Cryobiopsy as a New Tool for Complications Diagnosis During Follow-up After Lung Transplantation: Single Institution Case Series

2021 ◽  
Author(s):  
Sławomir Żegleń ◽  
Wojtek Karolak ◽  
Gabriela Mikołajczyk ◽  
Nicole Geryk ◽  
Zuzanna Gogulska ◽  
...  
Keyword(s):  
Lung Transplantation ◽  
Case Series ◽  
Single Institution

Long-term outcomes of lumbar microdiscectomy in the pediatric population: a large single-institution case series

2019 ◽  
Vol 24 (5) ◽  
pp. 549-557
Author(s):  
Malia McAvoy ◽  
Heather J. McCrea ◽  
Vamsidhar Chavakula ◽  
Hoon Choi ◽  
Wenya Linda Bi ◽  
...  
Keyword(s):  
Conservative Management ◽  
Functional Outcomes ◽  
Pediatric Patients ◽  
Clinical Presentation ◽  
Case Series ◽  
Csf Leak ◽  
Single Institution ◽  
The Mean

OBJECTIVEFew studies describe long-term functional outcomes of pediatric patients who have undergone lumbar microdiscectomy (LMD) because of the rarity of pediatric disc herniation and the short follow-up periods. The authors analyzed risk factors, clinical presentation, complications, and functional outcomes of a single-institution series of LMD patients over a 19-year period.METHODSA retrospective case series was conducted of pediatric LMD patients at a large pediatric academic hospital from 1998 to 2017. The authors examined premorbid risk factors, clinical presentation, physical examination findings, type and duration of conservative management, indications for surgical intervention, complications, and postoperative outcomes.RESULTSOver the 19-year study period, 199 patients underwent LMD at the authors’ institution. The mean age at presentation was 16.0 years (range 12–18 years), and 55.8% were female. Of these patients, 70.9% participated in competitive sports, and among those who did not play sports, 65.0% had a body mass index greater than 25 kg/m2. Prior to surgery, conservative management had failed in 98.0% of the patients. Only 3 patients (1.5%) presented with cauda equina syndrome requiring emergent microdiscectomy. Complications included 4 cases of postoperative CSF leak (2.0%), 1 case of a noted intraoperative CSF leak, and 3 cases of wound infection (1.5%). At the first postoperative follow-up appointment, minimal or no pain was reported by 93.3% of patients. The mean time to return to sports was 9.8 weeks. During a mean follow-up duration of 8.2 years, 72.9% of patients did not present again after routine postoperative appointments. The total risk of reoperation was a rate of 7.5% (3.5% of patients underwent reoperation for the same level; 4.5% underwent adjacent-level decompression, and one patient [0.5%] ultimately underwent a fusion).CONCLUSIONSMicrodiscectomy is a safe and effective treatment for long-term relief of pain and return to daily activities among pediatric patients with symptomatic lumbar disc disease in whom conservative management has failed.

Ultrasound Biomicroscopy Documented Anterior Uveal Melanoma Regression after Ruthenium-106 Plaque Therapy

2021 ◽  
pp. 1-9
Author(s):  
Biljana Kuzmanović Elabjer ◽  
Mladen Bušić ◽  
Andrej Pleše ◽  
Mirjana Bjeloš ◽  
Daliborka Miletić ◽  
...  
Keyword(s):  
Uveal Melanoma ◽  
Tumor Regression ◽  
Corneal Thickness ◽  
Case Series ◽  
Ultrasound Biomicroscopy ◽  
Close Monitoring ◽  
Single Institution ◽  
Retrospective Case ◽  
Caucasian Patients

<b><i>Introduction:</i></b> Ultrasound biomicroscopy (UBM) is the only widely used method for the evaluation of anterior uveal melanoma (AUM). <b><i>Objective:</i></b> Documentation of regression of AUM treated with ruthenium-106 (Ru-106) plaque types CCB and CCC using UBM. <b><i>Methods:</i></b> This single institution-based retrospective case series involved 10 Caucasian patients with AUM followed after brachytherapy with UBM from January 2014 until February 2019. The largest prominence of the tumor perpendicular to the sclera or the cornea (including scleral/corneal thickness) (<i>D</i>) and the largest basal dimension (<i>B</i>) were measured in millimeters with UBM for all patients prior to the brachytherapy and at 4-month interval follow-up. Tumor regression was calculated as a percentage of decrease in the initial <i>D</i> and <i>B</i> values. <b><i>Results:</i></b> The study involved 10 patients with a mean age of 64.4 years (yr) (range 46–80 yr). <i>D</i> ranged from 1.82 to 5.5 mm (median 2.99 mm) and <i>B</i> from 2.32 to 12.38 mm (median 4.18 mm). The apical radiation dose in all patients was 100 Gy. The median follow-up was 42.02 months. Regression for <i>D</i> was 21.11 ± 13.66%, 31.09 ± 14.66%, and 34.92 ± 19.86% at 1st, 2nd, and 3rd year of the follow-up, respectively, while for <i>B</i> it was 21.58 ± 16.05%, 28.98 ± 17.71%, and 32.06 ± 18.96%, respectively. Tumor recurrence was documented in 2/10 patients. <b><i>Conclusion:</i></b> The major regression of AUM, treated with Ru-106 plaque types CCB and CCC, was documented in the first 2 years after brachytherapy in our study group. In the following years, only minimal regression was documented that warns of the need for close monitoring and active search for local recurrences.

