scholarly journals Complete laparoscopic pancreaticoduodenectomy: our experience of the first case

2019 ◽  
Vol 22 (1) ◽  
pp. 26-30
Author(s):  
Mukund Raj Joshi ◽  
Sujan Regmee ◽  
Tanka Prasad Bohara ◽  
Rupesh Chakradhar ◽  
Mandesh Shrestha
Keyword(s):  
Blood Loss ◽  
Point Of View ◽  
Resected Specimen ◽  
Laparoscopic Pancreaticoduodenectomy ◽  
Technical Aspects ◽  
Technical Point ◽  
Operative Outcomes ◽  
Post Operative Period ◽  
First Case

Laparoscopic pancreaticoduodenectomy was described in 1994. It is considered the most challenging abdominal surgery. Although the procedure was found to be feasible in initial reports, the benefits were not considered favorable. In recent days, with the increasing experience of surgeons, acceptable outcomes are being observed and have been found to be technically beneficial and oncologically safe in selective cases in experienced hands. We performed the procedure in a 42-year-old gentleman with good operative and post-operative outcomes. The patient’s follow-up for six post-operative months seems satisfactory. The operation took 840 minutes with minimal blood loss. The resected specimen was adequate and satisfactory from an oncological and technical point of view. The patient developed some inherent complications of the procedure in the post-operative period. He recovered well. Details of the case and technical aspects are being discussed.  

scholarly journals Open haemorrhoidectomy revisited: the study of 25 cases

2018 ◽  
Vol 6 (11) ◽  
pp. 3542
Author(s):  
Ketan Vagholkar ◽  
Shantanu Chandrashekhar ◽  
Suvarna Vagholkar
Keyword(s):  
Urinary Retention ◽  
Therapeutic Option ◽  
Open Method ◽  
Operative Outcomes ◽  
Post Operative Period ◽  
Operative Findings ◽  
The Cost ◽  
Surgical Option ◽  
Grade Iii

Background: Haemorrhoids continue to be the commonest benign anorectal condition presenting with bleeding and constipation. The presentation may vary depending on the grade of haemorrhoids. Deciding the best therapeutic option is the biggest challenge faced by the attending surgeon in an era where newer therapeutic technologies for treatment continue to evolve. Therefore, revisiting the traditional surgical option of excision and ligation technique for grossly symptomatic piles was evaluated taking into consideration the cost of the procedure. Twenty five consecutive patients of symptomatic grade III and IV haemorrhoids were selected for the study to determine the outcome of the traditional open method (Milligan Morgan technique)Methods: Twenty five patients after having been checked for fitness for anaesthesia underwent the open method of haemorrhoidectomy under spinal anaesthesia. On admission to hospital a detailed proforma which contained demographic details, and comorbidities was completed. All 25 patients underwent the same procedure by ligation excision technique. Details of operative findings including post-operative outcomes were studied prospectively. Results were evaluated.Results: Of the 25 patients, one patient developed bleeding in the immediate post-operative period which required relook surgery and undermining of the oozing stump. Four patients required catheterisation for urinary retention. A six month follow up did not reveal recurrence or any sort of discomfort while passing stools.Conclusions: Open haemorrhoidectomy (Milligan Morgan) continues to be the most optimum method for treatment of symptomatic piles grade III and IV.

Early post-operative morbidity after tympanostomy tube insertion

2005 ◽  
Vol 119 (9) ◽  
pp. 699-703 ◽  
Author(s):  
Jacqui Allen ◽  
Randall P Morton ◽  
Zahoor Ahmad
Keyword(s):  
Prospective Observational Study ◽  
Tube Insertion ◽  
Operative Morbidity ◽  
Operative Outcomes ◽  
Post Operative Period ◽  
Operative Complications ◽  
Ventilation Tubes ◽  
Ear Drops ◽  
Recurrent Otitis Media

Insertion of ventilation tubes is regarded as a simple, effective and safe treatment for recurrent otitis media or prolonged middle-ear effusions. We conducted a prospective observational study of 112 children to ascertain what early post-operative complications were experienced. Our findings were consistent with previously published figures for post-surgical otorrhoea and obstruction rates, at 13.5 per cent and 4 per cent (by ear), respectively, using intra-operative administration of antibiotic/steroid ear drops. We identified unique characteristics of differing ethnic groups with regard to findings at surgery and post-operative outcomes. There was a tendency for grommets placed in the left ear to be extruded early and Maori andPacific Islanders were significantly more likely to have a non-functioning tube (blocked or extruded) in the early post-operative period. Overall, one in four children developed a post-operative complication (otorrhoea or non-functioning tube) suggesting that early and close follow up may allow timely identification and intervention where required.

