Primary Calvarial Ewing Sarcoma: A Case Series

2021 ◽  
Author(s):  
Sandeep Mohindra ◽  
Manjul Tripathi ◽  
Aman Batish ◽  
Ankur Kapoor ◽  
Ninad Ramesh Patil ◽  
...  
Keyword(s):  
Ewing Sarcoma ◽  
Tumor Resection ◽  
Case Series ◽  
Radical Excision ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Intradural Tumor ◽  
Age Range

Abstract Background Calvarial Ewing tumor is a relatively rare differential among bony neoplasms. We present our experience of managing primary calvarial Ewing sarcoma (EWS), highlighting their clinical and radiological findings. Method In a retrospective analysis, we evaluated our 12-year database for pathologically proven EWS. A literature search was conducted for the comparative presentation and update on the management and outcome. Result From January 2008 to December 2020, we managed eight patients (male:female = 5:3; age range 6 months to 19 years, mean 11.5 years) harboring primary calvarial EWS. All cases underwent wide local excision; two patients required intradural tumor resection, while one required rotation flap for scalp reconstruction. Mean hospital stay was 8 days. All patients received adjuvant chemo- and radiotherapy. Three patients remained asymptomatic at 5 years of follow-up, while two patients died. Conclusion Primary calvarial EWS is a rare entity. It usually affects patients in the first two decades of life. These tumors can be purely intracranial, causing raised intracranial pressure symptoms, which may exhibit rapidly enlarging subgaleal tumors with only cosmetic deformities or symptoms of both. Radical excision followed by adjuvant therapy may offer a favorable long-term outcome.

scholarly journals Long term outcome of combined phacoemulsification and excisional goniotomy with the Kahook Dual Blade in different subtypes of glaucoma

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ahmed Al Habash ◽  
Abdulrahman Albuainain
Keyword(s):  
Case Series ◽  
Angle Closure ◽  
Combined Surgery ◽  
Visual Rehabilitation ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Kahook Dual Blade ◽  
Significant Cataract

AbstractTo characterize changes in intraocular pressure (IOP) and IOP-lowering medications through up to 2 years of follow-up in patients undergoing combined phacoemulsification and excisional goniotomy with the Kahook Dual Blade (phaco-KDB), with simultaneous goniosynechialysis in cases of angle-closure glaucoma. Prospective, non-comparative, interventional case series. Consecutive patients with medically-treated glaucoma and visually-significant cataract underwent combined surgery. Analysis was conducted on open-angle (OAG) and angle-closure (ACG) glaucoma groups separately. Thirty-seven patients with OAG (24 with primary OAG and 13 with pseudoexfoliation glaucoma) and 11 with ACG were enrolled. In OAG eyes, mean (standard error) baseline IOP was 21.1 (0.9) mmHg and through 24 months of follow-up was reduced by 6.4–7.7 mmHg (24.6–32.1%; p ≤ 0.0001 at all time points). In ACG eyes, mean baseline IOP was 20.8 (1.6) mmHg and was reduced by 6.1–8.77 mmHg (23.4–39.0%; p ≤ 0.0353). Mean medications were reduced by 61.9–89.1% (p ≤ 0.0001) in OAG eyes and by 56.3–87.3% (p ≤ 0.0004) in ACG eyes. Phaco-KDB significantly lowered IOP ~ 30% and medications by > 50% through 24 months. This combined procedure provides meaningful long-term reductions in IOP and need for IOP-lowering medication and does not adversely affect visual rehabilitation in eyes with cataract and glaucoma.

Arthroscopic treatment of fragmented coronoid process with severe elbow incongruity

2013 ◽  
Vol 26 (01) ◽  
pp. 27-33 ◽  
Author(s):  
E. de Bakker ◽  
D. Van Vynckt ◽  
E. Coppieters ◽  
H. van Bree ◽  
B. Van Ryssen ◽  
...  
Keyword(s):  
Clinical Signs ◽  
Case Series ◽  
Term Treatment ◽  
Coronoid Process ◽  
Heavy Exercise ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Long Term Treatment

