Monitoring early response of lymph node metastases to radiotherapy in animal models: diffusion-weighted imaging vs. morphological MR imaging

2011 ◽  
Vol 52 (9) ◽  
pp. 989-994 ◽  
Author(s):  
Jie Chen ◽  
Jing Sheng ◽  
Wei Xing ◽  
Hussein Aoun ◽  
Ming Chen ◽  
...  
Keyword(s):  
Lymph Node ◽  
Animal Models ◽  
Mr Imaging ◽  
Lymph Nodes ◽  
Diffusion Weighted Imaging ◽  
Invasive Technique ◽  
Diffusion Weighted ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background Diffusion-weighted imaging (DWI) offers a non-invasive technique that can reveal microscopic details about the architecture of both normal and anomalous tissues. Some studies have confirmed DWI can detect the early changes of tumors that have originated from various organs, even after treatment. Purpose To compare the usefulness of apparent diffusion coefficient (ADC) and morphologic magnetic resonance (MR) imaging for monitoring the therapeutic response of metastatic disease in lymph nodes to radiotherapy. Material and Methods Twenty-six rabbits (metastatic, n = 17; non-metastatic, n = 9) were divided into group A (metastatic, n = 10), group B (metastatic, n = 7) and group C (non-metastatic, n = 9). Groups A and C underwent irradiation, whereas group B was set as a reference. Standard MR imaging and DWI were performed before and 1, 3, and 7 days after radiotherapy for all rabbits. The lymph node volumes and ADCs were measured and evaluated with repeated measures ANOVA. The difference between group A and B was analyzed using Student's t-test. Results In all rabbits, a total of 35 lymph nodes were found, including 16 nodes in group A, 10 in group B and nine in group C. In group A, 3 and 7 days after therapy ADCs were significantly higher than pre-treatment and 1 day after therapy ( P < 0.05). For groups A and B, a significant difference of ADCs was present 7 days after therapy. A significant difference of variation of ADCs among the three groups was also present ( P < 0.001). Conclusion DWI is superior to morphological MRI in monitoring early radiation response in animal models.

scholarly journals Microsurgical unilateral laminotomy for bilateral decompression of degenerative lumbar canal stenosis: a comparative study

2019 ◽  
Vol 55 (1) ◽  
Author(s):  
Mohamed I. Refaat ◽  
Amr K. Elsamman ◽  
Adham Rabea ◽  
Mohamed I. A. Hewaidy
Keyword(s):  
Patient Satisfaction ◽  
Blood Loss ◽  
Minimally Invasive ◽  
Invasive Technique ◽  
Decompression Surgery ◽  
Microsurgical Decompression ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

Abstract Background The quest for better patient outcomes is driving to the development of minimally invasive spine surgical techniques. There are several evidences on the use of microsurgical decompression surgery for degenerative lumbar spine stenosis; however, few of these studies compared their outcomes with the traditional laminectomy technique. Objectives The aim of our study was to compare outcomes following microsurgical decompression via unilateral laminotomy for bilateral decompression (ULBD) of the spinal canal to the standard open laminectomy for cases with lumbar spinal stenosis. Subjects and methods Cases were divided in two groups. Group (A) cases were operated by conventional full laminectomy; Group (B) cases were operated by (ULBD) technique. Results from both groups were compared regarding duration of surgery, blood loss, perioperative complication, and postoperative outcome and patient satisfaction. Results There was no statistically significant difference between both groups regarding the improvement of visual pain analogue, while improvement of neurogenic claudication outcome score was significant in group (B) than group (A). Seventy-three percent of group (A) cases and 80% of group (B) stated that surgery met their expectations and were satisfied from the outcome. Conclusion Comparing ULBD with traditional laminectomy showed the efficacy of the minimally invasive technique in obtaining good surgical outcome and patient satisfaction. There was no statistically significant difference between both groups regarding the occurrence of complications The ULBD technique was found to respect the posterior spinal integrity and musculature, accompanied with less blood loss, shorter hospital stays, and shorter recovery periods than the open laminectomy technique.

CLO19-049: Central Lymph Node Dissection in the Clinically Node-Negative (cN0) Papillary Thyroid Carcinoma: Is it Necessary?

