scholarly journals Long-term Clinical Course of Benign Fibro-osseous Lesions in the Paranasal Sinuses

2020 ◽  
Author(s):  
Jung Joo Lee ◽  
Gwanghui Ryu ◽  
Kyung Eun Lee ◽  
Sang Duk Hong ◽  
Yong Gi Jung ◽  
...  
Keyword(s):  
Paranasal Sinuses ◽  
Clinical Course ◽  
Demographic Data ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital ◽  
Image Study ◽  
The Mean ◽  
Clinical Conditions ◽  
Radiologic Features

Objectives. Fibro-osseous lesions of the paranasal sinuses can present various clinical conditions. This study aimed to report the long-term clinical course of benign fibro-osseous lesions (BFOLs) in the paranasal sinuses, including clinical and radiologic features. Methods. Radiologically confirmed BFOLs except osteoma cases were reviewed retrospectively between 1994 and 2016. We compared demographic data between the surgery and observation groups. Reason for image study, radiographic features, histopathology, and clinical course with serial image scans were analyzed.Results. A total of 183 subjects were selected from a thorough review of head and neck radiologic tests (n= 606,068) in a tertiary referral hospital over 22 years. The mean age was 28.6

Hemangiopericytoma of the Nasal Cavity: A Review of 15 Cases over a 40-Year Period

1992 ◽  
Vol 6 (6) ◽  
pp. 203-209 ◽  
Author(s):  
Kenneth V. Hughes ◽  
Michael C. Bard ◽  
Jean E. Lewis ◽  
Jan L. Kasperbauer ◽  
George W. Facer
Keyword(s):  
Local Recurrence ◽  
Nasal Cavity ◽  
Paranasal Sinuses ◽  
Clinical Course ◽  
Recurrence Rates ◽  
Long Term Follow Up ◽  
Vascular Origin ◽  
The Mean

Hemangiopericytomas are rare tumors of vascular origin most commonly found in the extremities or retroperitoneal area. When they originate from the nasal cavity and paranasal sinuses, they tend to be less aggressive and generally do not metastasize. The term “hemangiopericytoma-like lesion” has been coined for sinonasal hemangiopericytomas that display more benign histologic and growth characteristics than do those located elsewhere. Fifteen cases of hemangiopericytoma of the nasal cavity and paranasal sinuses were reviewed over the period 1951 to 1990; included are follow-up data on cases reported earlier from this institution. The clinical course, management, and outcome was evaluated and correlated with the histologic characteristics of the tumors. The recurrence rate in our series was 13.3%; the mean follow-up was 11 years. No patients died of their disease or had evidence of metastatic disease. This clinicopathologic review suggests that sinonasal hemangiopericytomas should not be classified as “hemangiopericytoma-like” lesions; rather, they should be expected to have significant local recurrence rates with low rates of distant metastasis and mortality. Long-term follow-up is essential as there can be local recurrence after many years.

Obliteration of the choroid plexus after endoscopic coagulation

2014 ◽  
Vol 14 (3) ◽  
pp. 230-233 ◽  
Author(s):  
Hideki Ogiwara ◽  
Kodai Uematsu ◽  
Nobuhito Morota
Keyword(s):  
Choroid Plexus ◽  
Demographic Data ◽  
Aqueductal Stenosis ◽  
Third Ventriculostomy ◽  
Infantile Hydrocephalus ◽  
Foramen Of Monro ◽  
Initial Surgery ◽  
Endoscopic Observation ◽  
The Mean

