Histologic evaluation of coronary exposure using an ultrasonic surgical aspirator

1994 ◽  
Vol 57 (4) ◽  
pp. 1054-1055 ◽  
Author(s):  
Yasushi Terada ◽  
Toshio Mitsui ◽  
Takuya Yazawa
2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Abbas Basiri ◽  
Iman Ghanaat ◽  
Hamidreza Akbari Gilani

Abstract Background Although involvement of the urinary system is not uncommon, endometriosis in the kidneys is rare. To date, laparoscopic partial nephrectomy has been the preferred approach for managing renal endometriosis. Here, we report for the first time the results of laparoscopic removal of a renal capsular endometriosis in a malrotated kidney in an attempt to save the whole kidney parenchyma, in terms of feasibility and safety. Case presentation A 37-year-old female presented with periodic right flank pain associated with her menstrual cycle. On imaging, a malrotated right kidney and a hypodense irregular-shaped lesion measuring 30 * 20 * 15 mm were seen in the superior portion of the right perinephric space. Histologic evaluation of the ultrasound-guided biopsy was consistent with renal capsular endometriosis. The patient underwent laparoscopic surgery to remove the capsular mass while preserving the normal renal parenchyma. Pathological examination of the biopsy obtained during surgery was in favor of renal endometriosis. At 6-month follow-up, the patient’s pain had completely disappeared and no complications had occurred. In addition, imaging did not show any remarkable recurrence. Conclusion Renal endometriosis should be strongly considered as a differential diagnosis in female patients with a renal capsular mass and exacerbation of flank pain during menstruation. Based on our experience, with preoperative needle biopsy and clearing the pathology, laparoscopic removal of the mass in spite of renal anatomic abnormality is feasible and safe and thus could be considered as a possible treatment option.


2021 ◽  
Vol 9 (1) ◽  
pp. 232596712097748
Author(s):  
Yusuke Ueda ◽  
Akimoto Nimura ◽  
Keisuke Matsuki ◽  
Kumiko Yamaguchi ◽  
Hiroyuki Sugaya ◽  
...  

Background: A better understanding of the morphology underneath the acromion is needed to prevent complications after arthroscopic subacromial decompression. The precise correlations between the morphologic features underneath the acromion and the surrounding structures including the attachment of the coracoacromial ligament (CAL) and the origin of the deltoid middle head have not yet been determined in the absence of artifacts on the bony surface caused by dissection techniques. Moreover, anatomic findings in previous studies using only older-aged cadavers or dried bones may not reflect the morphologic features of younger and healthy specimens. Purpose: To characterize the anterolateral structures morphologically in the inferior aspect of the acromion, assess the relationships of these structures with surrounding structures without dissection artifacts on the bony surface, and verify the cadaveric data in the asymptomatic shoulders of living middle-aged patients. Study Design: Descriptive laboratory study. Methods: We initially analyzed the relationship between the morphology of the anterolateral structures and surrounding structures in 18 cadaveric shoulders (mean age, 81.8 years), 15 of which were subjected to macroscopic investigation of the CAL attachment and 3-dimensional micro—computed tomography investigation with radiopaque markers and 3 of which were subjected to histologic examination. We also analyzed the morphology underneath the anterolateral acromion in 24 asymptomatic shoulders of middle-aged patients (mean age, 54.8 years) to verify the cadaveric data. In both the cadaveric shoulders and the asymptomatic shoulders of live patients, the long axis, width, and height of the anterolateral prominence were measured by use of 3-dimensional CT imaging. Results: In cadavers, the anterolateral prominence underneath the acromion corresponded to the attachment of the CAL. Histologic evaluation revealed that the CAL was continuous to the deep layer of the deltoid middle head in the lateral acromion. The study in asymptomatic shoulders of middle-aged patients revealed bony prominences similar to those observed in cadavers. Conclusion: The anterolateral prominence, which corresponds to the attachment of the CAL below the acromion, may be a native structure below the acromion. Moreover, the CAL is continuous to the deep layer of the deltoid middle head in the lateral acromion.


2005 ◽  
Vol 25 (4_suppl) ◽  
pp. 19-29 ◽  
Author(s):  
Kazuho Honda ◽  
Hideaki Oda

Pathology findings of encapsulating peritoneal sclerosis (EPS) are reviewed to establish histologic criteria for a diagnosis of EPS. The typical macroscopic finding is a cocoon-like encapsulation of the entire intestine. This encapsulation is frequently accompanied by fibrin deposition, focal bleeding on the peritoneum, and various quantities of bloody ascites. A thin membrane on the visceral peritoneum contributes to the formation of the intestinal encapsulation. Histologically, the membrane is composed mainly of organized fibrin, probably derived from plasma exudation from the peritoneal microvasculature. The peritoneal fibroblasts appear swollen and exhibit an increased level of cellularity, accompanied by expression of various activation and proliferation markers. According to the “two-hit” theory of EPS pathogenesis, deterioration of the peritoneum as a result of the peritoneal dialysis (PD) procedure (the first “hit”) and superimposition of inflammatory stimuli such as infectious peritonitis (the second “hit”) are thought to play key roles in the pathogenesis of EPS. Based on histologic examination of peritoneal biopsy specimens, the detection of fibrin deposition and fibroblast phenotypic alteration were proposed as important findings for early diagnosis of EPS. Persistent inflammatory changes are also predictive of the future onset of EPS. Careful histologic evaluation of peritoneal biopsy specimens, combined with laparoscopic observations after withdrawal of PD, is required for the early diagnosis and treatment of EPS.


