Assessing Profile and Treatment Outcome in Patients of Ocular Surface Squamous Neoplasia (OSSN)

2019 ◽  
Vol 11 (2) ◽  
pp. 181-188
Author(s):  
Eliya Shrestha ◽  
Laxman Banstola ◽  
Indra Man Maharjan ◽  
Babita Gurung ◽  
Harimaya Gurung ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Cell Carcinoma ◽  
Squamous Epithelium ◽  
Invasive Squamous Cell Carcinoma ◽  
Duration Of Symptoms ◽  
Direct Closure ◽  
Stratified Squamous Epithelium ◽  
The Mean ◽  
Conjunctival Lesion

Purpose: This study has attempted to assess the profile and treatment outcome of patients with OSSN and report the recurrence rate following treatment of primary OSSN. Materials and Methods: This was a retrospective, non-comparative hospital based observational study. The case files of OSSN patients from Jan 2010 to Dec 2017were assessed. The study site was Himalaya Eye Hospital, Gharipatan, Pokhara. This hospital is the only eye hospital in province 4, Nepal. All the files of suspicious cases of conjunctival mass or OSSN were reviewed. Data regarding demographic characteristics, vision acuity, involved eye, clinical features, conjunctival lesion type, duration of symptoms, preoperative clinical diagnosis, history, other eye disease, associated systemic diseases, occupation as well as treatment modalities of the patients and its outcome were taken. Results: Out of 40 cases, females were 21(52.5%) vesus 19(47.5%) male. Amongthem, 19 patients had keratinized stratified squamous epithelium, 17 had conjunctiva intraepithelial squamous neoplasia and 4 had invasive squalors cell carcinoma. Predominance age group was 15-59 age (25/40, 62.5%), among which 12 had keratinized stratified squamous epithelium, 11 conjunctival intraepithelial squamousneoplasia and 2 had invasive squamous cell carcinoma conjunctival lesion. The mean duration of symptoms was about nine months (S.D. = 5.972). The mean size of lesion mass was 3.28 mm (SD=1.569). More than half of the cases (55%, 22/40) had the mass located at nasal limbus. 95% (38/40) cases underwent lesion total excision and direct closure and 5% (2/40) underwent lesion excision followed by Amniotic Membrane grafting. Only 5% (2/40) cases, those who had undergone lesion excision, the lesion recurrence was observed during follow up period of 31 months. Conclusion: The outcome of the OSSN following the treatment was found to be satisfactory. Further studies with prolonged follow-up are recommended to evaluate the risk of recurrence and other adverse effects.

Diagnostic Utility of Lower Extremity Radiographs of Young Children With Gait Disturbance

PEDIATRICS ◽  
1991 ◽  
Vol 87 (2) ◽  
pp. 138-140
Author(s):  
Steven D. Blatt ◽  
Bruce M. Rosenthal ◽  
Douglas C. Barnhart
Keyword(s):  
Lower Extremity ◽  
Failure To Thrive ◽  
Gait Disturbance ◽  
Diagnostic Utility ◽  
Duration Of Symptoms ◽  
Soft Tissue Swelling ◽  
Chief Complaints ◽  
The Mean ◽  
Limiting Condition

The diagnostic utility of lower extremity radiographs was evaluated using 84 outpatients 1 to 5 years of age with gait disturbance whose lower extremities appeared physically normal. Chief complaints included limp (65 children [77%]), refusal to walk or stand (37 children [44%]), and frequent falling (6 children [7%]). A total of 43 children (51%) had more than one complaint. The mean age of patients was 26 months and the median duration of symptoms was 1 day. Trauma was reported in 43 (51%) cases and fever in 14 (17%). Results of radiographical studies appeared normal in 81 children (96%), demonstrated soft tissue swelling in 2 children, and revealed a bony island in 1 child. In 1 patient admitted to the hospital for failure to thrive and irritability, and whose radiographic results appeared normal, findings consistent with osteomyelitis later developed. Of the remaining children, 68 (81%) were available for follow-up observation 4 to 28 months after the initial visit and all reported spontaneous resolution of the initial complaint. It was concluded that in a well-appearing child with an otherwise normal physical examination results, an acute gait disturbance is likely to be a self-limiting condition and radiographs are unlikely to contribute to the diagnosis.

scholarly journals Surgical Treatment in Bronchiectasis: Analysis of Our Patients.