Object Endoscopic choroid plexus coagulation (CPC) with or without endoscopic third ventriculostomy (ETV) has been shown to be effective for selected patients with hydrocephalus. However, whether the effect of the coagulation is temporary and the choroid plexus regenerates or can be obliterated has remained largely unknown. The authors evaluate the effectiveness of CPC and report 3 cases of obliteration demonstrated by direct endoscopic observation. Methods The authors retrospectively analyzed the surgical results of patients with hydrocephalus primarily treated by CPC with or without ETV. Charts were reviewed for demographic data, clinical presentations, surgical therapies, and clinical outcomes. Results Eighteen patients with hydrocephalus were surgically treated using endoscopic CPC between July 2002 and July 2012. In 12 patients, ETV was concurrently performed. The etiology of hydrocephalus was posthemorrhagic in 5 patients, myelomeningocele in 3, postmeningitis in 2, congenital aqueductal stenosis in 1, hydranencephaly in 1, porencephaly in 1, and idiopathic in 5. The mean age at surgery was 8 months (range 0.3–24 months). The mean follow-up was 64 months. In 9 cases (50%), control of hydrocephalus was successful and the patients did not require further surgeries. In 9 patients (50%), treatment failed. Of these, 3 patients underwent repeat ETV 2, 3, and 38 months after the initial surgery. Endoscopic observation of the previous coagulation site revealed no regeneration of the choroid plexus in 2 patients, who underwent repeat ETV 2 and 3 months after CPC. In 1 patient who underwent repeat ETV 38 months after CPC, no regeneration of the choroid plexus, except for that in the proximity of the foramen of Monro, was observed. Conclusions Endoscopic CPC with or without ETV can be a safe and effective treatment alternative to shunt placement in infantile hydrocephalus. Obliteration of the choroid plexus can persist in the relatively long term following CPC, which may contribute to the long-term control of hydrocephalus in successful cases.

Earthquake Related Injuries: Assessment of 854 Victims of the 2003 Bam Disaster Transported to Tertiary Referral Hospitals

2008 ◽  
Vol 23 (6) ◽  
pp. 510-515 ◽  
Author(s):  
Hassan Ali Mohebbi ◽  
Shaban Mehrvarz ◽  
Masoud Saghafinia ◽  
Yadollah Rezaei ◽  
Seyed Mohsen Towliat Kashani ◽  
...  
Keyword(s):  
Medical Care ◽  
Injury Severity ◽  
Demographic Data ◽  
Mean Value ◽  
Outcome Data ◽  
Tertiary Referral ◽  
Disaster Victims ◽  
Richter Scale ◽  
Referral Hospitals ◽  
The Mean

AbstractBackground:In December 2003, the residents of Bam, Iran experienced an earthquake that measured 6.6 on the Richter scale and destroyed >90% of the city. After the assessment and initial treatment of injuries at national and international field hospitals, a considerable number of victims (approximately 12,000) were transferred to tertiary referral hospitals around the country. Objective: This report evaluated the injuries of 854 victims transferred to 12 referral hospitals in Tehran.Methods:The demographic data, injury patterns, injury severity score (ISS), diagnosis, treatment, and outcome data of 854 Bam earthquake victims were assessed.Results:There were 467 (54.7%) males and 387 (45.3%) females. The mean age of the patients was 29.0 years. Transportation by aircraft was the most common method used for evacuation, which was used to evacuate 555 patients (65%). Fifty-four percent of the victims required initial medical aid at field hospitals before transportation to Tehran. There were 1,322 patients with injuries, of which, fractures of the lower extremities were the most common (331; 25%). Limb fixation was the most commonly performed primary procedure in emergency wards (389 cases, 39.9%). The mean value ±SD for ISS was 6.7 ±5.2. Orthopedic operations were the most frequent surgical procedures performed (195/260 operations, 75%) and the overall mortality rate was 1.6% (n = 14).Conclusions:Along with the crucial importance of aid provided by national and international field hospitals in disasters, suitable triage of casualties and preparedness of tertiary referral centers in unaffected regions also play an important role in providing medical care to disaster victims. During these situations, the number of victims cannot be predicted accurately, and sufficient medical care, particularly for orthopedic problems, can be provided by referral centers.

Septal Perforation Repairing with Combination of Mucosal Flaps and Auricular Interpositional Grafts in Revision Patients

2011 ◽  
Vol 145 (5) ◽  
pp. 828-832 ◽  
Author(s):  
Umit Taskin ◽  
Ozgur Yigit ◽  
Sezim A. Sisman
Keyword(s):  
Chart Review ◽  
Case Series ◽  
Auricular Cartilage ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital ◽  
Nasal Floor ◽  
The Mean ◽  
Good Exposure ◽  
Septal Perforations

Objectives. To examine the closure of nasal septal perforations with bilateral nasal floor flaps combined with auricular cartilage grafts and a normally functioning nose in revision patients. Study Design. Case series with chart review. Setting. A tertiary referral hospital in Turkey. Subjects and Methods. Seventeen patients (11 men, 6 women) with nasal septal reperforation were treated surgically using combined bilateral nasal floor mucosal flaps with bilateral auricular cartilage interpositional grafts. Results. The mean follow-up was 15.2 (range, 9-28) months. The average anteroposterior diameter of perforation was 28 ± 3 (range, 20-38) mm, and the average vertical diameter was 23 ± 8 (range, 20-27) mm at the widest site. The nasal septal perforations were closed completely in 16 cases; in 1 case, the perforation was not repaired completely. Conclusions. A successful multilayer closure technique with good exposure was applied in patients with reperforation.

