ERECTILE DYSFUNCTION AND CAVERNOUS VENO-OCCLUSIVE DISEASE

GoalTo provide a state-of-the-art literature review on veno-occlusive diseases as a pathomechanism of vasculogenic erectile dysfunction (ED).MethodsA comprehensive systematic literature search was conducted followed by sorting, review, and summarizing. ResultsThe systematic review of the literature reveals a significant number of recent studies dealing with new minimally invasive methods to provide a potential solution of caverno-venous leakage. Even the long-term results reported demonstrate considerable improvement of ED caused by this condition. Furthermore, 3-D computed tomography cavernosography (CT-cavernosography) is a new technology, which can provide high-resolution images of venous drainage from any angle and shows to be very helpful for both the diagnosis of corporal veno-occlusive dysfunction and the anatomical study of the human penile venous system. The application of this technology may also lead to better strategies in venous leak treatment. Over 30 published studies were found in the literature with good results after caverno-venous leak treatment. Altogether, 13 comparable studies including 538 patients were found, in which a mean short-term success rate of almost 80% and a mean long-term success rate of up to 74% was achieved. None of the studies described major complications.ConclusionED is an increasingly important issue, especially in young men. Whereas the current treatment strategies are mostly focused on older men, young patients are seeking more a longer lasting or more definitive solutions, rather than a lifelong medical treatment. Various chronic disorders have been reported to be associated with elevated rates of ED including depression, diabetes, and cardiovascular and neurological disease in older men. Properly selected cases of young men may benefit from treatment of caverno-venous leak treatment. The current strategy in the treatment of ED in young men may be reconsidered.

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Long-term Results of Papillary Thyroid Cancer Treatment and Comparative Analisis of Various Treatment Strategies

Clinical and experimental thyroidology ◽

10.14341/cet201410131-37 ◽

2014 ◽

Vol 10 (1) ◽

pp. 31-37

Author(s):

R A Chernikov ◽

E A Valdina ◽

S L Vorobjev ◽

I V Sleptsov ◽

A A Semenov ◽

...

Keyword(s):

Thyroid Cancer ◽

Cancer Treatment ◽

Papillary Thyroid Cancer ◽

Treatment Strategies ◽

Long Term Results ◽

Papillary Thyroid

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Long-term results of invasive and non-invasive treatment strategies in the elderly patients with acute coronary syndrome

Cardiac Surgery and Interventional Cardiology ◽

10.31928/2305-3127-2019.3.2229 ◽

2019 ◽

pp. 22-29

Author(s):

R.R. Komorovsky ◽

◽

Keyword(s):

Acute Coronary Syndrome ◽

Elderly Patients ◽

Treatment Strategies ◽

The Elderly ◽

Long Term Results ◽

Invasive Treatment ◽

Coronary Syndrome ◽

Non Invasive

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Endoscopic Ultrasound-Guided Drainage and Treatment of Symptomatic Pancreatic Fluid Collection following Acute or Acute-on-Chronic Pancreatitis – A Single Center Case Series

Zentralblatt für Chirurgie - Zeitschrift für Allgemeine Viszeral- Thorax- und Gefäßchirurgie ◽

10.1055/a-0638-8505 ◽

2018 ◽

Vol 143 (06) ◽

pp. 577-585

Author(s):

Dominik Kaczmarek ◽

Jacob Nattermann ◽

Christian Strassburg ◽

Tobias Weismüller

Keyword(s):