SummaryThe purpose of this study was to investigate the long-term treatment results of fragmented coronoid process (FCP) in joints with a radio-ulnar step greater than 3 mm. Treatment of these patients only consisted of fragment removal, without correction of the incongruity.The eight Bernese Mountain Dogs (11 joints) included in this study showed obvious clinical signs of elbow disease and were diagnosed with severe elbow incongruity and concomitant FCP in the time period from 1999–2003. At that time, elbow radiography, computed tomography, and arthroscopy were performed. The mean follow-up period was 5.6 years. The follow-up consisted of a telephone questionnaire combined with a clinical and radiographic re-evaluation at our clinic.The questionnaire revealed that all dogs were either free of lameness or only lame following heavy exercise. One dog sporadically required medication after heavy exercise. The owner satisfaction rate was 100%. The clinical re-evaluation did not reveal any signs of pain or lameness in all cases. Range-of- motion was decreased in nine of the 11 elbows. Radiographs revealed an increase in severity of osteoarthritis in every case.In this case series, arthroscopic fragment removal without treatment of incongruity was demonstrated to be a valuable treatment option and may provide a satisfactory long-term outcome.

Complex basilar artery aneurysms treated using surgical basilar occlusion: a modern case series

2011 ◽  
Vol 115 (2) ◽  
pp. 319-327 ◽  
Author(s):  
Christopher P. Kellner ◽  
Raqeeb M. Haque ◽  
Philip M. Meyers ◽  
Sean D. Lavine ◽  
E. Sander Connolly ◽  
...  
Keyword(s):  
Basilar Artery ◽  
Case Series ◽  
Endovascular Techniques ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Complex Aneurysms ◽  
Long Term Follow Up ◽  
Clinical Records

Object Complex aneurysms of the basilar artery (BA) apex can be successfully treated using surgical occlusion of the proximal BA. Since the introduction of the Guglielmi detachable coil in 1991, the focus on treating BA aneurysms has been on using endovascular techniques. Outcomes with endovascular techniques have been less than optimal for large and complex aneurysms. The authors therefore report on their current 22-year experience with surgical BA occlusion for complex BA aneurysms and long-term outcome. Methods Fifteen patients underwent surgical BA occlusion at Columbia University Medical Center for complex basilar apex aneurysms between 1987 and 2009. The clinical records of each patient were reviewed for details of presentation, hospital course, operative intervention, and outcome. Results Postoperatively, all patient encounters were recorded at discharge, at the 1-month and 1-year follow-up evaluations, and at long-term outcome. Twelve (80%) of 15 patients experienced no new postoperative neurological deficits. Three patients presenting with severe neurological impairment (modified Rankin Scale [mRS] score > 3) made excellent recoveries (mRS Scores 1–2) at long-term follow-up. One patient died, 1 suffered a stroke during the postoperative angiogram which resulted in hemiparesis, and 1 suffered internuclear ophthalmoplegia which resolved by the 1-month follow-up. Long-term follow-up occurred at an average of 3 ± 4.5 years, ranging from 2 months (for a recently treated patient) to 18 years. The average mRS score at long-term follow-up was 1 ± 1.5. No patient experienced postoperative hemorrhage, rebleeding, or delayed neurological deterioration. Conclusions Surgical occlusion of the BA is an effective treatment option offering a high rate of angiographic cure in a single procedure for patients with complex BA aneurysms. The ability to surgically perform point occlusion of the BA without impairment of brainstem perforators, while maintaining collateral blood flow to the posterior circulation branch vessels, may provide an advantage compared with endovascular treatments.

Facet Joint Replacement: Intermediate- and Long-Term Outcome in a Large Case Series

2020 ◽  
Vol 82 (01) ◽  
pp. 034-042
Author(s):  
Ulrich J. Knappe ◽  
David Reinecke ◽  
Michael Flörke ◽  
Peter Horn ◽  
Robert Schönmayr
Keyword(s):  
Lumbar Spine ◽  
Joint Replacement ◽  
Facet Joint ◽  
Case Series ◽  
Leg Pain ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Disk Height