2019 ◽  
Vol 17 (3.5) ◽  
pp. CLO19-049
Author(s):  
Girish M. Suresh ◽  
C. Ramachandra ◽  
Ravi Arjunan ◽  
Rajshekar Halkud
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Postoperative Complication ◽  
Central Compartment ◽  
Central Neck ◽  
Papillary Thyroid ◽  
Node Dissection ◽  
Group A ◽  
Group B

Background: Surgery is the treatment of choice in papillary thyroid cancer (PTC), which is the most common thyroid malignancy and frequently has metastases in the central compartment lymph nodes (CLN). There is debate among surgeons whether removing normal-appearing lymph nodes in the central neck (prophylactic lymph node dissection) is better than removing only the abnormal-appearing lymph nodes. Herein, we review the potential utility of central compartment lymph nodal dissection (CLND) on surgical outcome and disease-free follow-up of PTC and 5-year survival of patients operated on at our center. Methods: A total of 246 patients from February 2009 to March 2012 who were treated for PTC in our Kidwai Cancer Institution was analyzed retrospectively. 135 patients who underwent total thyroidectomy and CLND were assigned to Group A, which was compared with 111 patients who received total thyroidectomy, without CLND, who were assigned to Group B by evaluation of postoperative complications (recurrent laryngeal nerve damage, hoarseness, hypocalcemia, and hemorrhage rates) and recurrence at the time of Iodine131 treatment and subsequently at 60 months follow-up. Results: In the present study, Mean DFS and OS did not differ in both groups. Male gender and age more than 45 years had statistically significant DFS but without any impact on OS. There was a significant postoperative complication in group A compared to group B (P≤.001), with a very minimal recurrence in the central neck. 4 patients (3.6%) had recurrences in CLN. Conclusion: Considering the significant postoperative complication, which outweighs benefit, we conclude that for cN0 PTC, routine CLND is not necessary.

scholarly journals Relevance of Regional Lymph Node Invasion in Radical Hepatectomy and Lymphadenectomy for Alveolar Echinococcosis: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Xianwei Yang ◽  
Tao Wang ◽  
Shu Shen ◽  
Wentao Wang
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Alveolar Echinococcosis ◽  
Regional Lymph Node ◽  
Regional Lymph Nodes ◽  
Node Number ◽  
Lymph Node Enlargement ◽  
Group A ◽  
Group B ◽  
Node Diameter

Abstract Background Hepatic Alveolar echinococcosis (AE) is also known as worm cancer, parasitic cancer, and it often invades the regional lymph nodes of the liver. The present study was to investigate the clinical value of radical hepatectomy and lymphadenectomy in AE patients. Methods Our study enrolled consecutive AE patients who underwent radical hepatectomy with removal the regional lymph nodes between January 2009 and April 2019. Patients with inflammatory lymph node enlargement was included in group A, and patients with AE lymph node invasion were included in group B. The clinical characteristics, survival and recurrence rates were compared.Results A total of 103 patients were enrolled group A, and 24 in group B. Preoperative computed tomography showed that the lymph node positivity rate in group B was 70.8% while that in group A was 43.7% (p=0.017). The lymph node diameter was 1.8±0.9 cm in group A vs 2.5±1.1 cm in group B (p=0.004), and the lymph node number (p=0.035) and lymph node location (p=0.001). A total of 10 patients (7.9%) had recurrent lesions, and 6 patients (4.7%) died (P>0.05). Conclusions lymph node diameter, number, and distance from the liver were important characteristics for describing lymph node invasion. There was no difference in the long-term efficacy of lymphadenectomy between patients with lymph node enlargement and those with invasion.

Robotic cystectomy histopathology outcomes in patients who have ‘failed’ Bacillus Calmette–Guérin: A case series

2021 ◽  
pp. 205141582097799
Author(s):  
Edward JM Hart ◽  
Liam E Kavanagh ◽  
Alexandra M Guy ◽  
Bronagh Lindsey ◽  
Jo Walters ◽  
...  
Keyword(s):  
Lymph Node ◽  
Case Series ◽  
Invasive Disease ◽  
Bacillus Calmette Guerin ◽  
Level Of Evidence ◽  
Number Of Patients ◽  
Significant Difference ◽  
Group A ◽  
Muscle Invasive ◽  
Group B