scholarly journals Metallic alloy with shape memory – selected properties and engineering aspects

2019 ◽  
Author(s):  
Krzysztof Kuś ◽  
Adam Frączyk ◽  
Adam Wojtkowiak
Keyword(s):  
Heat Treatment ◽  
High Temperature ◽  
Shape Memory ◽  
Experimental Studies ◽  
Point Of View ◽  
Ti Alloy ◽  
Practical Application ◽  
Technical Aspects ◽  
Technical Point ◽  
The Veil

In the case of shape memory alloys (SMA), a form to which a material is expected to return during its heating can be repeatedly programmed, whereas other related properties also individually adjusted. It was noticed that most producers of commercial assortment based on SMA or traders seldom are willing to lift the veil of secrecy on this topic. In the context of own experimental studies, the authors made reference to technical aspects of some post-treatments of a Ni-Ti alloy with a view to further practical application, e.g. design and construction of machinery and structures with the involvement of SMA. For these purposes, attempts concerning the high-temperature shape setting were carried out using various parameters of heat treatment with no secrecy surrounding the procedures applied. Some of the tested parameters proved effective, whereas some were less useful. Following the activation of the reverse transformation by heating, a somewhat different behaviour was observed, and simultaneously one of the crucial material temperatures was determined. The paper as a whole is reported from a specifically engineering/technical point of view, which is continuously emphasized in the content of the presented article.

Clinicopathologic Features of Two Rare Cases of Dedifferentiated Adamantinomas, Including Diagnostic Implications

2018 ◽  
Vol 27 (2) ◽  
pp. 193-202 ◽  
Author(s):  
Bharat Rekhi ◽  
Ayushi Sahay ◽  
Ajay Puri
Keyword(s):  
Microscopic Examination ◽  
Correct Diagnosis ◽  
Epithelial Differentiation ◽  
Resected Specimen ◽  
Intense Staining ◽  
Metastatic Lesions ◽  
First Case ◽  
Mitotic Figures ◽  
Aggressive Clinical Course

A dedifferentiated adamantinoma is a rare subtype of an adamantinoma, associated with a relatively aggressive clinical course, with less than 10 such cases reported so far. A 25-year-old-male presented with pain in his right leg of 1-year duration. Imaging disclosed a well-defined lytic, destructive lesion in his proximal tibia with a cortical break and a soft tissue component. Microscopic examination of the biopsy and resected specimen showed nests and clusters of atypical epithelial cells, along with significant areas showing markedly pleomorphic and spindly sarcomatous cells with interspersed mitotic figures and areas of stromal hyalinization. By immunohistochemistry, the areas of epithelial differentiation showed intense positivity for cytokeratin and p63, whereas the sarcomatous areas showed reduced to absent immunostaining. A 51-year-old lady presented with a recurrent tumor in her right tibia, which was initially diagnosed as an adamantinoma, along with metastatic lesions in her lung. Microscopic examination of the recurrent and metastatic tumors showed areas of epithelial differentiation along with spindly sarcomatous cells, arranged in fascicles. By immunohistochemistry, the areas of epithelial differentiation showed positivity for pan cytokeratin. Additionally, p63 was diffusely positive. p53 showed diffuse and intense staining pattern in the sarcomatous component (dedifferentiation). While the first case is disease-free, the second case is on follow-up. The 2 cases of dedifferentiated adamantinoma further confirm the rare occurrence of this tumor in our population. Its correct diagnosis has treatment implications. Differential diagnoses and literature review of similar reported cases are also presented in this article.

Immunocytochemical methodology for the localization of neuronal antigens at the ultrastructural level

1990 ◽  
Vol 48 (3) ◽  
pp. 876-877
Author(s):  
Jorge Pecci Saavedra ◽  
Mark Connaughton ◽  
Juan José López ◽  
Alicia Brusco
Keyword(s):  
Spinal Cord ◽  
Substantia Nigra ◽  
Polyclonal Antibodies ◽  
Ultrastructural Level ◽  
Point Of View ◽  
Nerve Tissue ◽  
Tissue Fixation ◽  
Optimal Conditions ◽  
Interpeduncular Nucleus ◽  
Technical Point

The use of antibodies as labels for the localization of specific molecules in the nervous systan has been extensively applied in recent years. Both monoand polyclonal antibodies or antisera have been employed. The knowledge of the organization of neuronal connectivities, gliovascular relationships, glioneuronal relationships and other features of nerve tissue has greatly increased.A number of areas of the nervous systan have been analyzed in our laboratory, including the nuclei of the raphe system, the reticular formation, interpeduncular nucleus, substantia nigra, caudate nucleus, putamen, pallidum, spinal cord, pineal gland and others.From a technical point of view, a number of variables needed to be taken into account in order to obtain reliable and reproducible results. The design of the optimal conditions of tissue fixation, embedding, sectioning, dilution of antibodies, and adaptation of Sternberger PAP technique were sane of the parameters taken into account to optimize the results. It is critical that each step of the technique be defined for each particular case.

