Laparoscopic Living-Donor Nephrectomy of a Horseshoe Kidney: A Case Report and Review of the Literature

We present the case of a living-donor nephrectomy of a horseshoe kidney. The recipient was a 33-year-old male with a history of end-stage renal disease secondary to IgA nephropathy. The donor was his 33-year-old partner who on preoperative cross-sectional imaging was found to have a horseshoe kidney with a single artery, vein and ureter. The donor operation was performed using a laparoscopic hand-assisted technique with transection of the interpolar fibrotic band using a stapler device. The backtable organ preparation was performed in a standard fashion with addition of a reinforcing hemostatic suture of the stapled fibrotic band. The donated kidney was transplanted extraperitoneally in the right iliac fossa of the recipient. The patient had an unremarkable postoperative course and was discharged home on post operative day 2 with normalizing renal function. To our knowledge, this is the first living donor nephrectomy of a horseshoe kidney performed using a laparoscopic hand-assisted technique.

A Short Review on OSMF : Oral Submucous fibrosis

Oral submucous fibrosis (OSMF) is a premalignant condition caused by betel chewing. OSMF is a premalignant condition that can lead to oral cancer. A risk that is further increased by concomitant tobacco consumption. OSMF is a diagnosis based on clinical symptoms and confirmation by histopathology. Major constituents of betel quid are arecoline from betel nuts and copper, which are responsible for fibroblast dysfunction and fibrotic band formation. Drug therapy include antifibrotic, anti-inflammatory, and antioxidants, homemade remedies including turmeric and tulsi . Prevention is most important in case of OSMF , because severe cases of OSMF are irreversible.

Seorang Penderita Siliko Tuberkulosis dengan Penyulit Pneumotoraks

Background: Silicosis is a lung disease caused by the work because of respirable crystalline silica. Often occurs in workers mining gold, iron, tin, granite, sandstone, slate, foundries, cement, ceramics and glass. The risk of silicosis develop into lung tuberculosis (TB) is higher than patients without silicosis. Another complication of silicosis is secondary spontaneous pneumothorax. Case : A man, 45 years old with a history of work as a bricklayer for 5 years with complaints shortness of breath since three days before admitted to the hospital, chest pain in the right hemithorax, and had chronic cough. Patients is on ATD therapy. From radiographic there is collapse lung, it was shown collapse line on the right hemithorax, and fibroinfiltrat with multiple cavities on both hemithorax. Patients then got chest tube insertion and evaluation for 3 weeks, but the lung has not expanded. From thoracoscopy, there is fibrotic band on the pleural space with conclution right trapped lung. From forcep biopsy on visceral pleura showed a widened alveolar epithelial layer coated with a pile of inflammatory lymphocytes and dust pigments. From broncoscopy, there is chronic lung inflamation. Spectrophotometric analysis from BAL specimens results showed a silica content of 4.25 ppm SiO2 from left BAL an 14.34 ppm SiO2 on the right BAL. Furthurmore, this patient got pleurodesis using betadine agent and continue the ATD. Evaluation the lung is fully expanded. Conclusion : This case illustrates the secondary spontaneous pneumothorax as a complication of silicotuberkulosis. No drug has proven effective for silicosis. Treatment is aimed to the disease complications that occur, in this case is secondary spontaneous pneumothorax and lung TB. Prevention at workplaces that have a risk of silicosis is very important.

Pathologic Study of Supernumerary Orbital Band in Type I Duane Syndrome

Background/Aims: Accessory orbital bands are relatively rare and very few reports detail histopathology. Cases in the literature describe the composition of the bands as muscular and/or fibrous. The composition of the supernumerary band lying deep in the medial rectus muscle in a patient with type I Duane syndrome was investigated. Methods: Histochemical stains were used in conjunction with polarized light for differentiating compressed collagen from muscle. Immunohistochemistry was used for verification of the presence of muscle. Results: Compressed collagen appeared red using Masson trichrome staining. Collagen was positively identified by illumination with polarized light on several stains including the underutilized Sirius red dye. Conclusions: The findings of dense collagen fibers in the fibrotic band with focal striated muscle correlated with the restrictive strabismus. In concert with other cases in the literature, it is proposed that the fibrous bands are generally associated with restrictive strabismus. Bands that are muscular may or may not be associated with strabismus. Special techniques are needed to positively identify compressed collagen.

Glial heterotopia of the lip: A rare presentation

ABSTRACTGlial heterotopia represents collections of normal glial tissue in an abnormal location distant to the central nervous system or spinal canal with no intracranial connectivity. Nasal gliomas are non-neoplastic midline tumours, with limited growth potential and no similarity to the central nervous system gliomas. The nose and the nasopharynx are the most common sites of location. Existence of glial heterotopia in the lip region is a rare developmental disorder. We report a case of large glial heterotopia in the upper lip region in a full-term female newborn which had intracranial extension with a fibrotic band. After the surgery, there was no recurrence in the follow-up period of 3 years. When glial heterotopia, which is a rare midline anomaly, is suspected, possible intracranial connection and properties of the mass should be evaluated by magnetic resonance imaging. By this way, lower complication rate and better aesthetic results can be achieved with early diagnosis and proper surgery.

Surgical management of idiopathic torticollis secondary to a fibrotic band

Congenital muscular torticollis (CMT) is the third commonest congenital deformity, commonly presenting in the first week of life. Due to contracture and shortening of the sternocleidomastoid muscle, the head is tilted towards the affected side; however there may also be a varying degree of rotation towards the contralateral side. Most infants with CMT can be managed non-surgically, however if this is unsuccessful surgery may be necessary, with many different techniques described. In this case report, we describe a 17-year old woman with persistent left sided CMT despite botulinum toxin paralysis that was successfully treated with surgery.