scholarly journals Maxillary ameloblastoma: results of the treatment in 11 patients

2018 ◽  
Vol 24 (1) ◽  
pp. 6-10 ◽  
Author(s):  
Rasmané Béogo ◽  
Tarcissus Konsem ◽  
Mathieu Millogo ◽  
Hèra Michel Kohoun ◽  
Toua Antoine Coulibaly ◽  
...  
Keyword(s):  
Tumor Recurrence ◽  
Wound Closure ◽  
Facial Asymmetry ◽  
Facial Morphology ◽  
Tumor Removal ◽  
Dental Rehabilitation ◽  
Defect Repair ◽  
Type 3

Introduction: Surgery of maxilla ameloblastoma is mutilating and the tumor propensity for recurrence high. Patients and Methods: The oral and visual functions, facial morphology and tumor recurrence in 11 patients after maxillary ameloblastoma surgery are retrospectively reviewed. Results: Facial morphology was satisfactory in 7 patients who had all tumor removal by a type 1 or 2A maxillectomy and surgical wound closure. Out of these patients, 4 who had dental rehabilitation by conventional prosthesis presented satisfactory mastication. Four patients subjected to the tumor removal by a type 3 maxillectomy had all facial asymmetry. Out of these, 1 patient who did not have the orbital floor defect repair presented diplopia and enophtalmos, 2 patients subjected to the palate defect repair by a prosthetic obturator or oral mucosa had elocution impairment. The tumor recurrence occurred in 2 patients after tumor enucleation and in 1 patient after radical surgery out of 8 patients who had a postoperative follow-up. Discussion: In ameloblastoma surgery, achieving both the tumor recurrence prevention and a satisfactory facial reconstruction is challenging. Conclusion: Avoiding the tumor recurrence should be the major goal when patient post-surgical follow-up cannot be guaranteed.

Characterisation of macular neovascularisation in geographic atrophy

2021 ◽  
pp. bjophthalmol-2021-318820
Author(s):  
Riccardo Sacconi ◽  
Maria Brambati ◽  
Alexandra Miere ◽  
Eliana Costanzo ◽  
Vittorio Capuano ◽  
...  
Keyword(s):  
Fundus Autofluorescence ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
First Year ◽  
Age Related ◽  
Treatment Naïve ◽  
Type 3 ◽  
Endothelial Growth Factor

AimTo characterise macular neovascularisation (MNV) developing in eyes affected by geographic atrophy (GA).MethodsIn this multicentric longitudinal study involving three retina referral centres, patients previously affected by GA who developed an active MNV were included. Patients were investigated using structural optical coherence tomography (OCT), fundus autofluorescence, OCT-angiography and dye angiographies. Patients were treated with ProReNata antivascular endothelial growth factor (VEGF) injections and were revaluated after treatment.ResultsAmong 512 patients previously diagnosed with GA, 40 eyes of 40 patients (mean age 80.8±7.9 years, mean GA area 8.73±7.39 mm2) presented with treatment-naïve exudative MNV (accounting for an estimated prevalence of 7.81%; 5.49 to 10.13, 95% CIs) and thus were included in the analysis. 67.5% of MNVs were classified as type 2 MNV, 25% as type 1, 2.5% as type 3 and 5% as mixed phenotype. In 92.5% of cases, active MNV in GA showed subretinal hyperreflective material with or without evidence of subretinal/intraretinal hyporeflective exudation. During a mean follow-up of 28±25 months, patients were treated with 6.6±6.3 anti-VEGF injections, with 2.9±1.4 injections in the first year of treatment. No patient developed GA enlargement in the area of MNV.ConclusionsMNVs in GA showed different features and therapeutic response in comparison to previously reported features of MNV in age-related macular degeneration (AMD) without GA. For these reasons, the combined phenotype (ie, GA with neovascular AMD) should be considered as a distinct entity in the research and clinical setting.