2017 ◽  
Vol 32 (5) ◽  
pp. 1647-1653 ◽  
Author(s):  
Scott R. Nodzo ◽  
Christina I. Esposito ◽  
Hollis G. Potter ◽  
Chitranjan S. Ranawat ◽  
Timothy M. Wright ◽  
...  

HPB Surgery ◽  
1993 ◽  
Vol 6 (3) ◽  
pp. 169-173 ◽  
Author(s):  
Michel Gagner ◽  
Ramon Blanco ◽  
Ricardo L. Rossi

The Cavitron Ultrasonic Surgical Aspirator (CUSA) may be used to remove mucosa of organs of the gastro-intestinal tract. A histological analysis was performed on gallbladders treated with a CUSA-mucosectomy to assess the extent and degree of mucosectomy and to evaluate parietal damage. The histological studies performed on three specimens of chronic cholecystitis revealed a complete mucosectomy except in areas where Rokitansky-Aschof sinuses were present. There was no evidence of parietal damage. The CUSA may be used to remove the mucosa of gallbladders without injury to other layers, and may have a potential application in procedures such as mucosal cholecystectomy.


1994 ◽  
Vol 4 (5) ◽  
pp. 348-351 ◽  
Author(s):  
R. Chenoy ◽  
S. Manohar ◽  
C. W.E. Redman ◽  
D. M. Luesley

Colposcopic assessment may be normal in the presence of severe or persistent minor cytologic abnormality. To assess the significance of negative satisfactory colposcopy in patients with abnormal cervical smears, a retrospective review was carried out on 1170 patients who had undergone out-patient loop diathermy excision for abnormal cervical cytology. Of these, 69 patients were treated for abnormal cervical cytology, despite normal colposcopic findings. Cytologic abnormalities ranged from persistent borderline changes to severe dyskariosis. Histologic assessment of the excision specimens revealed cervical intraepithalial neoplasia (CIN) in 43 (62.3%) cases, of which high-grade CIN accounted for 24 (34.8%) cases. There was good correlation between cytologic and histologic diagnosis. Simple regression analysis showedr= 0.46,P< 0.0001. The cytologic abnormality was highly predictive of the corresponding histologic diagnosis. This analysis has shown that significant intraepithelial lesions may exist despite negative colposcopic examination and highlights the need for histologic evaluation in such cases. In these circumstances, loop cone biopsy permits accurate definition of lesion severity, avoids potential undertreatment of significant lesions and causes less morbidity than conventional cone biopsy.


Neurosurgery ◽  
1991 ◽  
Vol 29 (5) ◽  
pp. 651-657 ◽  
Author(s):  
Jacques Brotchi ◽  
Olivier Dewitte ◽  
Danielle Balériaux ◽  
Arlette Vandesteene ◽  
Christian Raftopoulos ◽  
...  

Abstract Between January 1984 and December 1990. 65 intramedullary spinal cord tumors were diagnosed and operated on. In this series, all patients underwent magnetic resonance imaging investigations and were operated on with the Cavitron ultrasonic surgical aspirator whenever necessary. Major surgical difficulties have been found in patients previously treated by radiotherapy with or without biopsy. We found magnetic resonance imaging to be a highly sensitive imaging procedure and the method of choice for visualizing tumors within the spinal cord. Nevertheless, accurate diagnosis may only be suggested by magnetic resonance imaging, rather than made definitively. Surgery is necessary in every case in order to obtain a definite diagnosis. Radical surgery can be performed when a plane exists between the tumor and the normal spinal cord: biopsy or debulking with the Cavitron ultrasonic surgical aspirator should be performed when the tumor is infiltrative. We have performed 33 so-called total resections, 22 partial resections, and 10 biopsies, among which 5 were performed on lipomas. Surgical results were assessed at 3 months after surgery, showing 35 improvements (53%), 24 stabilizations (37%), and 6 deteriorations (10%).


2015 ◽  
Vol 41 (5) ◽  
pp. 543-549 ◽  
Author(s):  
Philip J. DeNicolo ◽  
M. Kelly Guyton ◽  
Michael F. Cuenin ◽  
Steven D. Hokett ◽  
Mohamed Sharawy ◽  
...  

Platelet-rich plasma (PRP) is an autogenous source of growth factors shown to facilitate human bone growth. Bio-Oss, an osteoconductive xenograft, is used clinically to regenerate periodontal defects, restore dental alveolar ridges, and facilitate sinus-lift procedures. The purpose of this study was to analyze whether a combination of PRP and Bio-Oss would enhance bone regeneration better than either material alone. PRP and/or Bio-Oss were administered in an 8-mm critical-size defect (CSD) rat calvarial model of bone defect between 2 polytetrafluoroethylene membranes to prevent soft tissue incursion. Eight weeks after the induction of the CSD, histologic sections were stained with hematoxylin and eosin stain and analyzed via light microscopy. Qualitative analyses revealed new bone regeneration in all 4 groups. The Bio-Oss and PRP plus Bio-Oss groups demonstrated greater areas of closure in the defects than the control or PRP-only groups because of the space-maintaining ability of Bio-Oss. The groups grafted with Bio-Oss showed close contact with new bone growth throughout the defects, suggesting a stronger graft. The use of PRP alone or in combination with Bio-Oss, however, did not appear to enhance osseous regeneration at 8 weeks. Areas grafted with Bio-Oss demonstrated greater space-maintaining capacity than controls, and PRP was an effective vehicle for placement of the Bio-Oss. However, at 8 weeks this study was unable to demonstrate a significant advantage of using PRP plus Bio-Oss over using Bio-Oss alone.


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