2018 ◽  
Vol 2 (1) ◽  
Author(s):  
Fadil Gradica ◽  
Lutfi Lisha ◽  
Dhimitraq Argjiri ◽  
Fahri Kokici ◽  
Alma Cani ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Pulmonary Resection ◽  
Lower Lobe ◽  
Lung Abscess ◽  
Duration Of Symptoms ◽  
Operative Morbidity ◽  
Massive Haemoptysis ◽  
Localized Disease ◽  
The Mean

Background: Bronchiectasis is usually caused by pulmonary infections and bronchial obstructions. It is still a serious problem in developing countries, as our country. We reviewed the morbidity and mortal-ity rates and outcomes of bronchiectasis surgical treatment. Patients and methods: Between years 2000 and 2016, one hundred and seven (107) patients, sixty nine (69) of whom female and thirty eight (38) male underwent pulmonary resection for bronchiecta-sis. The mean age was 35years (range, 13–66 years). Mean duration of symptoms was 12 years. Results: Symptoms were copious amount of purulent sputum in 84 patients, expectoration of foul-smelling sputum in 72, haemoptysis in 21 and cough in all patients. The indications for pulmonary resection were: medical therapy failure in eighty two (82) patients, massive haemoptysis in eighteen and lung abscess in seven (7) patients. The disease was bilateral in twenty seven (27) patients and mainly confined in the lower lobe. Eighty six (86) patients had a lobectomy, 7 had a segmentectomy, two patients right pneumonectomy. Operative morbidity was seen in 47 patients (43.9 %) and mor-tality in two (2) patients. Follow-up was complete in 97 patients with a mean of 5 years. Overall, 78 patients were asymptomatic after surgical treatment; symptoms were improved in 24, and unchanged or worse in 5. Conclusions: Surgical treatment of bronchiectasis is more effective in patient with localized disease. It is satisfactory with acceptable ratio of morbidity and mortality.

scholarly journals Malignant Eyelid Tumors in India: A Study of 536 Asian Indian Patients

2018 ◽  
Vol 5 (3) ◽  
pp. 210-219 ◽  
Author(s):  
Swathi Kaliki ◽  
Nandini Bothra ◽  
Kavya Madhuri  Bejjanki ◽  
Arpita Nayak ◽  
George Ramappa ◽  
...  
Keyword(s):  
Cell Carcinoma ◽  
Asian Indian ◽  
Malignant Tumors ◽  
Tumor Location ◽  
Sebaceous Gland Carcinoma ◽  
Gland Carcinoma ◽  
The Mean ◽  
Asian Indian Population ◽  
Tumor Extent

Purpose: To study the proportion of eyelid malignant tumors in an Asian Indian population and to review their clinical features and outcomes. Methods: This is a retrospective study of 536 patients. Results: The mean age at presentation with eyelid malignancy was 58 years. Histopathology-proven diagnoses of these patients included sebaceous gland carcinoma (SGC) (n = 285, 53%), basal cell carcinoma (BCC) (n = 128, 24%), squamous cell carcinoma (SCC) (n = 99, 18%), and miscellaneous tumors (n = 24, 4%). The statistically significant differences between eyelid malignant tumors included age at presentation, tumor location, and tumor extent. The clinicopathological correlation of SGC, BCC, SCC, and miscellaneous tumors was 91, 86, 46, and 38% (p = 0.001), respectively. Comparing SGC with BCC, SCC, and miscellaneous tumors, SGC was more commonly associated with tumor recurrence (21 vs. 3, 8, and 13%; p = 0.001), systemic metastasis (13 vs. 0, 4, and 13%; p = 0.001), and death (9 vs. 0, 4, and 0%; p = 0.004). Compared to SGC, BCC, and SCC, locoregional lymph node metastasis was more common with miscellaneous tumors (26 vs. 16, < 1, and 8%; p = 0.001) over a mean follow-up period of 19 months. Conclusion: In Asian Indians, SGC is twice as common as BCC and 3 times more common than SCC. SGC is associated with poorer prognosis compared to other eyelid malignant tumors.

scholarly journals Tubular approach to minimally invasive microdiscectomy for pediatric lumbar disc herniation

2018 ◽  
Vol 21 (5) ◽  
pp. 449-455 ◽  
Author(s):  
Julio D. Montejo ◽  
Joaquin Q. Camara-Quintana ◽  
Daniel Duran ◽  
Jeannine M. Rockefeller ◽  
Sierra B. Conine ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Pediatric Patients ◽  
Lumbar Disc ◽  
Low Back ◽  
Duration Of Symptoms ◽  
Patient Reported ◽  
The Mean