Early results of surgery in patients with nonfunctioning pituitary adenoma and analysis of the risk of tumor recurrence

2008 ◽  
Vol 108 (3) ◽  
pp. 525-532 ◽  
Author(s):  
Marco Losa ◽  
Pietro Mortini ◽  
Raffaella Barzaghi ◽  
Paolo Ribotto ◽  
Maria Rosa Terreni ◽  
...  
Keyword(s):  
Tumor Recurrence ◽  
Postoperative Radiotherapy ◽  
Residual Tumor ◽  
Benign Tumors ◽  
Surgical Removal ◽  
Tumor Diameter ◽  
Tumor Removal ◽  
Early Results ◽  
Results Of Surgery

Object Nonfunctioning pituitary adenomas (NFPAs) are benign tumors of the pituitary gland that typically cause visual and/or hormonal dysfunction. Surgery is the treatment of choice, but patients remain at risk for tumor recurrence for several years afterwards. The authors evaluate the early results of surgery and the long-term risk of tumor recurrence in patients with NFPAs. Methods Between 1990 and 2005, 491 previously untreated patients with NFPA underwent surgery at the Università Vita-Salute. Determinations of recurrence or growth of the residual tumor tissue during the follow-up period were based on neuroradiological criteria. Results Residual tumor after surgery was detected in 173 patients (36.4%). Multivariate analysis showed that invasion of the cavernous sinus, maximum tumor diameter, and absence of tumor apoplexy were associated with an unfavorable surgical outcome. At least 2 sets of follow-up neuroimaging studies were obtained in 436 patients (median follow-up 53 months). Tumors recurred in 83 patients (19.0%). When tumor removal appeared complete, younger age at surgery was associated with a risk of tumor recurrence. In patients with incomplete tumor removal, adjunctive postoperative radiotherapy had a marked protective effect against growth of residual tumor. Conclusions Complete surgical removal of NFPAs can be safely achieved in > 50% of cases. Visual symptoms and, less frequently, pituitary function may improve after surgery. However, tumor can recur in patients after apparently complete surgical removal. In patients with incomplete tumor removal, radiation therapy is the most effective adjuvant therapy for preventing residual tumor growth.

scholarly journals High-pressure balloon dilatation in children: our results in 30 patients with POM and the implications of the cystoscopic evaluation

2020 ◽  
Vol 42 (1) ◽  
Author(s):  
Francesca Destro ◽  
Giorgio Selvaggio ◽  
Federica Marinoni ◽  
Andrea Pansini ◽  
Giovanna Riccipetitoni
Keyword(s):  
High Pressure ◽  
Balloon Dilatation ◽  
Invasive Procedure ◽  
Definitive Treatment ◽  
Ureteral Stenting ◽  
Diagnostic Modalities ◽  
Almost All ◽  
Type 3

Primary Obstructive Megaureter (POM) is a common cause of hydronephrosis in children with spontaneous resolution in most cases. High-Pressure Balloon Dilatation (HPBD) has been proposed as a minimally invasive procedure for POM correction in selected patients. The aim of the paper is to review our experience with HPBD in patients with POM. We performed a retrospective study in a single Centre collecting data on patients’ demographics, diagnostic modalities, surgical details, results and follow-up. In particular, the endoscopic aspect of the orifice permitted the identification of 3 patterns: adynamic ureteral segment, stenotic ureteric ring and pseudoureterocelic orifice. We performed HPBD in 30 patients over 6 years. We had 23 patients with adynamic distal ureteral segment (type 1), 4 with stenotic ring (type 2) and 3 with ureterocelic orifice (type 3). In 3 patients (10%) the guidewire did not easily pass into the ureter requiring ureteral stenting or papillotomy. Post-operative course was uneventful. Five patients (3 pseudoureterocelic) required open surgery during follow-up. HPBD for the treatment of POM is a safe and feasible procedure and it can be a definitive treatment of POM. Complications are mainly due to double J stent and none of our patients had symptoms related to vescico-ureteral reflux. The aspect of the orifice, identified during cystoscopy, seems to correlate with the efficacy of the dilatation: type 1 and 2 are associated with good and excellent results respectively; type 3 do not permit dilatation in almost all cases requiring papillotomy. HPBD can be performed in selected patients of all paediatric ages as first therapeutic line. The presence of a pseudoureterocelic orifice or long stenosis might interfere with the ureteral stenting and seems associated with worse outcomes.