Success Rate ◽

Endoscopic Ultrasound ◽

Clinical Success ◽

Fluid Collection ◽

Clinical Success Rate ◽

Long Term Results ◽

Pancreatic Fluid Collection ◽

Endoscopic Procedures ◽

Pancreatic Fluid

Abstracts Introduction Pancreatic fluid collection (PFC) is a common complication of acute pancreatitis. Endoscopic ultrasound (EUS)-guided drainage, which is often followed by direct endoscopic necrosectomy (DEN), has become the primary approach to treat PFC, including pancreatic pseudocysts (PP) and walled-off necrosis (WON). We aimed to determine retrospectively the short- and long-term results of patients treated in our endoscopy unit and to identify parameters that are associated with treatment efficacy and outcome. Methods The data of 41 consecutive patients with post-pancreatitic PFC, who underwent endoscopic transmural intervention between 2014 and 2016, were analyzed retrospectively. After an initial EUS-guided puncture, one or more plastic stents were placed and DEN was performed if necrotic tissue remained. Results The mean diameter of the PFC was 74.0 ± 4.8 mm. Of the PFCs, 29.3% were classified as PP and 70.7% as WON. Altogether, 196 transmural endoscopic procedures were performed, including 73 endoscopic necrosectomies in a subgroup of 21 patients (20 WON, 1 PP). Initial technical success was achieved in 97.6% of patients and the short-term clinical success rate was 90.2%. The long-term clinical success rate was 82.9%, since four patients died from septic shock and/or multiple organ failure and three patients developed recurrent PFC some months after the initial discharge from endoscopic treatment. Procedural complications were registered in 9 patients during 10 of 196 endoscopic procedures (5.1%): bleeding (6), cardiorespiratory insufficiency (2), perforation with pneumoperitoneum (1), aspiration with respiratory insufficiency (1), and non-perforating superficial damage of the gastric wall (1). Neither the size of the PFC nor the initial value of C-reactive protein (CRP) or other biochemical markers were correlated with efficacy or outcome of treatment. Only the cumulative number of days with CRP > 50 mg/L significantly correlated with the number of follow-up endoscopic sessions and DEN. Fungal colonization of PFC correlated significantly (p < 0.05) with the risk of mortality (44% vs. 0%), need for intensive care treatment (66.7% vs. 25%), and sepsis (55.6% vs. 12.5%). Conclusions We confirm that EUS-guided drainage followed by DEN in patients with solid necrotic material is an effective and relatively safe therapeutic approach. Prolonged elevation of CRP and fungal colonisation of the PFC are associated with a worse course of the disease.

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Reconstruction of finger joints using autologous rib perichondrium – an observational study at a single Centre with a median follow-up of 37 years

BMC Musculoskeletal Disorders ◽

10.1186/s12891-020-03310-5 ◽

2020 ◽

Vol 21 (1) ◽

Cited By ~ 1

Author(s):

Daniel Muder ◽

Ola Nilsson ◽

Torbjörn Vedung

Keyword(s):

Range Of Motion ◽

Young Patients ◽

Long Term Results ◽

Dash Score ◽

Finger Joints ◽

Joint Reconstruction ◽

Additional Surgery ◽

Contralateral Hand ◽

The Mean

Abstract Background Gratifying long-term results are difficult to achieve when reconstructing osteoarthritic finger joints. Implant surgery is the most commonly used method to restore function and dexterity. However, all types of implant have disadvantages and may be a less favorable option in some cases, especially in young patients with a long expected lifetime and high demands on manual load. Implant related complications as loosening, instability, subsidence and stiffness are the main concerns. In this context, joint reconstruction using rib perichondrium might be a reasonable alternative in selected cases. The aim of the study was to evaluate the long-term results of finger joint reconstruction using rib perichondrial transplantation. Methods The study group (n = 11) consisted of eight individuals reconstructed in the proximal interphalangeal (PIP) joints and three reconstructed in the metacarpophalangeal (MCP) joints during 1974–1981. All patients were evaluated at clinical visits (median: 37 years after perichondrial transplantation, range: 34–41 years) using radiographs, disability in arm-shoulder-hand (DASH) score, Visual Analog Scale (VAS), range-of-motion (ROM) and manual strength (JAMAR). Results None of the 11 patients had undergone additional surgery. All of the PIP-joints (n = 8) were almost pain-free at activity (VAS 0,6) (range 0–4), had an average range-of-motion of 41 degrees (range 5–80) and a mean DASH-score of 8,3 (range 1–51). The mean strength was 41 kg compared to 44 kg in the contralateral hand (93%). The three MCP joints were almost pain-free at activity (VAS 0,7), (range 0–1). The ROM was on average 80 degrees (range 70–90) and the mean DASH-score was 2 (range 1–3). The mean strength was 43 kg compared to 53 kg in the contralateral hand (81%). Conclusions Perichondrium transplants restored injured PIP and MCP joints that remained essentially pain-free and mostly well-functioning without need for additional surgeries up to 41 years after the procedure. Additional studies are needed to evaluate long-term results in comparison to modern implants and to better describe the factors that determine the outcome of these procedures. Level of evidence Level IV, Therapeutic Study.