Objective: Robot-assisted radical cystectomy (RARC) is considered the gold-standard for patients who fail Bacillus Calmette–Guérin (BCG) treatment for high-grade non-muscle-invasive bladder cancer. We reviewed our histopathological outcomes to assess whether we are proceeding to cystectomy at an appropriate time. Methods: A retrospective analysis of the RARC database (2015–2020) was performed to identify patients who received intravesical BCG before cystectomy. Data regarding demographics, number of BCG instillations and staging were collected. Histopathological stage at cystectomy was compared between patients who received an induction course of BCG only (group A), and those who had continued maintenance doses (group B). Results: A total of 73 patients (57 males and 16 females) met the final inclusion criteria, with 24 patients in group A and 49 patients in group B. At cystectomy, 19 patients had ⩾T2 disease (group A: 7; group B: 12). There was no significant difference between groups ( p=0.78). Pelvic lymph node dissection was performed in 68 patients, with six patients found to have lymph node metastases. Conclusion: RARC plays a key role in managing BCG failure, considering the number of patients with muscle-invasive disease at final staging. However, prolonged BCG treatment was not associated with more advanced disease in our case series. Thus, persistence with intravesical treatment warrants consideration for selected patients. Level of evidence: Level 4.

scholarly journals Sonographic Evaluation of Medial Iliac Lymph Nodes-to-Aorta Ratio in Dogs

2020 ◽  
Vol 7 (1) ◽  
pp. 22
Author(s):  
Simonetta Citi ◽  
Martina Oranges ◽  
Elena Arrighi ◽  
Valentina Meucci ◽  
Daniele Della Santa ◽  
...  
Keyword(s):  
Statistical Analysis ◽  
Lymph Nodes ◽  
Reference Values ◽  
Reference Range ◽  
Ultrasound Examination ◽  
Sonographic Evaluation ◽  
Significant Difference ◽  
Group A ◽  
Healthy Dogs ◽  
Group B

Medial iliac lymph nodes drain many districts and are easy to identify during an ultrasound examination of the abdomen. Since there are no reference values for their size in healthy dogs, the aim of this work was to evaluate the size of the medial iliac lymph nodes by using a ratio with the aortic diameter and find a reference range. The population was divided into group A (healthy dogs) and group B, with diseases of the medial iliac lymph nodes. The ratio of length, height and thickness of the medial iliac lymph nodes with the diameter of the aorta were calculated and underwent statistical analysis, p < 0.05 was considered statistically significant. Sixty-three patients were enrolled in group A, and 37 in group B. Significant differences were found between the ratio of sick and healthy patients and neoplastic and healthy patients. No significant difference was found between healthy and inflammatory patients. The best cut-off value to discriminate sick and healthy patients was 0.57, with a sensitivity of 78% and a specificity of 71%. The cut-off value of neoplastic and healthy patients was 0.69, with a sensitivity of 89.47% and a specificity of 84.13%. This value is highly predictive of neoplasia.

Clinical significance of the redundant nerve roots of the cauda equina documented on magnetic resonance imaging

2007 ◽  
Vol 7 (1) ◽  
pp. 27-32 ◽  
Author(s):  
Atsushi Ono ◽  
Futoshi Suetsuna ◽  
Tomoyuki Irie ◽  
Toru Yokoyama ◽  
Takuya Numasawa ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Mr Imaging ◽  
Clinical Symptoms ◽  
Japanese Orthopaedic Association ◽  
Cauda Equina ◽  
Nerve Roots ◽  
Ambulatory Ability ◽  
Significant Difference ◽  
Group A ◽  
Group B

Object Previous reports of redundant nerve roots (RNRs) of the cauda equina have been limited to evaluations based on myelography. Neither the imaging nor the clinical features of RNRs in relation to magnetic resonance (MR) imaging have been elaborated. The MR imaging characteristics of RNRs were evaluated using the Japanese Orthopaedic Association score before and after the surgery. Methods There were 44 patients with L4–5 spondylolisthesis in which a complete blockage was demonstrated on myelography. All patients underwent posterior L4–5 interbody fusion. Based the myelographic and MR imaging findings, the patients were stratified into the following three groups: RNRs recognized on both myelographic and MR imaging (Group A); RNRs recognized on myelography but not very evident on MR imaging (Group B); and RNRs not recognized on either myelographic or MR imaging (Group C). Among these three groups, pre- and postoperative clinical symptoms were compared. Results There were 16 patients in Group A, 14 in Group B, and 14 in Group C. In terms of preoperative clinical symptoms, there was a significant difference between Groups A and C in the incidence of leg pain and tingling sensation. Significant differences were also noted between Groups A and C and between Groups B and C in ambulatory ability. Evaluation of postoperative clinical symptoms showed a significant difference between Groups A and C in ambulatory ability. Conclusions Patients with MR imaging evidence of RNRs presented with more severe clinical symptoms. It is believed that the RNR features derived from MR images represent important findings.