OBJECTIVELumbar disc herniation (LDH) in the pediatric population is rare and exhibits unique characteristics compared with adult LDH. There are limited data regarding the safety and efficacy of minimally invasive surgery (MIS) using tubular retractors in pediatric patients with LDH. Here, the outcomes of MIS tubular microdiscectomy for the treatment of pediatric LDH are evaluated.METHODSTwelve consecutive pediatric patients with LDH were treated with MIS tubular microdiscectomy at the authors’ institution between July 2011 and October 2015. Data were gathered from retrospective chart review and from mail or electronic questionnaires. The Macnab criteria and the Oswestry Disability Index (ODI) were used for outcome measurements.RESULTSThe mean age at surgery was 17 ± 1.6 years (range 13–19 years). Seven patients were female (58%). Prior to surgical intervention, 100% of patients underwent conservative treatment, and 50% had epidural steroid injections. Preoperative low-back and leg pain, positive straight leg raise, and myotomal leg weakness were noted in 100%, 83%, and 67% of patients, respectively. The median duration of symptoms prior to surgery was 9 months (range 1–36 months). The LDH level was L5–S1 in 75% of patients and L4–5 in 25%. The mean ± SD operative time was 90 ± 21 minutes, the estimated blood loss was ≤ 25 ml in 92% of patients (maximum 50 ml), and no intraoperative or postoperative complications were noted at 30 days. The median hospital length of stay was 1 day (range 0–3 days). The median follow-up duration was 2.2 years (range 0–5.8 years). One patient experienced reherniation at 18 months after the initial operation and required a second same-level MIS tubular microdiscectomy to achieve resolution of symptoms. Of the 11 patients seen for follow-up, 10 patients (91%) reported excellent or good satisfaction according to the Macnab criteria at the last follow-up. Only 1 patient reported a fair level of satisfaction by using the same criteria. Seven patients completed an ODI evaluation at the last follow-up. For these 7 patients, the mean ODI low-back pain score was 19.7% (SEM 2.8%).CONCLUSIONSTo the authors’ knowledge, this is the longest outcomes study and the largest series of pediatric patients with LDH who were treated with MIS microdiscectomy using tubular retractors. These data suggest that MIS tubular microdiscectomy is safe and efficacious for pediatric LDH. Larger prospective cohort studies with longer follow-up are needed to better evaluate the long-term efficacy of MIS tubular microdiscectomy versus other open and MIS techniques for the treatment of pediatric LDH.

scholarly journals Utility of a New Artificial Dermis as a Successful Tool in Face and Scalp Reconstruction for Skin Cancer: Analysis of the Efficacy, Safety, and Aesthetic Outcomes

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Fedele Lembo ◽  
Liberato Roberto Cecchino ◽  
Domenico Parisi ◽  
Aurelio Portincasa
Keyword(s):  
Skin Cancer ◽  
Cell Carcinoma ◽  
Operating Time ◽  
Cancer Module ◽  
Artificial Dermis ◽  
Local Surgery ◽  
Ablative Surgery ◽  
Patient Reported ◽  
The Mean

Radical ablative surgery is the gold standard treatment of head skin cancer. The authors expose their experience with a new artificial dermis (Pelnac®), analyzing retrospectively the overall morbidity and aesthetic outcomes. 16 consecutive patients underwent two surgical procedures under local anesthesia. The first involved the tumor removal and application of the ADM. In the second, the exposed tissue was covered with a split-thickness skin graft. On follow-up (6 months), tumor recurrences, quality of scars (using the Vancouver Scar Scale), and patient reported outcomes (using FACE-Q Skin Cancer Module) were evaluated. 10 were males and 6 females, with a mean age of 73 years (61–89). The follow-up ranged from 12 to 48 months (mean: 30). The sites of skin tumor were scalp (12 cases), forehead (2), cheek (1), and zygomatic area (1). Nine patients underwent previous local surgery; two received radiotherapy. The average length of hospital stay was 3.2 days. The mean surface area of the defect was 59.15 cm2 (16.9–89.5). In three cases, the surgical bed was bone without periosteum. The malignant tumors excised were basal cell carcinoma (68.75%), squamous cell carcinoma (18.75%), malignant melanoma (6.25%), and sarcoma (6.25%). The mean operating time was 41 minutes for the first operation (25–55) and 34 for the second (25–48). No significant problems were observed and 15 patients (93.75%) had 100 percent intake of graft. The mean time of healing was 39 days (32–45). At 6 months post-op, no tumor recurrence. Satisfactory cosmetic and functional results were obtained in all patients as shown by the VSS Scale and FACEQ skin cancer module mean scores. We believe that the artificial dermis is a reliable alternative to flaps and should be considered an excellent option in head reconstruction for skin cancer, especially in critical patients (old, with large and deep defects, with recurrent tumors, required radiotherapy).