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Treatment strategies and long-term results in paediatric patients treated in four consecutive AML-BFM trials

Leukemia ◽

10.1038/sj.leu.2403920 ◽

2005 ◽

Vol 19 (12) ◽

pp. 2030-2042 ◽

Cited By ~ 154

Author(s):

U Creutzig ◽

◽

M Zimmermann ◽

J Ritter ◽

D Reinhardt ◽

...

Keyword(s):

Treatment Strategies ◽

Long Term Results ◽

Paediatric Patients

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Zenker's Diverticulotomy with the Carbon Dioxide Laser: Perioperative Management and Long-Term Results

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348940311200302 ◽

2003 ◽

Vol 112 (3) ◽

pp. 202-205 ◽

Cited By ~ 21

Author(s):

Markus Hoffmann ◽

Heinrich H. Rudert ◽

David Scheunemann ◽

Steffen Maune

Keyword(s):

Carbon Dioxide Laser ◽

Perioperative Management ◽

Treatment Strategies ◽

Functional Results ◽

Long Term Results ◽

Special Equipment ◽

Laser Systems ◽

Zenker’S Diverticulotomy ◽

Low Rate

We analyzed 119 files of patients with Zenker's diverticulum who were treated with CO2 laser systems concerning treatment management, complications, and long-term results. Although the tissue bridge was dissected down to the fundus of the diverticulum, opening the mediastinum, mediastinitis was observed in none of the cases. Of the patients followed up for long-term results, 90.3% were completely symptom-free, and 5.8% of the patients reported an improvement in general condition. In view of the low rate of complications and the low level of morbidity and because of the good functional results, microendoscopic laser surgical diverticulotomy can be recommended as suitable therapy, especially as compared to external approaches or even other endoscopic treatment strategies. The main advantage as compared to staple-assisted esophagodiverticulostomy is that no special equipment is needed and that even small pouches can be treated successfully.

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Long-Term Results of a Simultaneous Trial of Deep Brain and Motor Cortex Stimulation in Refractory Neuropathic Pain

Translational Neuroscience and Clinics ◽

10.18679/cn11-6030_r.2017.002 ◽

2017 ◽

Vol 3 (1) ◽

pp. 4-15

Author(s):

Byung-chul Son ◽

Jin-gyu Choi ◽

Sang-woo Ha ◽

Deog-ryeong Kim

Keyword(s):

Neuropathic Pain ◽

Pain Relief ◽

Motor Cortex ◽

Success Rate ◽

Rating Scale ◽

Long Term Results ◽

Motor Cortex Stimulation ◽

Significant Difference ◽

Deep Brain

Objective Although deep brain stimulation (DBS) and motor cortex stimulation (MCS) are effective in patients with refractory neuropathic pain, their application is still empirical; there is no consensus on which technique is better. Methods To enhance the success rate of trial stimulation of invasive neuromodulation techniques and identify approapriate stimulation targets in individual patients, we performed a simultaneous trial of thalamic ventralis caudalis (Vc) DBS and MCS in 11 patients with chronic neuropathic pain and assessed the results of the trial stimulation and long-term analgesia. Results Of the 11 patients implanted with both DBS and MCS electrodes, nine (81.8%) had successful trials. Seven of these nine patients (77.8%) responded to MCS, and two (18.2%) responded to Vc DBS. With long-term follow-up (56 ± 27.5 months), the mean numerical rating scale decreased significantly (P < 0.05). The degree of percentage pain relief in the chronic MCS (n = 7) and chronic DBS (n = 2) groups were 34.1% ± 18.2% and 37.5%, respectively, and there was no significant difference (P = 0.807). Five out of the seven MCS patients (71%) and both DBS patients had long-term success with the treatments, defined as >30% pain relief compared with baseline. Conclusions With simultaneous trial of DBS and MCS, we could enhance the success rate of invasive trials. Considering the initial success rate and the less invasive nature of epidural MCS over DBS, we suggest that MCS may be a better, initial means of treatment in chronic intractable neuropathic pain. Further investigations including other subcortical target-associated medial pain pathways are warranted.

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