Abstract Background The long-term outcome of facet joint replacement (FJR) still is to be proven. Methods We present a prospective case series of 26 (male-to-female ratio of 1:1; mean age: 61 years) patients undergoing FJR with a follow-up of at least 1 year (range: 12–112; mean: 67 months). Visual analog scale (VAS) for back and leg pain, Oswestry Disability Index (ODI), and the 12-Item Short Form Health Survey (SF-12) were applied pre- and postoperatively (after 3, 6, and 12 months) as well as at the last follow-up (N = 24). Using X-rays of the lumbar spine (N = 20), the range of motion (ROM) and disk height in the indicator and adjacent levels were assessed. Results FJR was performed at L3/L4 (N = 7), L4/L5 (N = 17), and L5/S1 (N = 2). Mean VAS (mm) for back pain decreased from 71 to 18, mean VAS for right leg pain from 61 to 7, and from 51 to 3 for the left leg. Mean ODI dropped from 51 to 22% (for all p < 0.01). Eighty seven percent of patients were satisfied and pretreatment activities were completely regained in 78.3% of patients. Disk height at the indicator and adjacent levels and ROM at the indicator segment and the entire lumbar spine were preserved. No loosening of implants was observed. Explantation of FJR and subsequent fusion had to be performed in four cases (15.4%). Conclusions In selected cases, long-term results of FJR show good outcome concerning pain, quality of life, preservation of lumbar spine motion, and protection of adjacent level.

Tibial Apophyseal Percutaneous Pinning in Skeletally Immature Dogs: 25 Cases (2016–2019)

2020 ◽  
Author(s):  
Dirsko J.F. von Pfeil ◽  
Sara Megliolia ◽  
Sarah Malek ◽  
Mark Rochat ◽  
Mathieu Glassman
Keyword(s):  
Tibial Plateau ◽  
Skeletal Maturity ◽  
Case Series ◽  
Skeletally Immature ◽  
Percutaneous Pinning ◽  
Term Outcome ◽  
Avulsion Fractures ◽  
Long Term Outcome

Abstract Objective The aim of this study was to report the clinical experience with fluoroscopically guided tibial apophyseal percutaneous pinning (TAPP) for tibial tuberosity avulsion fractures (TTAF). Study Design This is a retrospective case series. Materials and Methods Medical records of skeletally immature dogs (n = 25) were reviewed. The association of pin design [smooth (SP); negatively threaded (NTP)], pin insertion angles, TTAF-type, age and breed with various outcome variables was statistically evaluated. Long-term follow-up was assessed via direct examination, radiographs, questionnaires and videos. Results Mean age, weight and surgery times were 6.2 months, 9.6 kg and 21 minutes respectively. No major complications occurred among the 19 SP and 6 NTP; no pin broke. Seromas and patellar desmitis rates were higher with SP (11/19; 16/19) versus NTP (0/6; 2/6) (p = 0.02; 0.03). The median horizontal pin cross angles for cases without and with desmitis were 40 and 26 degrees respectively (p = 0.047). Explantation was needed in 5/19 SP and 0/6 NTP cases. The mean tibial plateau angle (TPA) changed significantly between initial (25.6 degrees) and follow-up (18.8 degrees) radiographs (p = 0.0002). Long-term outcome, obtained at a mean of 19.9 months, was excellent in all cases. Conclusion Tibial apophyseal percutaneous pinning can be considered to treat TTAF. Divergent pin placement and using NTP might reduce complications. Tibial plateau angle should be monitored until skeletal maturity has been reached. Long-term outcome post TAPP can be expected to be excellent.

scholarly journals Long-term outcome in pediatric surgical bypass grafting after traumatic injury and tumor resection: retrospective cohort analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Stephanie Kampf ◽  
Madeleine Willegger ◽  
Christopher Dawoud ◽  
Gerhard Fülöp ◽  
Philipp Lirk ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Traumatic Injury ◽  
Tumor Resection ◽  
Limb Length ◽  
Bypass Grafting ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Vascular Bypass