VIN 3: a clinicopathologic review

2002 ◽  
Vol 12 (5) ◽  
pp. 490-495 ◽  
Author(s):  
O. M. Mcnally ◽  
N. J. Mulvany ◽  
R. Pagano ◽  
M. A. Quinn ◽  
R. M. Rome
Keyword(s):  
Gynecological Cancer ◽  
Intraepithelial Neoplasia ◽  
Complete Information ◽  
Hpv Infection ◽  
Vulvar Intraepithelial Neoplasia ◽  
Invasive Squamous Cell Carcinoma ◽  
History Of ◽  
The Mean ◽  
Labium Majus

A retrospective review of the management of vulvar intraepithelial neoplasia 3 (VIN 3) over a 16-year period from 1981 to 1997 was conducted. Complete information was available for analysis on 101 patients. The mean age was 53.9 years (range 14–102 years). The mean duration of follow-up was 36 months (range 2–184 months). Fifty-eight percent of patients presented with pruritus. The disease was multifocal in 51% and unifocal in 49% of cases and the left labium majus was the most frequently affected site (27%). Co-existent or previous genital disease was identified in 39% of patients and 8% had a history of invasive gynecological cancer. Histologic evidence of human papillomavirus (HPV) infection was found in 31% of patients. Wide local excision was the most frequently used treatment modality (78%). Thirty-eight percent of patients required at least one further treatment for recurrent disease. Smoking, multifocality, HPV effect, and positive surgical margins were not found to be significant predictors of recurrence. There were three (3%) cases of progression to invasive squamous cell carcinoma of the vulva, one at 6, 7, and 7 years after initial treatment.

Brainstem gangliogliomas: a retrospective series

2013 ◽  
Vol 118 (4) ◽  
pp. 884-888 ◽  
Author(s):  
Si Zhang ◽  
Xiang Wang ◽  
Xuesong Liu ◽  
Yan Ju ◽  
Xuhui Hui
Keyword(s):  
Subtotal Resection ◽  
Who Grade ◽  
Duration Of Symptoms ◽  
West China Hospital ◽  
West China ◽  
Clinical Presentations ◽  
Close Observation ◽  
The Mean ◽  
Residual Lesions

Object The authors retrospectively analyzed data on brainstem gangliogliomas treated in their department and reviewed the pertinent literature to foster understanding of the preoperative characteristics, management, and clinical outcomes of this disease. Methods In 2006, the authors established a database of treated lesions of the posterior fossa. The epidemiology findings, clinical presentations, radiological investigations, pathological diagnoses, management, and prognosis for brainstem gangliogliomas were retrospectively analyzed. Results Between 2006 and 2012, 7 patients suffering from brainstem ganglioglioma were treated at the West China Hospital of Sichuan University. The mean age of the patients, mean duration of symptoms prior to diagnosis, and mean duration of follow-up were 28.6 years, 19.4 months, and 38.1 months, respectively. The main presentations were progressive cranial nerve deficits and cerebellar signs. Subtotal resection was achieved in 2 patients, and partial resection in 5. All tumors were pathologically diagnosed as WHO Grade I or II ganglioglioma. Radiotherapy and adjuvant chemotherapy were not administered. After 21–69 months of follow-up, patient symptoms were resolved or stable without aggravation, and MRI showed that the size of residual lesions was unchanged without progression or recurrence. Conclusions The diagnosis of brainstem ganglioglioma is of great importance given its favorable prognosis. The authors recommend the maximal safe resection followed by close observation without adjuvant therapy as the optimal treatment for this disease.

scholarly journals Outcomes and Return to Sport After Ulnar Collateral Ligament Reconstruction in Adolescent Baseball Players

2018 ◽  
Vol 6 (4) ◽  
pp. 232596711876932 ◽  
Author(s):  
Michael Saper ◽  
Joseph Shung ◽  
Stephanie Pearce ◽  
Viviana Bompadre ◽  
James R. Andrews
Keyword(s):  
Case Series ◽  
Return To Sport ◽  
Ulnar Collateral Ligament ◽  
Collateral Ligament ◽  
Baseball Players ◽  
Duration Of Symptoms ◽  
Excellent Outcome ◽  
Patient Reported ◽  
The Mean