Retethering of transected fatty filum terminales

2011 ◽  
Vol 7 (1) ◽  
pp. 42-46 ◽  
Author(s):  
Hideki Ogiwara ◽  
Arleta Lyszczarz ◽  
Tord D. Alden ◽  
Robin M. Bowman ◽  
David G. McLone ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Simple Procedure ◽  
Demographic Data ◽  
Rare Condition ◽  
Bladder Capacity ◽  
Leg Pain ◽  
Filum Terminale ◽  
The Mean

Object Untethering of a tethered spinal cord (TSC) by transecting or removing a fatty filum terminale is a relatively simple procedure that can prevent or ameliorate neurological symptoms, and the postoperative prognosis is usually good. Progressive neurological deterioration caused by recurrent tethering has been rarely reported. The authors present their experience in cases in which a sectioned fatty filum terminale has become retethered. Methods The authors retrospectively analyzed the surgical results of pediatric patients with fatty filum terminale–TSC treated by transection of the filum. The patients' charts were reviewed for demographic data, clinical presentation, surgical therapy, and follow-up data. Results Of the 225 children who underwent TSC release by sectioning the fatty filum from 1992 to 2005, there were 6 patients (2.7%; 3 males, 3 females) in whom the fatty filum retethered. The mean age at the first diagnosis of TSC was 5.2 years (range 2 months–12.3 years). The mean duration from the first untethering procedure to retethering was 5.4 years. The mean age at the time of retethering was 10.6 years (range 7–17.5 years). Symptoms of retethering were urinary incontinence, low-back pain, difficulty walking, constipation, leg pain, and worsening foot deformity. Patients underwent cystometrography at the time retethering was indicated by increased bladder capacity, large post-void residual volume, decreased bladder capacity, increase in filling pressure, and poor sensation of filling. Magnetic resonance imaging revealed adherence of the rostral stump of the sectioned filum to the midline dorsal dural surface. All patients underwent the second untethering procedure. Four patients improved neurologically and experienced no retethering thereafter (mean follow-up period 5.5 years). Two patients experienced additional retethering after temporary improvement following the second untethering procedure. Conclusions Retethering of the spinal cord is a rare condition occurring after the sectioning of a fatty filum terminale. Awareness of this rare sequela is necessary for appropriate long-term management of TSC caused by a fatty filum terminale. Cystometrography is useful for detecting the lesion and confirming the diagnosis of retethering.

scholarly journals Osteoarticular Infections in Newborns: Prognostic Factors and Outcome

2020 ◽  
pp. 1-7
Keyword(s):  
Prognostic Factors ◽  
Antibiotic Treatment ◽  
Clinical Laboratory ◽  
Clinical Course ◽  
Newborn Infants ◽  
Bone Lesions ◽  
Osteoarticular Infections ◽  
The Mean

Purpose: To analyze clinical, laboratory, microbiologic, imaging and therapeutic data that contribute to outcome in newborn infants with osteoarticular (OSA) infection. Methods: Clinical course, imaging and follow-up data of 15 newborns with the diagnosis of OSA infection were retrospectively reviewed. Results: 15 newborns with 23 acute osteoarthritis foci were included: risk factors were identified in 73%, lower extremities were affected in 8 (53%) and more than half of the children had two-or multifocal involvement. The predominant causative agent was Staphylococcus aureus. While plain radiography showed osteolytic bone lesions in only 33%, scintigraphy was consistent with osteomyelitis in 74% of study infants. Magnetic resonance imaging revealed an inflammatory process even when other imaging modalities did not detect any OSA signs. All newborns underwent surgical and antibiotic treatment; the average time from admission to surgical treatment was 3.6 days. No bone and joint deformities or limb-length disturbances were found in the mean follow-up period of 8.5 years. Conclusion: Our study confirms that the most important prognostic factors in predicting a long-term favorable outcome are early diagnosis and therapy consisting of a combination of both surgical and appropriate antibiotic treatment.