Circulating matrix metaloproteinases as biomarkers in colorectalcancer

2020 ◽  
Vol 99 (9) ◽  
Keyword(s):  
Colorectal Cancer ◽  
Tumor Markers ◽  
Point Of View ◽  
Tissue Inhibitors ◽  
Natural Tissue

The aim of this research is to offer comprehensive point of view related to perspective tumor markers called matrix metaloproteinases and their natural tissue inhibitors. Those markers are potentially useable mainly in postoperative follow-up in patients with colorectal cancer.

Localized Irrigation System for Thuja Orientalis in Intensive Culture

2018 ◽  
Vol 20 (1) ◽  
pp. 119-126
Author(s):  
Mădălina Stănescu ◽  
Constantin Buta ◽  
Geanina Mihai ◽  
Lucica Roșu
Keyword(s):  
Irrigation System ◽  
Ornamental Plants ◽  
Point Of View ◽  
First Year ◽  
Intensive Culture ◽  
Technical Point ◽  
Production Factors ◽  
Thuja Orientalis ◽  
Agricultural Farm

Abstract In order to increase the competitiveness of an agricultural holding through the efficient use of the production factors, the modernization of an agricultural farm was carried out by exending the existing greenhouse with at least 700m2 for the intensive cultivation of ornamental plants - Thuja Orientalis. The material is produced by initiating crops in pots, with seedlings grown in pots or transplanting them in pots right after the first year of the multiplication and growing them in containers, appropriate to their size, until reaching their full value. From a technical point of view, reaching the objective will also be possible through a localized irrigation system.

When fever is more than infection: two cases of vancomycin-induced drug reaction with eosinophilia and systemic symptoms (DRESS)

2021 ◽  
Vol 14 (1) ◽  
pp. e238006
Author(s):  
Mitchell Cox ◽  
Sophie Paviour ◽  
Sophie Gregory ◽  
Rusheng Chew
Keyword(s):  
Drug Reaction ◽  
Cytomegalovirus Reactivation ◽  
First Case ◽  
Metropolitan Hospital ◽  
Orthopaedic Ward ◽  
Systemic Hypersensitivity ◽  
Systemic Symptoms ◽  
Inflammatory Syndrome ◽  
Intravenous Glucocorticoids

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare, but serious systemic hypersensitivity reaction associated with a range of medications. We present two cases of vancomycin-induced DRESS, which occurred simultaneously in the orthopaedic ward in an outer metropolitan hospital. These cases demonstrate the complexity in the diagnosis and management of this inflammatory syndrome on the background of known infection as well as evidence for linezolid as an alternative to vancomycin. The first case was managed conservatively, but developed progressive renal and liver injury along with demonstrated cytomegalovirus reactivation and recurrent colitis, and was eventually palliated. The second was commenced on intravenous glucocorticoids and achieved remission, although had ongoing renal dysfunction at the time of discharge from outpatient follow-up.

Complete resolution of acute pancreatitis-induced chylous ascites following transhepatic portal vein stenting

2020 ◽  
Vol 13 (12) ◽  
pp. e235986
Author(s):  
Alexander Tindale ◽  
James Jackson ◽  
Darina Kohoutova ◽  
Panagiotis Vlavianos
Keyword(s):  
Portal Vein ◽  
Complete Resolution ◽  
Chylous Ascites ◽  
Biliary Pancreatitis ◽  
Acute Biliary Pancreatitis ◽  
Portal Vein Stenosis ◽  
First Case ◽  
Vein Stenosis ◽  
Inflammatory Changes

We introduce a case of a 73-year-old man who developed intractable chylous ascites due to portal vein compression as a result of peripancreatic inflammatory changes after acute biliary pancreatitis. After stenting the portal vein stenosis, the chylous ascites improved from requiring weekly paracentesis to requiring no drainage within 4 months of the procedure and at the 15-month follow-up. To our knowledge, it is the first case reported in the literature where portal vein stenting has successfully been used to treat pancreatitis-induced chylous ascites.

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