Mapping the Sentinel Lymph Node in Malignant Melanoma by Blue Dye, Lymphoscintigraphy and Intraoperative Gamma Probe

2000 ◽  
Vol 86 (4) ◽  
pp. 343-345 ◽  
Author(s):  
Giuseppe Villa ◽  
Giuseppe Agnese ◽  
Pietro Bianchi ◽  
Ferdinando Buffoni ◽  
Rosario Costa ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Lymphatic Mapping ◽  
Gamma Probe ◽  
Primary Melanoma ◽  
Blue Dye ◽  
Radioisotope Method ◽  
Patent Blue ◽  
Group A ◽  
Group B

Eighty-eight consecutive patients (48 men and 40 women; mean age, 58.9 years; range, 16–84 years) with clinically localized cutaneous melanoma involving the trunk, extremities or head and neck underwent lymphatic mapping at our institution. The primary melanoma had a mean thickness of 2.74 mm (range, 0.95 to 9 mm). Patients were divided into two groups: group A (39 patients) underwent only vital blue dye (VBD) mapping, while group B (49 patients) underwent lymphatic mapping with VBD and radio-guided surgery (RGS) combined. In all patients 1-1.5 mL of VBD was injected subdermally around the biopsy scar 10–20 min before surgery. In group B 37 MBq in 150 μL of 99mTc-HSA nanocolloid was additionally injected intradermally 18 h before surgery (3–6 aliquots injected perilesionally). In all lymphatic basins where drainage was noted the sentinel lymph nodes (SNs) were identified and marked with a cutaneous marker. Final identification of the SN was then performed externally by a hand-held gamma probe. After the induction of anesthesia 0.5–1-0 mL of patent blue V dye was injected intradermally with a 25-gauge needle around the site of the primary melanoma. SNs were examined by routine hematoxylin and eosin (H&E) staining and immunohistochemistry. Patients with histologically positive SN(s) underwent standard lymph node dissection (SLND) in the involved lymph node basin. The SN was identified in 37/39 patients (94.9%) of group A and in 48/49 patients (98.0%) of group B. Blue dye mapping failed to identify the SN in 5 of the 88 patients (5.8%), while the radioisotope method failed in only 1 of 49 patients (2.0%). Similar results were obtained with the combined use of the two probes. The average number of SNs harvested was 1.9 per basin sampled, which does not differ significantly from the numbers reported by other authors114. The SN was histologically positive in 18 patients (20.5%). None of the 12 patients with a Breslow thickness less than 1.5 mm had positive SNs, whereas 18 of the 77 patients (23.4%) with a Breslow index exceeding 1.5 mm showed metastatic SNs with H&E or immunohistochemistry. The latter all underwent SLND of the affected basin. In 10 patients (55.6%) the SN was the only site of tumor invasion; eight patients (44.4%) with positive SNs had one or more metastatic lymph nodes in the draining basin.

DeVega versus ring annuloplasty in severe functional tricuspid insufficiency and their impact on the right ventricle

2019 ◽  
Vol 1 (4) ◽  
pp. 133-139
Author(s):  
Yasser Hamdy ◽  
Mohammed Mahmoud Mostafa ◽  
Ahmed Elminshawy
Keyword(s):  
Right Ventricular ◽  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Early Postoperative Period ◽  
Tricuspid Valve Repair ◽  
Ring Annuloplasty ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
The Right

Background: Functional tricuspid valve regurgitation secondary to left-sided valve disease is common. DeVega repair is simple, but residual regurgitation with subsequent impairment of the right ventricular function is a concern. This study aims to compare tricuspid valve repair using DeVega vs. ring annuloplasty and their impact on the right ventricle in the early postoperative period and after six months. Methods: This is a prospective cohort study of 51 patients with rheumatic heart disease who underwent tricuspid valve repair for secondary severe tricuspid regurgitation. Patients were divided into two groups: group A; DeVega repair (n=34) and group B; ring annuloplasty repair (n=17). Patients were assessed clinically and by echocardiography before discharge and after six months for the degree of tricuspid regurgitation, right ventricular diameter and tricuspid annular plane systolic excursion (TAPSE). Results: Preoperative echocardiographic assessment showed no difference in left ventricular end-systolic diameter, end-diastolic diameter, ejection fraction and right ventricular diameter, however; group A had significantly better preoperative right ventricular function measured by TAPSE (1.96 ± 0.27 vs1.75 ± 0.31 cm; p=0.02). Group B had significantly longer cardiopulmonary bypass time (127.65 ± 13.56 vs. 111.74 ± 18.74 minutes; p= 0.003) and ischemic time (99.06 ± 11.80 vs. 87.15 ± 16.01 minutes; p= 0.009). Pre-discharge, there was no statistically significant difference in the degree of tricuspid regurgitation, but the right ventricular diameter was significantly lower in group B (2.66 ± 0.41 and 2.40 ± 0.48 cm; p=0.049). After six months of follow up, the degree of tricuspid regurgitation (p= 0.029) and the right ventricular diameter were significantly lower in the ring annuloplasty group (2.56 ± 0.39 and 2.29 ± 0.44 cm; p=0.029). Although there was a statistically significant difference in preoperative TAPSE, this difference disappeared after six months. Conclusion: Both DeVega and ring annuloplasty techniques were effective in the early postoperative period, ring annuloplasty was associated with lesser residual regurgitation and better right ventricular remodeling in severe functional tricuspid regurgitation than DeVega procedure after 6-months of follow up.