Total Ankle Arthroplasty Survivorship, Complication, and Revision Rates in Patients Younger Than 55 Years

2021 ◽  
pp. 193864002098092
Author(s):  
Devon W. Consul ◽  
Anson Chu ◽  
Travis M. Langan ◽  
Christopher F. Hyer ◽  
Gregory Berlet
Keyword(s):  
Case Series ◽  
Ankle Arthrodesis ◽  
Total Ankle Replacement ◽  
Implant Survival ◽  
Ankle Arthritis ◽  
Single Institution ◽  
Retrospective Case ◽  
Ankle Replacement ◽  
End Stage

Total ankle replacement has become a viable alternative to ankle arthrodesis in the surgical management of advanced ankle arthritis. Total ankle replacement has generally been reserved for patients who are older and for those who will have a lower demand on the replacement. The purpose of the current study is to review patient outcomes, complications, and implant survival in patients younger than 55 years who underwent total ankle replacement at a single institution. A single-center chart and radiographic review was performed of consecutive patients who underwent total ankle replacement for treatment of end-stage ankle arthritis. All surgeries were performed by 1 of 5 fellowship-trained foot and ankle surgeons at a single institution. A total of 51 patients met inclusion criteria with a mean follow-up of 31.2 months (SD = 16.2). Implant survival was 94%, There were 7 major complications (13%) requiring an unplanned return to the operating room and 8 minor complications (15%) that resolved with conservative care. The results of this study show that total ankle replacement is a viable treatment option for patients younger than 55 years. Levels of Evidence: A retrospective case series

Management of De Novo Mycobacterial Infection After Lung Transplantation Without Rifampicin: Case Series of a Single Institution

2018 ◽  
Vol 50 (9) ◽  
pp. 2764-2767 ◽  
Author(s):  
H. Suzuki ◽  
Y. Matsuda ◽  
M. Noda ◽  
H. Oishi ◽  
T. Watanabe ◽  
...  
Keyword(s):  
Lung Transplantation ◽  
De Novo ◽  
Case Series ◽  
Mycobacterial Infection ◽  
Single Institution

scholarly journals PEDIATRIC IDIOPATHIC INTERVERTEBRAL DISC CALCIFICATION: A SINGLE INSTITUTION CASE SERIES OF A RARE DISORDER

2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e41-e41
Author(s):  
Molly Dushnicky ◽  
Ronald Laxer ◽  
Abhaya Kulkarni ◽  
Manohar Shroff ◽  
Hidehiro Okura
Keyword(s):  
Intervertebral Disc ◽  
English Language ◽  
Medical Condition ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Spinal Pain ◽  
Single Institution ◽  
Intervertebral Disc Calcification ◽  
Age Range

Abstract BACKGROUND Paediatric idiopathic intervertebral disc calcification (PIIVDC) is a rare, poorly understood condition with just over 300 reported cases in the literature since the first report in 1924. The condition is characterized by calcification of an intervertebral disc which can progress to inflammation or extrusion and lead to neck or spinal pain in some patients. OBJECTIVES We report a series of patients seen at a single institution with PIIVDC and outline the disease course, management and outcome and review the literature. DESIGN/METHODS A retrospective chart review was performed at a single institution spanning the period between January 2001 and February 2016 for diagnoses of PIIVDC. Patient age, gender, symptoms, and medical history and physical and neurologic findings were reviewed. Laboratory and imaging findings, management, follow-up, and outcome were also studied. A literature review was carried out by MEDLINE and Embase, using the search terms “pediatric disc calcification” and “disc calcification in children” between the years 1997 and 2017, in the English language. Articles were reviewed and data was extracted. RESULTS Nine cases of PIIVDC were identified (6 males, 3 females) with an age range of 1 to 14 years. Two patients were asymptomatic and PIIVDC was discovered incidentally. Of the remaining patients, five presented with neck/back pain, one painless torticollis, and one painful torticollis. One patient was noted to have pain radiating along one dermatome. Disc spaces affected were five cervical, five thoracic, and two lumbar, with two patients having more than one space affected. All patients were managed conservatively. In one case, symptoms and lesions persisted after 5-years, but the remainder had complete symptom resolution, generally within 6 months. CONCLUSION Although the etiology of PIIVDC remains unknown it appears to occur spontaneously, without preceding trauma or underlying medical condition. A conservative approach to patients without severe neurologic deficit with out-patient close follow-up is supported.