scholarly journals The effects of vertebral body tethering on sagittal parameters: evaluations from a 2-years follow-up

2021 ◽  
Author(s):  
Alice Baroncini ◽  
Aurelien Courvoisier ◽  
Pedro Berjano ◽  
Filippo Migliorini ◽  
Jörg Eschweiler ◽  
...  
Keyword(s):  
Thoracic Kyphosis ◽  
Vertical Axis ◽  
Sagittal Profile ◽  
Sagittal Vertical Axis ◽  
Lumbar Level ◽  
Thoracic Level ◽  
Sagittal Parameters ◽  
Type 3

Abstract Introduction While the effects of VBT on coronal parameters have been investigated in various studies, this has not yet been the case for sagittal parameters. This is of particular relevance considering that VBT does not allow direct correction of the sagittal profile. Thus, we investigated the effects of VBT on sagittal parameters in patients with adolescent idiopathic scoliosis. Materials and methods Retrospective, 2-Center study. Patients who underwent VBT and presented a 2-years follow-up were included. The differences in sagittal parameters were evaluated, along with modifications of sagittal profile following Abelin-Genevois’ classification. Results Data from 86 patients were obtained. Mean Cobb angle was 52.4 ± 13.9° at thoracic level and 47.6 ± 14.3° at lumbar level before surgery, and 28.5 ± 13.6 and 26.6 ± 12.7° at the 2-year follow-up, respectively. Mean thoracic kyphosis increased from 28.3 ± 13.8 to 33 ± 13°, the lumbar lordosis (LL) was unvaried (from 47.5 ± 13.1 to 48.4 ± 13.5°), PT decreased from 9.4 ± 8.5 to 7.4 ± 6.1°, the sagittal vertical axis SVA decreased from 4.5 ± 31.4 to − 3.6 ± 27.9 mm. No kyphotic effect on LL in patients who underwent lumbar instrumentation was observed. Before surgery, 39 patients had a type 1 sagittal profile, 18 were type 2a, 14 type 2b and 15 type 3. Postoperatively, 54 were type 1, 8 were 2a, 13 were 2b and 11 were type 3. Conclusions VBT positively influences sagittal parameters and does not have a kyphotic effect on LL.

Maintenance Efficacy of Low Dose Imiglucerase for Gaucher Disease

2020 ◽  
Author(s):  
Zhengqing Qiu ◽  
Baohui Zhang ◽  
Yuhang Song ◽  
Hongbing Zhang ◽  
Yuting Wu
Keyword(s):  
Gaucher Disease ◽  
Low Dose ◽  
Standard Dose ◽  
Mineral Density ◽  
Recommended Treatment ◽  
Type 3 ◽  
Term Maintenance

Abstract Background Imiglucerase is the recommended treatment for Gaucher disease (GD), a hereditary metabolic disease. In high risk adults and all children, the minimum recommended dose for long-term maintenance is 30 U/kg/2 weeks. However, the extremely high cost of this enzyme largely hinders its clinical use. The minimal maintenance dose of imiglucerase has thus been a subject of debate. We aimed to analyze the long-term maintenance outcomes of imiglucerase at dosage < 20 U/kg/2 weeks after standard dose. Methods Seventeen patients with GD type 1 or GD type 3 were enrolled for analysis. We evaluated maintenance efficacy of imiglucerase on hemoglobin, platelet, visceral volumes and bone conditions during the 7-year follow-up. Results Parameters on hemoglobin, platelet, liver, and spleen volumes of all patients were stabilized or improved. Seven out of 14 patients showed bone mineral density improvement. Three out of 16 patients showed worse bone pain; 6 out of 15 patients showed worse Erlenmeyer flask; 6 out of 15 patients showed worse bone infarction; 1 out of 16 patients showed worse marrow infiltration and 3 out of 15 patients showed worse osteonecrosis. Conclusions Imiglucerase less than 20 U/kg/2 weeks is enough to maintain blood and visceral parameters, but is not sufficient to stabilize skeletal conditions.

