Removal of retained intracavernous needle tip using intraoperative fluoroscopy

Intracavernous injections of vasoactive drugs, such as alprostadil, are widely used as an effective treatment method for erectile dysfunction. Intracavernous breakage of the needle is a very rare complication of self-injections, with only a few case reports available in the current literature. Treatment methods described vary in the literature, ranging from immediate surgical exploration under ultrasound guidance to non-operative management with delayed needle removal once it is easily palpable. We report a case of an 82-year-old man with a retained intracavernous 1 cm 30 gauge needle tip after injection of alprostadil (Caverject; marketing authorisation number PL 00057/0942) and the innovative use of intraoperative X-ray imaging (fluoroscopy) for removal of this. Level of evidence: level 5 (case report/technique)

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The non-operative management of bony mallet injuries

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193421992986 ◽

2021 ◽

pp. 175319342199298

Author(s):

Ryan W. Trickett ◽

James Brock ◽

David J. Shewring

Keyword(s):

Fragment Size ◽

Visual Analogue Score ◽

Operative Management ◽

Clinical Results ◽

Range Of Movement ◽

Level Of Evidence ◽

Custom Made ◽

Evaluation Measure ◽

Non Operative Management ◽

Extensor Lag

Over a 4-year period, 218 mallet fractures in 211 adult patients were treated using a custom-made thermoplastic splint. Clinical results were collected prospectively, including the visual analogue score for pain, the range of motion and extensor lag, and the Patient Evaluation Measure (PEM). The joints were congruent in 168 and subluxed in 50. There were no differences in range of movement, extensor lag or PEM associated with articular subluxation or the size of the articular fragment. Pre-existing joint degeneration did not influence outcome. Non-surgical treatment demonstrates predictably good outcomes regardless of fragment size or subluxation in most patients and should be considered when discussing treatment for patients with bony mallet fractures. Level of evidence: III

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Failure Risk Factor For Non-Operative Treatment of Splenic Trauma

10.21203/rs.3.rs-39924/v1 ◽

2020 ◽

Author(s):

Alexandre Maubert ◽

Jonathan Douissard ◽

Pierre-Alain Tokoto ◽

Damien Massalou

Keyword(s):

Statistical Significance ◽

Operative Management ◽

University Hospital ◽

Splenic Trauma ◽

Level Of Evidence ◽

Failure Group ◽

The Hours ◽

Successful Group ◽

Grade 3 ◽

Non Operative Management

Abstract Background: Splenic trauma is a common pattern for admission in blunt abdominal trauma. The objective of this study is to identify risk factors for failure of non-operative management (NOM) in splenic trauma.Methods: This is a retrospective monocentric analysis of a prospectively collected database. All patients admitted in the university hospital of Nice [Centre Hospitalier Universitaire (CHU) de Nice, France] for a splenic trauma from January 1st 2006 to January 6th 2018 were included. Primary outcome was the need for delayed splenectomy as an indicator of NOM failure.Results: Two-hundred-eighty patients were included in this study. Most splenic lesions were severe grades (grade 3 or higher). In total, 83 splenectomies were performed urgently, i.e. 29% of patients; 88 angio-embolizations, i.e., 31% of patients with a success rate greater than 80%; 14.7% of 136 patients who had no previous angio-embolization required secondary splenectomy; 19.7% of the 61 patients who had anterior angio-embolization required secondary splenectomy. Age was not found associated with a higher failure rate (44 years in successful embolization vs 37.5 years in NOM-failure group, p = 0.15). Higher drop in hemoglobin levels between admission and 6 hours after admission was detected in the embolization failure group (-1.44 g/dl) as compared with the successful group (-0.68 g/dl), which approached statistical significance (p = 0.064).Conclusions: Hemoglobin monitoring in the hours following the admission of a patient with splenic trauma might be an important factor during the medical supervision of hemodynamically stable patients. Early identification of patients at high risk of NOM failure by hemoglobin monitoring may prevent late splenectomy.Level of evidence: IV (retrospective study)

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A RARE COMPLICATION POTT’S PUFFY TUMOR TREATED WITH FRONTOETHMOIDECTOMY: A CASE REPORT

Journal of University Medical & Dental College ◽

10.37723/jumdc.v12i3.614 ◽

2021 ◽

Vol 12 (3) ◽

Author(s):

Muhammad Hamza Rana ◽

Muhammad Saleem

Keyword(s):

Rare Complication ◽

Signs And Symptoms ◽

Surgical Excision ◽

Frontal Bone ◽

Frontal Sinusitis ◽

X Ray ◽

Subperiosteal Abscess ◽

X Ray Imaging ◽

Pott’S Puffy Tumor ◽

Gold Standards

Untreated or undiagnosed frontal sinusitis develops as a subperiosteal abscess in the frontal bone named Pott’s puffy tumor (PPT). Pott’s puffy tumor is a rare complication that needs surgical excision. In this communication, we report a 50-year-old woman presenting with typical signs and symptoms of PPT. CT-Scan and X-ray imaging are the gold standards to measure the extent of tumor and involvement of structures, if any.