359: Cadaveric Lobar Lung Transplantation: Long Term Follow Up of a Case Series

2009 ◽  
Vol 28 (2) ◽  
pp. S190
Author(s):  
D.T. Keating ◽  
G.P. Westall ◽  
S.F. Marasco ◽  
J. Negri ◽  
J.H. Burton ◽  
...  
Keyword(s):  
Lung Transplantation ◽  
Case Series ◽  
Long Term Follow Up

Intermediate-Term Outcomes of a Third-Generation, 2-Component Total Ankle Prosthesis

2021 ◽  
pp. 107110072098611
Author(s):  
Calvin J. Rushing ◽  
Bryon J. Mckenna ◽  
Emily A. Zulauf ◽  
Christopher F. Hyer ◽  
Gregory C. Berlet
Keyword(s):  
Medical Records ◽  
Case Series ◽  
Third Generation ◽  
Single Institution ◽  
Short Term ◽  
Level Of Evidence ◽  
Ankle Prosthesis ◽  
Low Incidence ◽  
Component Revision

Background: Short-term outcomes for the INBONE I and INBONE II tibial stems have been favorable. The INBONE-II talus has been shown to have lower reoperation and failure rates compared to its predecessor at short term follow-up. The purpose of the present study was to assess mid-term outcomes for the third generation, two component total ankle prosthesis at 5 to 9 years follow-up, evaluating both the tibial and talar components. Methods: All patients who underwent primary total ankle arthroplasty (TAA) with INBONE-II between July 2010 and July 2014 at a single institution and who were at least 5 years postoperative were included. A total of 15 ankles with a mean follow-up of 85 months (range, 61-113 months) met the criteria. Radiographs were assessed using coronal and sagittal alignment parameters preoperatively, at 6 weeks postoperatively, and at the most recent follow-up. Medical records were reviewed and revisions, reoperations, and complications were classified according to the criteria established by Vander Griend et al and Glazebrook et al, respectively. Results: The survivorship of the prosthesis at a mean of 85 months was 93.7%. The coronal and sagittal tibiotalar alignments 6 weeks after surgery were 2.1 degrees ( P = .081) and 36% ( P = .15), respectively. Maintenance of this alignment was observed during the latest follow-up ( P = .684 and P = .837, respectively). One ankle (6.7%) required early component revision, while 4 (26.7%) required a non–implant-related revision. Six complications (2 high grade, 1 intermediate, and 3 low) in 5 ankles (33.3%) were recorded according to the Glazebrook classification system. Conclusion: The present study is the first to report midterm follow-up after TAA with this third-generation, 2-component prothesis. High survivorship, maintenance of correction, and a low incidence of major complications were observed in this small case series. The most common complication overall was lateral gutter impingement, which accounted for the majority of the nonrevisional reoperations. Level of Evidence: Level IV, case series.

scholarly journals PROGNOSTIC FACTORS IN PATIENTS WITH APPENDICULAR MYXOFIBROSARCOMA

2018 ◽  
Vol 26 (5) ◽  
pp. 320-324 ◽  
Author(s):  
Juan Pablo Zumárraga ◽  
Felipe Augusto Ribeiro Batista ◽  
André Mathias Baptista ◽  
Marcelo Tadeu Caiero ◽  
Luis Pablo de la Rosa Martino ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Confidence Interval ◽  
Cox Regression ◽  
Case Series ◽  
Tumor Grade ◽  
Common Site ◽  
Single Institution ◽  
Level Of Evidence ◽  
Cox Regression Analysis

ABSTRACT Objective: Myxofibrosarcoma (MFS) is a common soft tissue sarcoma (STS) that affects the extremities in elderly patients. The objective was to analyze the prognostic factors and outcomes of patients with MFS treated at a single institution. Methods: We retrospectively reviewed the records of 75 patients with MFS. We compared age, sex, tumor size and location, grade and stage of the disease. Median age was 49.7 years (range, 1 to 88 y). Location: upper extremity (25.4%), lower extremity (66.6%) and pelvis (8%). Patients had high-grade tumors in 46.7% of the reports. Margins were negative in 76% of the cases. Bivariate Cox regression analysis was used to determine associations between clinical and treatment factors with local recurrence (LR). Results: Median follow-up time was 30.7 months (range, 1.8 to 383.8 m). We found 26.7% of LR. Distant metastasis (DM) was reported in 27 (36%) patients. Lung was the most common site of DM, reported in 92.6% of patients. Overall survival (OS) with metastasis was 21.2 months (range, 4.8 to 114.8 m). Predictors of OS were grade, LR (hazard ratio [HR] 5.13, 95% confidence interval, 2.15-12.24, P <0.001), and DM (HR 540.97, 95% confidence interval, 5.04-58112.03, P< 0.001). Conclusions: Tumor grade, LR, positive margins and DM were significant predictors of poor OS prognosis. Level of Evidence IV, Case Series.