scholarly journals Are There Clinical Differences in Limited Systemic Sclerosis according to Extension of Skin Involvement?

2014 ◽  
Vol 2014 ◽  
pp. 1-5
Author(s):  
Marina Scolnik ◽  
Luis J. Catoggio ◽  
Eliana Lancioni ◽  
Mirtha R. Sabelli ◽  
Carla M. Saucedo ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Interstitial Lung Disease ◽  
Skin Involvement ◽  
Male Ratio ◽  
Limited Systemic Sclerosis ◽  
Anticentromere Antibodies ◽  
Type 3

Objectives. To examine the characteristics of our patients with limited systemic sclerosis (lSSc) for differences between Barnett Type 1 (sclerodactyly only) and Type 2 or intermediate (acrosclerosis-distal but may reach up to elbows and/or knees plus face) subsets.Methods. Records of patients between January 1, 2000, and December 31, 2011, with SSc or those with anti-Scl-70, anticentromere, or antinucleolar antibodies were reviewed. Only cases fulfilling ACR 1980 criteria were included and classified as diffuse or limited according to LeRoy’s criteria. Limited SSc was separated into sclerodactyly and acrosclerosis (Barnett’s Types 1 and 2).Results. 234 SSc patients (216 females) fulfilled criteria. Female/male ratio was 12 : 1; 24% had dSSc and 76% lSSC (64% Type 1 and 12% Type 2). Total follow-up was 688 patient-years. Within lSSC, the Type 2 group had significantly shorter duration of Raynaud’s and more anti-Scl-70 and less anticentromere antibodies. In particular, interstitial lung disease (ILD) was significantly more prevalent in Type 2 group and similar to Type 3.Conclusions. These results appear to confirm that extension of skin involvement within limited SSc may identify two different subsets with clinical and serologic characteristics.

scholarly journals Evaluation of Results of Fixation of Unstable Distal Radial Fractures by Volar Locking Plating System

2017 ◽  
Vol 11 (2) ◽  
pp. 62-66
Author(s):  
Md Maiyeen Uddin ◽  
Anadi Ranjan Mondal ◽  
Narayan Chandra Karmakar ◽  
Md Masudur Rahman ◽  
Syed Asif Ul Alam
Keyword(s):  
Locking Plate ◽  
Volar Locking Plate ◽  
Wrist Flexion ◽  
Distal Radial Fractures ◽  
Surgical Fixation ◽  
Single Bone ◽  
Trauma Surgeons ◽  
Type 3

Distal radial fractures are most common fractures accounts 15% of whole skeletal injuries, as high as 40% to 49% are considered to be unstable that requires surgical fixation. The purpose of the study was to ascertain good functional hand by using volar locking plate & screws, as with locking system, distal screws are locked to the plate, which stabilized the screws against lateral movement (toggle effect), thus providing a "single bone-plate-screws construct" which producing a scaffold in the mostly cancellous distal radial metaphysis, so preventing from collapse. This study was done from January 2007 to December 2008 at National Institute of Traumatology & Orthopaedic Rehabilitation (NITOR). Total numbers of cases were 17. All patients were admitted in hospital & most of them returned home within 4 days. Most patients were managed early within 1-10 days of injury. Most patients were Fernandez type 1, type 2, and type 3. Most patients were in the age group of 4th decade. All patients were followed up for a period of at least 3 months, mean follow up period was 6 months. Results showed that wrist pain, wrist stiffness, reduced grip strength were minimum with volar locking plate & screws as there is minimal radial shortening, radial angulation, volar tilt & ulnar variance and wrist flexion, wrist extension, ulnar deviation, supination, pronation were very good. So, the trauma surgeons can safely use this procedure.Faridpur Med. Coll. J. Jul 2016;11(2): 62-66