AbstractVascular bypass surgery in children differs significantly from adults. It is a rarely performed procedure in the setting of trauma and tumor surgery. Besides technical challenges to reconstruct the small and spastic vessels, another concern in bypass grafting is the adequate limb length growth over time. The primary aim of this study was to assess long-term outcome after pediatric bypass grafting, in a single academic center, focusing on potential effects on limb development. In this retrospective cohort analyses we included all pediatric patients undergoing vascular bypass grafting at our department between 2002 and 2017. All patients ≤ 18 years suffered a traumatic injury or underwent a tumor resection of the lower or upper limb. The youngest female patient was 0.4 years, the youngest male patient was 3.5 years. During the observation period, 33 pediatric patients underwent vascular repair, whereby 15 patients underwent bypass grafting. Median overall follow-up was 4.7 years (IQR ± 9). 8 patients (53%) had a traumatic injury (traumatic surgery group) and 7 patients had a planned orthopedic tumor resection (orthopedic surgery group). In 13/15 (87%) a great saphenous vein (GSV) graft and in 2/15 (13%) a Gore-Tex graft was used for bypassing. Both Gore-Tex grafts showed complete occlusion 12 and 16 years after implantation. No patient died in the early postoperative phase (< 30 days), however 3/7 (43%) in the orthopedic group died during follow-up. Revision surgery had to be performed in 1/15 (7%) patients. A functional use of the extremity was reported in all patients. Normal limb length growth according to the contralateral site, and therefore bypass growth, could be documented in 14/15 patients. Children are surgically challenging. In our study, surgery by a specialized vascular surgery team using GSV grafts led to adequate limb length and bypass growth, and we observed no functional restrictions.

scholarly journals Long term outcome of 5-Fluorouracil(5-FU) augmented bleb needling revision of failed and failing filtration blebs.

2016 ◽  
Vol 14 (4) ◽  
Author(s):  
Arijit Mitra ◽  
R. Ramakrishnan ◽  
Mohideen Abdul Kader
Keyword(s):  
Survival Analysis ◽  
Success Rate ◽  
Case Series ◽  
Time To Failure ◽  
Term Outcome ◽  
Cross Sectional ◽  
Long Term Outcome ◽  
Long Term Study

Purpose: To evaluate the long term outcome of 5-Fluorouracil (5-FU) augmented bleb needling revision of failed and failing filtration blebs based on survival analysis and to identify risk factors for failure, indicators for success and complications.Methods: This was a prospective, interventional case series with survival analysis. 32 eyes of 32 patients underwent bleb needling augmented with 5-FU and were then followed up. Statistical analysis was done to assess the association between study factors and time to failure. Main outcome measures were reduction in IOP (<21 mm of Hg), number of antiglaucoma medications (AGM’s), complications and factors associated with outcome including indicators for success. Results: At one year followup 9 (28. 13%) eyes had IOP <21 mmHg without the use of any antiglaucoma medications. 13 eyes (40. 63%) had qualified success with mean IOP <21 mm Hg after 1 or multiple needlings but with the help of one or more AGM’s (1. 2±0. 4). 10 cases (31. 25%) failed and had to undergo repeat Trabeculectomy or shunt surgery. In the cases which achieved overall success, complete and qualified together (n = 22) the baseline IOP pre needling was 26. 7±8. 2 mmHg which was reduced to 13. 6±4. 6 mmHg at the end of the minimum follow up period of 1 year. The median interval between the “index” filtration surgery and the first (or only) needling procedure was 7. 5 months (Range 3 months to 4 years). Overall reduction in mean number of topical AGM’s was from 2. 68±0. 82 to 0. 82±0. 34. Overall cross sectional success rate at 1 year follow up (complete and qualified) was 68. 76%(n=32) and the overall cross-sectional success rate (complete and qualified) at the 3 year follow up period was 66. 91%(n=24) and 65. 82%(n=16) at 5 year follow up. Strong evidence was found for association between pre needling IOP >28 mm of Hg and failure and immediate attainment of low IOP <11 mmHg and longer survival. None of the other proposed factors were identified as having statistically significant effect. Conclusions: This long term study shows that bleb needling augmented with 5-FU is a safe and effective method by which a significant number of failed or failing filtration blebs can be rescued. Attaining an immediate reduction in IOP <11 mmHg seems to be a favorable factor with respect to reasonably long-term efficacy. 

Jones lacrimal bypass tubes in children and adults

2018 ◽  
Vol 103 (9) ◽  
pp. 1248-1252 ◽  
Author(s):  
Ilse Mombaerts ◽  
Elodie Witters
Keyword(s):  
Incidence Rate ◽  
Age Groups ◽  
Self Care ◽  
Case Series ◽  
Limiting Factor ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Tube Type