Effect of short-term use of oral contraceptive pills on intraocular pressure

2020 ◽  
Vol 35 (3) ◽  
Author(s):  
Tayyaba Gul Malik ◽  
Hina Nadeem ◽  
Eiman Ayesha ◽  
Rabail Alam
Keyword(s):  
Oral Contraceptive ◽  
Childbearing Age ◽  
Short Term ◽  
Oral Contraceptive Pills ◽  
Contraceptive Pills ◽  
Time Period ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Short Time

Objective: To study the effect of short-term use of oral contraceptive pills on intra-ocular pressures of women of childbearing age.   Methods: It was a comparative observational study, conducted at Arif memorial teaching hospital and Allied hospital Faisalabad for a period of six months. Hundred female subjects were divided into two groups of 50 each. Group A, included females, who had been taking oral contraceptive pills (OCP) for more than 6 months and less than 36 months. Group B, included 50 age-matched controls, who had never used OCP. Ophthalmic and systemic history was taken. Careful Slit lamp examination was performed and intraocular pressures (IOP) were measured using Goldman Applanation tonometer. Fundus examination was done to rule out any posterior segment disease. After collection of data, we analyzed and compared the intra ocular pressures between the two groups by using ANOVA in SPSS version 21.   Results: Average duration of using OCP was 14.9 months. There was no significant difference of Cup to Disc ratios between the two groups (p= 0.109). However, significant difference was noted between the IOP of OCP group and controls. (p=0.000). Conclusion: OCP significantly increase IOP even when used for short time period.

Comparative Clinical study of Jatyadi Taila and Jatyadi Ghrita in the management of Dushta Vrana

2018 ◽  
Vol 3 (3) ◽  
Author(s):  
Rajendra Joshi ◽  
N. B. Mashetti ◽  
Rakesh Kumar Gujar
Keyword(s):  
Clinical Study ◽  
Burning Sensation ◽  
Normal Process ◽  
Surgical Practice ◽  
Local Factors ◽  
Significant Difference ◽  
Comparative Clinical Study ◽  
Group A ◽  
Contaminated Wound ◽  
Group B

Dushta Vrana is a common and frequently encountered problem faced in surgical practice. The presence of Dushta Vrana worsens the condition of the patient with different complications and may become fatal. Local factors on wound like slough, infection and foreign body, affect the normal process of healing. A healthy wound in a normal body heals earlier with a minimum scar as compared to a contaminated wound. Therefore in this study all the efforts are made to make a Dushta Vrana into a Shuddha Vrana. Once the Vrana becomes Shuddha, Ropana of the Vrana will start. The objective of the study was to evaluate the clinical efficacy of Jatyadi Taila and Jatyadi Ghrita in Dushta Vrana. Clinically diagnosed 60 Patients of Dushta Vrana were randomly divided into two groups, each consisting of 30 Patients. Group A were treated with the Jatyadi Taila and Group B was treated by Jatyadi Ghrita. The results observed was based on the relief obtained on the subjective and objective parameters taken for consideration for this study viz, size of ulcer, discharge, smell, pain, burning sensation, itching and granulation were found significant (P Lass Than 0.05). On the basis of assessment criteria and overall result of treatment, the patients of Jatyadi Taila group showed better results when compared to Jatyadi Ghrita group. Even though statistically there is no much significant difference between the two groups, but by seeing the effect on individual parameters (subjective and objective) and over all response, Jatyadi Taila seems to be effective when compared to Jatyadi Ghrita. It is having more Ropana qualities when compared to Shodhana.

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