Multimodality management of Spetzler-Martin Grade III arteriovenous malformations

2012 ◽  
Vol 116 (6) ◽  
pp. 1279-1288 ◽  
Author(s):  
Paritosh Pandey ◽  
Michael P. Marks ◽  
Ciara D. Harraher ◽  
Erick M. Westbroek ◽  
Steven D. Chang ◽  
...  
Keyword(s):  
Neurological Deficit ◽  
Arteriovenous Malformations ◽  
Venous Drainage ◽  
Neurological Deficits ◽  
Eloquent Cortex ◽  
Type 3 ◽  
Grade Iii

Object Grade III arteriovenous malformations (AVMs) are diverse because of their variations in size (S), location in eloquent cortex (E), and presence of central venous drainage (V). Because they may have implications for management and outcome, the authors evaluated these variations in the present study. Methods Between 1984 and 2010, 100 patients with Grade III AVMs were treated. The AVMs were categorized by Spetzler-Martin characteristics as follows: Type 1 = S1E1V1, Type 2 = S2E1V0, Type 3 = S2E0V1, and Type 4 = S3E0V0. The occurrence of a new neurological deficit, functional status (based on modified Rankin Scale [mRS] score) at discharge and follow-up, and radiological obliteration were correlated with demographic and morphological characteristics. Results One hundred patients (49 female and 51 male; age range 5–68 years, mean 35.8 years) were evaluated. The size of AVMs was less than 3 cm in 28 patients, 3–6 cm in 71, and greater than 6 cm in 1; 86 AVMs were located in eloquent cortex and 38 had central drainage. The AVMs were Type 1 in 28 cases, Type 2 in 60, Type 3 in 11, and Type 4 in 1. The authors performed embolization in 77 patients (175 procedures), surgery in 64 patients (74 surgeries), and radiosurgery in 49 patients (44 primary and 5 postoperative). The mortality rate following the management of these AVMs was 1%. Fourteen patients (14%) had new neurological deficits, with 5 (5%) being disabling (mRS score > 2) and 9 (9%) being nondisabling (mRS score ≤ 2) events. Patients with Type 1 AVMs (small size) had the best outcome, with 1 (3.6%) in 28 having a new neurological deficit, compared with 72 patients with larger AVMs, of whom 13 (18.1%) had a new neurological deficit (p < 0.002). Older age (> 40 years), malformation size > 3 cm, and nonhemorrhagic presentation predicted the occurrence of new deficits (p < 0.002). Sex, eloquent cortex, and venous drainage did not confer any benefit. In 89 cases follow-up was adequate for data to be included in the obliteration analysis. The AVM was obliterated in 78 patients (87.6%), 69 of them (88.5%) demonstrated on angiography and 9 on MRI /MR angiography. There was no difference between obliteration rates between different types of AVMs, size, eloquence, and drainage. Age, sex, and clinical presentation also did not predict obliteration. Conclusions Multimodality management of Grade III AVMs results in a high rate of obliteration, which was not influenced by size, venous drainage, or eloquent location. However, the development of new neurological deficits did correlate with size, whereas eloquence and venous drainage did not affect the neurological complication rate. The authors propose subclassifying the Grade III AVMs according to their size (< 3 and ≥ 3 cm) to account for treatment risk.