scholarly journals Long Term Follow-up Results of Ablation Treatment for Patients with Small Renal Mass

2020 ◽  
Author(s):  
Bilal Gumus ◽  
Ali Albaz ◽  
Fatih Düzgün ◽  
Oktay Ucer ◽  
Gokhan Temeltas ◽  
...  
Keyword(s):  
Renal Mass ◽  
Demographic Data ◽  
Left Kidney ◽  
Treatment Success ◽  
Minor Bleeding ◽  
Small Renal Mass ◽  
The Mean ◽  
The Right

Objective: The aim of this study is to evaluate the outcome of ablation therapy in our clinic for the treatment of patients with small renal mass Materials and Methods: We retrospectively evaluated the technic and follow-up data of 30 patients with 36 tumors who underwent Radiofrequency Ablation (RFA) and Microwave Ablation (MWA) in our clinic. Demographic data, ablation type, tumor characteristics, peroperative and postoperative complications and treatment success of the patients were evaluated. Results: A total of 36 tumors who underwent ablation treatments, 23 were treated with RFA, 13 with MWA. The mean tumor size was 28.9 ± 6.92 mm in RFA and 29.3 ± 7.70 mm in MWA. 12 (52.1%) of the RFA procedures were applied to the right kidney while 11 (47.8%) were applied to the left kidney. 6 (46.1%) of the MWA procedures were performed on the right kidney and 7 (53.8%) on the left kidney. Of the 36 tumors, 4 (11.1%) were located central and 32 (88.8%) were peripheral. Complications occurred in 2 patients. In one of these patients, acute renal failure and urea creatinine were found to be elevated. In the other patient, local pain was found in the ablation side and minor bleeding was detected at the ablation site in USG. The mean follow-up period was 49.6 ± 24.7 months in patients with RFA and mean follow-up was 16 ± 8,05 months in MWA treatments. The overall success in MWA administration was calculated as 76.9%, while the overall success in RFA was 80%. Conclusion: Long-term oncologic efficacy of RFA appears to be successful in the treatment of T1a renal carcinomas. Further studies can be conducted to elucidate the influence of MWA on long-term oncological outcomes.

scholarly journals A Retrospective Study on Snakebite Victims in a Tertiary Referral Center

2016 ◽  
Vol 10 (3) ◽  
pp. 47-50
Author(s):  
Nasim Zamani ◽  
◽  
Leila Modir-Fallah Rad ◽  
Kambiz Soltaninejad ◽  
Shahin Shadnia ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Demographic Data ◽  
Clinical Manifestations ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital ◽  
Laboratory Findings ◽  
Cross Sectional ◽  
Tertiary Referral Center

Background: Snakebite is a serious public health problem in the world. The annual incidence of snakebites ranges from 4.5-9.1 in 100,000 population in Iran. With regard to diversity of envenomation profiles in different geographical parts of Iran, the aim of this study was to determine the demographical data, clinical and laboratory findings, and the outcome of the snakebite victims referred to a tertiary referral hospital. Methods: In this retrospective, cross-sectional study in Loghman Hakim Hospital Poisoning Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran, during a four-year period from March 2007 to March 2011. The demographic data, clinical manifestations, paraclinical findings, treatments performed before hospital admission, time elapsed between the bite and hospital admission, total dose of antivenom and the patients’ outcomes were investigated. Results: Seventy cases (58 males, 12 females) were evaluated. Most of the cases (79%) were older than 20 year old. The most common bite site was upper extremity (67%). Most of the patients were admitted within 5 h after the snakebite. The most common local and systemic manifestations were swelling (90%), pain (81.4%), nausea and vomiting (24.3%). Leukocytosis (35.7%) and thrombocytopenia (25.7%) were the most common laboratory abnormalities. Most of the patients (97.1%) were treated with antivenom. Fifty percent of the patients only received 3-5 vials of antivenom. The mortality rate was 1.4%. Necrosis of the toes and compartment syndrome were the only serious complications. Conclusion: The findings emphasize the importance of early admission to the hospital and treatment with antivenom to avoid morbidity and mortality.

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