The INFINITY Total Ankle Prosthesis: Outcomes at Short-Term Follow-up

2020 ◽  
pp. 193864002094619 ◽  
Author(s):  
Calvin J. Rushing ◽  
Kurt Kibbler ◽  
Christopher F. Hyer ◽  
Gregory C. Berlet
Keyword(s):  
Case Series ◽  
The United States ◽  
Fourth Generation ◽  
Low Grade ◽  
Single Institution ◽  
Short Term ◽  
Radiographic Outcomes ◽  
Early Revision ◽  
Grade 3

Background The INFINITY total ankle prothesis remains the most widely used fourth-generation total ankle arthroplasty (TAA) system in the United States. The purpose of the present study was to assess radiographic outcomes for INFINITY at short-term follow-up. Methods All patients who underwent primary TAA with INFINITY between August 2015 and June 2018 at a single institution and who were at least 1 year postoperative were included. A total of 55 ankles with a mean follow up 22 months (range, 12-43 months) met the criteria. Weightbearing radiographs were assessed using coronal and sagittal alignment parameters preoperatively, at 6 to 8 weeks postoperatively, and at the most recent follow-up. Medical records and charts were reviewed and revisions, reoperations, and complications were classified according to the criteria established by Vander Griend et al and Glazebrook at el, respectively. Results Overall, INFINITY survivorship was 98.2%. Coronal and sagittal tibiotalar alignment improved after surgery ( P < .001, P = .09, respectively), and was maintained during the latest follow-up ( P = .62, P = .47, respectively). Only 1 ankle (1.8%) required early revision; while 5 (9.1%) indicated non-implant-related revision; 85.5% required no reoperation. In nineteen ankles (34.5%), postoperative periprosthetic lucency was observed; most were not progressive (17 ankles, 89.5%). Twelve complications (3 high grade, 3 intermediate, and 6 low grade) in 11 ankles (20%) were recorded according to the Glazebrook classification system. Conclusion INFINITY survivorship was 98.2% at a mean of 1.8 years of follow-up, and only 1 ankle required prosthetic revision. Additional studies with longer follow-up are warranted for fourth-generation TAA prostheses. Levels of Evidence: Level IV: Case series

scholarly journals Incidence, clinical features, and treatment of familial moyamoya in pediatric patients: a single-institution series

2017 ◽  
Vol 19 (5) ◽  
pp. 553-559 ◽  
Author(s):  
Jonathan Gaillard ◽  
Jennifer Klein ◽  
Daniel Duran ◽  
Armide Storey ◽  
R. Michael Scott ◽  
...  
Keyword(s):  
Case Series ◽  
Current Data ◽  
Limited Data ◽  
Single Institution ◽  
Stroke Prevalence ◽  
Unilateral Disease ◽  
History Of ◽  
Male Patients ◽  
Revascularization Procedures

OBJECTIVELimited data exist on familial moyamoya in children. The purpose of this study was to characterize presentation and outcomes of pediatric moyamoya patients who have relatives diagnosed with moyamoya.METHODSThe authors performed a single-institution retrospective analysis of a case series including all surgically treated children with moyamoya with first- or second-degree relatives with moyamoya. Clinical and radiographic characteristics were analyzed, along with surgical outcomes.RESULTSA total of 537 patients underwent surgery for moyamoya during the study period. Eighteen of those patients (3.4% of the total series) had moyamoya and a family history of moyamoya and were included in this study. Of these 18 patients, 14 were non-twin siblings, and the remaining 4 represented 2 pairs of identical (affected) twins.The presentation was predominantly ischemic (72%), but 4 patients (33%) were asymptomatic when they were found to have moyamoya. Bilateral disease was present in 13 patients (72%). Radiographic stroke prevalence (67%), Suzuki grade (3.3), and angiographic findings were comparable to findings in nonfamilial moyamoya patients. Thirty revascularization procedures were performed, with a 3.3% operative stroke rate per hemisphere and no new strokes in an average follow-up period of 4.5 years.CONCLUSIONSIn a North American surgical series, familial moyamoya existed in 3.4% of cases, and was distinguished by manifesting in a broad range of ethnic groups, with a higher proportion of male patients and increased rates of asymptomatic and unilateral disease in comparison to nonfamilial moyamoya. Screening indications remain controversial and the current data are used to suggest guidelines. Surgical therapy is warranted, effective, and durable in these patients, but patients should be carefully selected.

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