Anterior expandable strut cage replacement for osteoporotic thoracolumbar vertebral collapse

2006 ◽  
Vol 4 (6) ◽  
pp. 454-462 ◽  
Author(s):  
Kenzo Uchida ◽  
Shigeru Kobayashi ◽  
Hideaki Nakajima ◽  
Yasuo Kokubo ◽  
Takafumi Yayama ◽  
...  
Keyword(s):  
Neurological Status ◽  
Neurological Deficits ◽  
Vertebral Body Replacement ◽  
Vertebral Collapse ◽  
Expandable Cage ◽  
Cage Subsidence ◽  
The Mean ◽  
Type 3

Object The authors investigated the usefulness of using an expandable cage strut in anterior reconstruction after osteoporotic vertebral collapse in patients with neurological deficits. Methods Twenty-eight patients who had undergone expandable cage strut–augmented anterior thoracolumbar reconstruction participated in a follow-up review for a mean of 4.9 years. Radiographs were reviewed for kyphosis, lateral tilt of the implant, cage subsidence, the presence of a solid fusion mass, and instrumentation failure. Changes in neurological status and visual analog scale (VAS) pain score, as well as technique-related complications, were examined. The mean angles ± the standard deviations of kyphosis correction 4 to 6 weeks after surgery and at final follow-up examination were 10.4 ± 7.6° and 5.6 ± 6.0°, respectively. The mean subsidence of the expandable cage within the adjacent vertebrae was 2.5 ± 3.0 mm at the final follow-up examination. Neurological improvement at the final follow up was more significant in patients with Type 1 (wedge-type) than Type 2 (flat-type) (p = 0.037) or Type 3 (concave-type) (p = 0.006) vertebral collapse. Follow-up VAS scores were significantly higher in patients with Type 1 than Type 3 collapse (p = 0.012). In all cases the authors observed solid union with incorporation of the cage. There were no surgery-related complications. Conclusions An expandable titanium cage strut seems useful in vertebral body replacement in patients with osteoporotic thoracolumbar collapse. Favorable results were obtained in cases of Type 1 collapse (wedge type) in which the middle and posterior columns remained comparatively intact.

scholarly journals Persistent cloaca: persistence of the challenge

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Amr Abdelhamid AbouZeid ◽  
Ahmed Bassiouny Radwan ◽  
Mohamed Eldebeiky ◽  
Sameh Abdel Hay
Keyword(s):  
Case Series ◽  
Pubic Symphysis ◽  
Urinary Continence ◽  
Level Of Evidence ◽  
Renal Anomalies ◽  
Persistent Cloaca ◽  
Type 3 ◽  
Common Association

Abstract Background Persistent cloaca or cloacal anomalies represent a special category of anorectal anomalies affecting the female sex with a reported incidence of about one in 25,000 live birth. The study included 34 cases of cloaca that were managed at our unit between 2003 through 2017. We retrospectively reviewed patients’ records that included clinical presentation, investigations, operative data, and follow-up notes. Anatomically, we stratified cloaca into three types according to the level of urogenital confluence. A low confluence (type 1) was defined by being at or below the level of the lower border of pubic symphysis with a short common channel (11 cases). A high confluence (type 3) was defined by being at or above the level of the upper border of pubic symphysis (9 cases). Between the low and high types, we defined an intermediate type (type 2) where the urogenital confluence was behind the mid-portion of pubic symphysis (14 cases). Results Renal anomalies were common association: solitary kidney in seven, pelvic kidney in two, and urinary tract dilatation (hydroureteronephrosis) in 12 cases. At follow-up, chronic renal insufficiency was detected in seven cases The prognosis for urinary continence was excellent in low confluence (type 1) cloaca. On the other hand, urinary incontinence was common among type 3 (high confluence) cloaca (62.5%). Conclusion Renal anomalies represent a common association with cloaca and a major cause of morbidity. Efforts should be directed to preserve renal function during the initial management, and to preserve the continence potential following the definitive repair. Level of evidence This is a case series with no comparison group (level IV).

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