (36.7%) ultimately underwent pancreaticoduodenectomy. Attaining a stationary or stable disease via ADC/RECIST was achieved in the majority of cases (60%/53.3% respectively). Of the 12 patients (40%) who achieved a regression by ADC, 11 underwent surgery with an R0 status. These surgical cases showed variable RECIST responses (PR=5, SD=4, PD=3). Responders by ADC to neoadjuvant therapy were significantly associated to presenting with abdominal pain (p =0.07), a decline in post-therapy CA19-9 (p<0.001), going through surgery (p<0.001), and even achieving better survival (p<0.001 vs. 0.66).ConclusionDWI-MRI ADC picked up patients most likely to undergo a successful operative procedure better than traditional RECIST criteria. An algorithm incorporating novel radiological advances with CA19-9 deserves further assessment in future studies.

scholarly journals Surgical Approach to Insulinomas: Are Pre-Operative Localisation Tests Necessary?

2007 ◽  
Vol 89 (3) ◽  
pp. 212-217 ◽  
Author(s):  
K Ravi ◽  
BJ Britton
Keyword(s):  
Medical Records ◽  
Operative Procedure ◽  
Anatomical Site ◽  
Venous Sampling ◽  
Non Invasive ◽  
Valuable Adjunct ◽  
Operative Exploration ◽  
Biochemical Diagnosis ◽  
Operative Ultrasound

INTRODUCTION Insulinoma is a rare, but curable, endocrine tumour. The ability to localise the tumour accurately before or during surgery is an important factor in the management of these elusive lesions, which has been extensively debated. We have reviewed our experience of these lesions to establish the role of localisation tests. PATIENTS AND METHODS The medical records of 20 consecutive patients who had surgery for sporadic insulinomas since 1985 at this institution were retrospectively reviewed. All the patients had a definite biochemical diagnosis of endogenous hyperinsulinism. Results of pre-operative and intra-operative localisation tests were compared with the final outcome. RESULTS Of the 20 patients with sporadic insulinomas reviewed, 17 patients (85%) had multiple pre-operative localising investigations. Overall accuracy of pre-operative localisation tests was 33%. Non-invasive pre-operative localisation tests (ultrasonography, CT, MRI) had a combined localisation rate of 25% with MRI having the highest sensitivity of 71%. Invasive tests (angiography, transhepatic portal venous sampling [THPVS], endoscopic ultrasound) detected 48% of lesions with THPVS being most sensitive (67%). THPVS was particularly helpful in localising lesions before re-operation. Intra-operative inspection and palpation localised the lesions correctly in 91% and intra-operative ultrasound in 93% of cases. All 5 occult tumours (indeterminate anatomical site before operation) were palpable at surgery and four of these were also correctly identified by intra-operative ultrasound. Site and size of tumour correlated poorly with pre-operative localisation. Operative procedure did not influence outcome with three patients needing re-operation. One patient died (5% mortality) and 9 patients (45%) had complications. Normoglycaemia has been obtained in all but one patient. CONCLUSIONS Insulinomas can be readily localised by systematic operative exploration. Non-invasive pre-operative investigations (ultrasonography/MRI) may help identify the location of tumour to determine the appropriate surgical procedure. Invasive pre-operative localisation tests like angiography and THPVS may be a valuable adjunct for re-operations. This also helps reduce the costs.

scholarly journals Predictor of early post-operative small bowel obstruction in patients undergoing emergency laparotomy and the role of computed tomography in detecting need for re-laparotomy

2018 ◽  
Vol 5 (10) ◽  
pp. 3321
Author(s):  
Sunil Kumar Singh ◽  
Arun Singh ◽  
Rajnikant Kumar
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Operative Procedure ◽  
Wound Dehiscence ◽  
Emergency Laparotomy ◽  
Previous Surgery ◽  
Cross Sectional ◽  
History Of

Background: Early Post-Operative Small Bowel Obstruction (EP-SBO) is common complication following laparotomy. Pathophysiology of early post-operative small bowel obstruction is poorly understood.Methods: This cross-sectional observational study was conducted over a period of 18 month on 180 patients who underwent emergency abdominal laparotomy.Results: EP-SBO developed in 35.55% patients. History of previous surgery, location of disease, degree of peritonitis, operative procedure, wound dehiscence was found to be significantly related with occurrence of EP-SBO.Conclusions: EP-SBO is more likely to develop if patient had history of previous surgery, peritonitis, some operative procedure, ostomy, wound dehiscence. We should have a preventive attitude towards any risk factor at any stage- Before, During and After surgery and CECT-Abdomen is a helpful tool in establishing need of re-laparotomy.