Background: The number of ulnar collateral ligament (UCL) reconstructions in adolescent athletes has increased over the past 2 decades. Clinical results in this population have not been well studied. Purpose/Hypothesis: The purpose of this study was to evaluate the outcomes and return to sport after UCL reconstruction in a large group of adolescent baseball players. We hypothesized that excellent clinical outcomes and high rates of return to sport would be observed in this population at a minimum 2-year follow-up. Study Design: Case series; Level of evidence, 4. Methods: We reviewed 140 adolescent (aged ≤19 years) baseball players who underwent UCL reconstruction with the American Sports Medicine Institute (ASMI) technique by a single surgeon. Medical records were reviewed for patient demographics, injury characteristics, operative details, and surgical complications. Patient-reported outcomes were assessed using the Conway scale, the Andrews-Timmerman (A-T) score, the Kerlan-Jobe Orthopaedic Clinic (KJOC) score, and a 0- to 100-point subjective scale for elbow function and satisfaction. Return to sporting activity was assessed using a custom-designed questionnaire. Results: The mean age at the time of surgery was 18.0 years (range, 13-19 years), and the mean follow-up was 57.9 months (range, 32.4-115.4 months). Over half (60%) of patients were high school athletes. The mean duration of symptoms before surgery was 6.9 months (range, 0.5-60.0 months). Partial tears were identified in 57.9% of patients, and 41.3% of patients had preoperative ulnar nerve symptoms. Graft type included the ipsilateral palmaris in 77.1% of patients. Concomitant procedures were performed in 25% of patients. Outcomes on the Conway scale were “excellent” in 86.4% of patients. The mean A-T and KJOC scores were 97.3 ± 6.1 and 85.2 ± 14.6, respectively. Mean patient satisfaction was 94.4. Overall, 97.8% of patients reported returning to sport at a mean of 11.6 months (range, 5-24 months), and 89.9% of patients returned to sport at the same level of competition or higher. A total of 11.6% of patients went on to play professional baseball. Conclusion: UCL reconstruction with the ASMI technique is an effective surgical option in adolescents, with excellent outcome scores. At a minimum of 2-year follow-up, nearly 90% of patients returned to their preinjury level of sport.

Outcome of facial physiotherapy in patients with prolonged idiopathic facial palsy

2015 ◽  
Vol 129 (4) ◽  
pp. 348-352 ◽  
Author(s):  
G J Watson ◽  
S Glover ◽  
S Allen ◽  
R M Irving
Keyword(s):  
Standard Deviation ◽  
Facial Paralysis ◽  
Grading System ◽  
Duration Of Treatment ◽  
Duration Of Symptoms ◽  
Average Improvement ◽  
The Mean ◽  
Pre Treatment ◽  
Idiopathic Facial Palsy

AbstractObjective:This study investigated whether patients who remain symptomatic more than a year following idiopathic facial paralysis gain benefit from tailored facial physiotherapy.Methods:A two-year retrospective review was conducted of all symptomatic patients. Data collected included: age, gender, duration of symptoms, Sunnybrook facial grading system scores pre-treatment and at last visit, and duration of treatment.Results:The study comprised 22 patients (with a mean age of 50.5 years (range, 22–75 years)) who had been symptomatic for more than a year following idiopathic facial paralysis. The mean duration of symptoms was 45 months (range, 12–240 months). The mean duration of follow up was 10.4 months (range, 2–36 months). Prior to treatment, the mean Sunnybrook facial grading system score was 59 (standard deviation = 3.5); this had increased to 83 (standard deviation = 2.7) at the last visit, with an average improvement in score of 23 (standard deviation = 2.9). This increase was significant (p < 0.001).Conclusion:Tailored facial therapy can improve facial grading scores in patients who remain symptomatic for prolonged periods.

Benign Granular Cell Tumors of the Larynx: A Review of 36 Cases with Clinicopathologic Data

1975 ◽  
Vol 84 (3) ◽  
pp. 308-314 ◽  
Author(s):  
John Compagno ◽  
Vincent J. Hyams ◽  
Pierre Ste-Marie
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Vocal Cord ◽  
Granular Cell Tumor ◽  
Squamous Epithelium ◽  
Granular Cell ◽  
Cell Tumor ◽  
Clinical Impression ◽  
True Vocal Cord

The clinical, microscopic, and gross features of 36 cases of benign granular cell tumor arising in the larynx are reviewed and studied. This infrequent lesion, when in the larynx, is found most commonly on the true vocal cord in adults in their third, fourth, and fifth decades; there is no obvious sex predilection. Slowly increasing hoarseness was the primary complaint in our cases. Clinically, the tumors are considered benign. The most common clinical impression was a vocal cord papilloma. The microscopic pattern of the granular cell tumors is uniform and bland, but there may be a marked pseudoepitheliomatous hyperplasia of the overlying squamous epithelium, often stimulating squamous cell carcinoma. Follow-up information is discussed, as is the origin and histogenesis of this lesion.

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