Background/aimsAlthough a Jones tube is considered the mainstay for epiphora in patients with total blockage of the canalicular system, it has been discouraged in children for reasons of inadequate self-care and maintenance. The purpose of this study is to compare the long-term outcome of Jones tube surgery in paediatric versus adult patients.MethodsRetrospective, interventional case series of a single academic institution. The medical records of all children (≤16 years old) and adults (>16 years old) who underwent conjunctivorhinostomy with placement of a 130° angled extended Jones tube were reviewed. The outcome measures were patency and anatomical position of the tube, type and frequency of complications and subjective relief of epiphora.ResultsThe study included 10 children (11 eyes) (range, 5.1–16.0 years old) and 102 adults (127 eyes) (range, 19.7–82.4 years old). The success and complication rate did not differ between the two age groups. Tube dislodgement and obstruction occurred in 4 (36.4%) of the paediatric tubes with an incidence rate of 6.1%/year and in 47 (37.0%) of the adult tubes with an incidence rate of 9.3%/year (p=0.3867). Two adults required routine self-irrigation of the tube. The median follow-up was 6.7 years for the children and 8.7 years for the adults (p=0.3430).ConclusionWith a similar outcome profile and minimal self-care, young age is not a prognostic nor limiting factor for surgery with angled Jones tubes. Exchange with tubes of a longer length is not required during growth.

Klinische Langzeitergebnisse der perkutanen transluminalen Angioplastie bei Patienten mit peripherer arterieller Verschlusskrankheit

VASA ◽  
2002 ◽  
Vol 31 (1) ◽  
pp. 36-42 ◽  
Author(s):  
. Bucek ◽  
Hudak ◽  
Schnürer ◽  
Ahmadi ◽  
Wolfram ◽  
...  
Keyword(s):  
Success Rate ◽  
Clinical Stage ◽  
Ankle Brachial Index ◽  
Clinical Situation ◽  
Clinical Results ◽  
Transluminal Angioplasty ◽  
Term Outcome ◽  
Long Term Outcome

Background: We investigated the long-term clinical results of percutaneous transluminal angioplasty (PTA) in patients with peripheral arterial occlusive disease (PAOD) and the influence of different parameters on the primary success rate, the rate of complications and the long-term outcome. Patients and methods: We reviewed clinical and hemodynamic follow-up data of 166 consecutive patients treated with PTA in 1987 in our department. Results: PTA improved the clinical situation in 79.4% of patients with iliac lesions and in 88.3% of patients with femoro-popliteal lesions. The clinical stage and ankle brachial index (ABI) post-interventional could be improved significantly (each P < 0,001), the same results were observed at the end of follow-up (each P < 0,001). Major complications occurred in 11 patients (6.6%). The rate of primary clinical long-term success for suprainguinal lesions was 55% and 38% after 5 and 10 years (femoro-popliteal 44% and 33%), respectively, the corresponding data for secondary clinical long-term success were 63% and 56% (60% and 55%). Older age (P = 0,017) and lower ABI pre-interventional (P = 0,019) significantly deteriorated primary clinical long-term success for suprainguinal lesions, while no factor could be identified influencing the outcome of femoro-popliteal lesions significantly. Conclusion: Besides an acceptable success rate with a low rate of severe complications, our results demonstrate favourable long-term clinical results of PTA in patients with PAOD.

Psychopathology 8½ Years Post Parasuicide

Crisis ◽  
1999 ◽  
Vol 20 (3) ◽  
pp. 115-120 ◽  
Author(s):  
Stephen Curran ◽  
Michael Fitzgerald ◽  
Vincent T Greene
Keyword(s):  
Rating Scales ◽  
Psychiatric Morbidity ◽  
Parental Bonding ◽  
Social Maladjustment ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Face To Face ◽  
Long Term Follow Up

There are few long-term follow-up studies of parasuicides incorporating face-to-face interviews. To date no study has evaluated the prevalence of psychiatric morbidity at long-term follow-up of parasuicides using diagnostic rating scales, nor has any study examined parental bonding issues in this population. We attempted a prospective follow-up of 85 parasuicide cases an average of 8½ years later. Psychiatric morbidity, social functioning, and recollections of the parenting style of their parents were assessed using the Clinical Interview Schedule, the Social Maladjustment Scale, and the Parental Bonding Instrument, respectively. Thirty-nine persons in total were interviewed, 19 of whom were well and 20 of whom had psychiatric morbidity. Five had died during the follow-up period, 3 by suicide. Migration, refusals, and untraceability were common. Parasuicide was associated with parental overprotection during childhood. Long-term outcome is poor, especially among those who engaged in repeated parasuicides.

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