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Gas in the Inferior Mesenteric Vein – successful non operative management of a rare complication of diverticulitis

International Journal of Case Reports ◽

10.28933/ijcr-2021-07-1005 ◽

2021 ◽

pp. 232

Author(s):

Keyword(s):

Case Report ◽

Surgical Management ◽

Rare Complication ◽

Operative Management ◽

Inferior Mesenteric Vein ◽

Mesenteric Vein ◽

Important Complication ◽

Non Operative Management

Septic phlebitis (also known as pyelephlebitis) because of diverticulitis is a rare but important complication. Many previous cases have mandated urgent surgical management for fear of further deterioration. This case report details one of the first cases where septic phlebitis was successfully managed conservatively, and details important clinical lessons clinicians should be aware of.

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Defects of Platelet Function Recognized by X-Ray Imaging and Scanning Electron Microscopy

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100119806 ◽

1985 ◽

Vol 43 ◽

pp. 610-613

Author(s):

M.G. Baldini ◽

S. Morinaga ◽

D. Minasian ◽

R. Feder ◽

D. Sayre ◽

...

Keyword(s):

Electron Microscopy ◽

Scanning Electron Microscopy ◽

Cell Biology ◽

Imaging Technique ◽

Human Platelets ◽

X Rays ◽

X Ray ◽

X Ray Imaging ◽

Complex Phenomena ◽

Scanning Electron

Contact X-ray imaging is presently developing as an important imaging technique in cell biology. Our recent studies on human platelets have demonstrated that the cytoskeleton of these cells contains photondense structures which can preferentially be imaged by soft X-ray imaging. Our present research has dealt with platelet activation, i.e., the complex phenomena which precede platelet appregation and are associated with profound changes in platelet cytoskeleton. Human platelets suspended in plasma were used. Whole cell mounts were fixed and dehydrated, then exposed to a stationary source of soft X-rays as previously described. Developed replicas and respective grids were studied by scanning electron microscopy (SEM).

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Designing high-resolution slow scan CCD-based TEM camera systems

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s042482010012936x ◽

1992 ◽

Vol 50 (2) ◽

pp. 946-947

Author(s):

James F. Mancuso ◽

William B. Maxwell ◽

Russell E. Camp ◽

Mark H. Ellisman

Keyword(s):

Fiber Optics ◽

Ccd Camera ◽

High Energy ◽

Phosphor Layer ◽

X Ray ◽

Light Production ◽

Camera Systems ◽

X Ray Imaging ◽

Electron Image ◽

Scintillating Fiber

The imaging requirements for 1000 line CCD camera systems include resolution, sensitivity, and field of view. In electronic camera systems these characteristics are determined primarily by the performance of the electro-optic interface. This component converts the electron image into a light image which is ultimately received by a camera sensor.Light production in the interface occurs when high energy electrons strike a phosphor or scintillator. Resolution is limited by electron scattering and absorption. For a constant resolution, more energy deposition occurs in denser phosphors (Figure 1). In this respect, high density x-ray phosphors such as Gd2O2S are better than ZnS based cathode ray tube phosphors. Scintillating fiber optics can be used instead of a discrete phosphor layer. The resolution of scintillating fiber optics that are used in x-ray imaging exceed 20 1p/mm and can be made very large. An example of a digital TEM image using a scintillating fiber optic plate is shown in Figure 2.

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Ionic homeostasis and subcellular element compartmentation

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s042482010013434x ◽

1990 ◽

Vol 48 (2) ◽

pp. 150-151

Author(s):

Ann LeFurgey ◽

Peter Ingram ◽

J.J. Blum ◽

M.C. Carney ◽

L.A. Hawkey ◽

...

Keyword(s):

Leishmania Major ◽

Ionic Homeostasis ◽

X Ray ◽

Functional Studies ◽

Cell Compartments ◽

X Ray Imaging ◽

Resolution Electron ◽

Multiple Cell ◽

Role Of Zn

Subcellular compartments commonly identified and analyzed by high resolution electron probe x-ray microanalysis (EPXMA) include mitochondria, cytoplasm and endoplasmic or sarcoplasmic reticulum. These organelles and cell regions are of primary importance in regulation of cell ionic homeostasis. Correlative structural-functional studies, based on the static probe method of EPXMA combined with biochemical and electrophysiological techniques, have focused on the role of these organelles, for example, in maintaining cell calcium homeostasis or in control of excitation-contraction coupling. New methods of real time quantitative x-ray imaging permit simultaneous examination of multiple cell compartments, especially those areas for which both membrane transport properties and element content are less well defined, e.g. nuclei including euchromatin and heterochromatin, lysosomes, mucous granules, storage vacuoles, microvilli. Investigations currently in progress have examined the role of Zn-containing polyphosphate vacuoles in the metabolism of Leishmania major, the distribution of Na, K, S and other elements during anoxia in kidney cell nuclel and lysosomes; the content and distribution of S and Ca in mucous granules of cystic fibrosis (CF) nasal epithelia; the uptake of cationic probes by mltochondria in cultured heart ceils; and the junctional sarcoplasmic retlculum (JSR) in frog skeletal muscle.

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