scholarly journals Laparoscopic cholecystectomy in acute calculus cholecystitis

2018 ◽  
Vol 5 (5) ◽  
pp. 1843
Author(s):  
Ankit Meena ◽  
Abhay Chaudhari ◽  
Murtaza A. Akhtar
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Operative Time ◽  
Operative Procedure ◽  
Tertiary Care ◽  
Open Interval ◽  
Secondary Outcome ◽  
Conversion To Open Surgery ◽  
Open Conversion ◽  
The Mean

Background: Acute calculus cholecystitis was traditionally treated conservatively followed by open interval cholecystectomy. Laparoscopy has revolutionized abdominal surgeries. Laparoscopic cholecystectomy is gold standard in management of cholelithiasis. Role of laparoscopic cholecystectomy in acute calculus cholecystitis is still controversial. Present study is evaluating the role of Laparoscopic cholecystectomy as treatment of acute calculus cholelithiasis.  Methods: An observational study was conducted at tertiary care academic hospital and a total of 33 patients were enrolled. The inclusion criteria for enrollment of patients were patient with acute abdomen with clinically and ultrasonologically diagnosed as acute cholecystitis. All patients with Acalculus cholecystitis, Choledocholithiasis, obstructive jaundice, Cholangitis and pregnant patient were excluded from this study. The study factor was standard four port laparoscopic cholecystectomy was performed within 72 hours of onset all patients. The primary outcomes were operative time, intra-operative complications, conversion to open surgery and secondary outcome was postoperative complications.Results: A total of 33 cases were enrolled. The mean age of the patients was 44.00 ± 12.2 years (26-68 years) with female preponderance Mean duration of pain was 1.16 days. Mean Operative time was 102.06 ± 10.36 minutes (60-142 minutes). Post-operative surgical site infection present with 4 (12.1%) patients and post-operative fever in 5 (15.2%) patients. The mean hospital stay was 5.30 ± 1.42 days. The open conversion rate was 9.1% and there were no complications.Conclusions: Laparoscopic cholecystectomy in acute calculus cholecystitis is a safe operative procedure.

Physico-chemical analysis of Haratala w.s.r. to its various Shodhana procedures

2017 ◽  
Vol 2 (2) ◽  
Author(s):  
Bandeppa Sangolgi ◽  
Ganapathi Rao ◽  
Sangameshwar Benne
Keyword(s):  
Chemical Analysis ◽  
Analytical Study ◽  
Operative Procedure ◽  
Pharmacological Properties ◽  
Arsenic Compounds ◽  
Single Drug ◽  
Physico Chemical ◽  
The Media ◽  
Pharmaceutical Processes

Kalpana is the process through which a substance can be transformed into the form of medicine according to the need. Samskaras are to be done for potentiating the drug or the formulation. Among all these pharmaceutical processes Shodhana is one of them. For a single drug many process of Shodhana have been mentioned. Arsenic compounds are being popularly used in Ayurveda therapeutics since centuries, Haratala being important among them. It is commonly used in treating the diseases like Sleshmaroga, Raktapitta, Vatarakta, Kustha etc. Haratala is called orpiment of yellow arsenic with two molecules of Arsenic and three molecules of Sulphur (AS2S3). Patra Haratala is Srestha and used for the present study. Haratala consumed without proper Shodhana shortens the life span, causes diseases of Kapha and Vata, Prameha, Santapa, Spotha, Snayu Sankocha. Hence Shodhana of Haratala is essential. There are different Medias explained in literature for Shodhana of Haratala. According to the media of purification the quality and pharmacological properties of Haratala will vary. Depending on the change in properties the therapeutic effect may also vary. The present study includes Shodhana of Patra Haratala as per Classical reference of Rasa Ratna Samucchaya where Shodana of Patra Haratala is done by Kushmanda Swarasa, Tila Kshara Jala and Churnodaka. Standard Operative Procedure of the process is done in the pharmaceutical study. The analytical study reveals the standards which can be given for Ashuddha Haratala and Shuddha Haratala of various Samples. The differences in the parameters reveal that there are some changes which give us the idea regarding role of a particular media in purification of a substance, where it adds some properties of the media used.

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