Nievescovington6138

Gastrointestinal stromal tumor of the stomach with lymph node metastasis is a rare condition, and few cases have been treated by gastrectomy and systematic lymph node dissection.

We report the case of a patient who was treated by local resection with laparoscopic and endoscopic cooperative surgery and lymph node pick-up resection. A 73-year-old woman presented with gastric submucosal tumor and swollen lymph node. The submucosal tumor was 30 mm in size. After surgery, the tumor was confirmed to be a gastrointestinal stromal tumor by immunostaining. No recurrence was noted 36 months following the surgery.

Laparoscopic and endoscopic cooperative surgery allows minimal resection because the exact resection margin can be identified. Therefore, endoscopy is a useful aid in the treatment of gastric gastrointestinal stromal tumor. The MIB-1 index of metastatic lymph node was lower than that of a primary lesion; hence, the prognosis might not depend on lymph node metastasis.

Laparoscopic and endoscopic cooperative surgery and lymph node pick-up resection were useful and minimally invasive. Systematic lymph node dissection is not a viable option.

Laparoscopic and endoscopic cooperative surgery and lymph node pick-up resection were useful and minimally invasive. Systematic lymph node dissection is not a viable option.

Hirschsprung's disease (HSCR) or megacolon congenital is the most common congenital intestinal motility disorder and characterized by the absence of ganglion cells (aganglionosis) in the myenteric plexus and submucosa of the distal intestine.

This study reports three cases of adult HSCR, with all young female patients who underwent colostomy for obstructive ileus. The chosen definitive therapies were Duhamel pull-through procedure combined with a temporary coloanal stump.

The three patients underwent Duhamel pull-through procedure with temporary anal stump in conjunction with stoma reversal. The temporary anal stumps were removed within 1-2 weeks after pull-through procedure. All patients were discharged from the hospital and underwent routine follow-up. All patients had fecal incontinence in early follow-up which resolved shortly afterwards. Long term follow-up showed normal intestinal functions and good cosmetic results.

The combination of Duhamel pull-through procedure with temporary coloanal stump in definitive therapy of adults with HSCR is a safe and effective technique.

The combination of Duhamel pull-through procedure with temporary coloanal stump in definitive therapy of adults with HSCR is a safe and effective technique.

Hamartoma of the hypothalamus represents a well-known but rare cause of central precocious puberty and gelastic epilepsy. Due to the delicate site in which a tumor is located, surgery is often difficult and associated with considerable risks.

10-Year old girl presented with early and regular menstruation at the age of 1 year each cycle lasted for 3 days. She had developed breast, axillary and pubic hair at the age of five, and seven years respectively, with history of difficulty in speech especially articulation and epilepsy since childhood for which she is on medications. She had attacks of an inappropriate laugh. The laboratory tests were consisted with central precocious puberty, MRI shows suprasellar mass. She received leuprolide and antiepileptic medicines until surgery planned. Surgery was done with complete resection, with histopathology showing hypothalamic hamartoma. After surgery, there was complete remission of seizure. She developed recurrence 4 years later and she is currently on anticonvulsa are managed by an experienced multidisciplinary team and lifelong follow up is recommended.

Herniation of the ureter into the inguinal canal is a rare occurrence. There have been reports of inadvertent injury to the ureter during routine inguinal hernia repair. After an extensive search of the literature, we believe that this is the first case to be managed via laparoscopic Trans Abdominal Pre-Peritoneal Repair and would like to highlight the technical details of the laparoscopic procedure and is presented in line with SCARE 2018 Guidelines [1].

A 60-year-old male presented with left inguinal hernia. He also complained of an increase in frequency of micturition, with an occasional radiating pain from loin to the groin. Imaging revealed the left ureter coursing into the left inguinal canal, descending into the scrotum, and looping back to enter the bladder with mild hydroureteronephrosis. Patient underwent a laparoscopic repair of the inguinal hernia with reduction of ureter under ureteroscope guidance and stent placement.

The presence of ureter buried in a large amount of fat can be mistaken for a lipoma of the cord or extraperitoneal fat and injured with blind clamping and division. Presence of fat without an obvious sac should alert the surgeon to the possibility of ureter being a content.

Laparoscopy is safe, technically feasible, offers good visualization of all hernial orifices, demonstrates complete reduction of ureter from inguinal canal under vision, allows manipulation of ureter under the vision for ureteroscopy and stenting, making sure there are no loops or kinking and allows placement of mesh in the preperitoneal space.

Laparoscopy is safe, technically feasible, offers good visualization of all hernial orifices, demonstrates complete reduction of ureter from inguinal canal under vision, allows manipulation of ureter under the vision for ureteroscopy and stenting, making sure there are no loops or kinking and allows placement of mesh in the preperitoneal space.

Gestational gigantomastia (GG) is a rare condition manifesting as a fast and excessive growth of the breasts in pregnant women. CC-92480 datasheet Its etiology is still unclear, with theories ranging from hormonal imbalances, unregulated immune response, to hypersensitivity. Medical interventions are mainly surgical in nature, though some pharmacological medications are of debatable efficacy.

A 33-year old Saudi gravida 3 para 2 presents continuous breast enlargement since the start of her pregnancy. She complains of skin ulcerations and discharge which was initially treated conservatively with topical antibiotics. Days after she came back with worsening GG symptoms, and was admitted for bilateral skin sparing mastectomy and reconstruction, and successfully recovered. The patient came back with problems concerning the surgical implant and wound infection. Emergency operation was performed for implant removal and wound treatment. Labor induction was performed by the OB-GYN on her 39 week. The patient opted for autogenous reconstruction by bilateral latissimus dorsi flap months after delivery. After treatment of minor surgical complications, the patient successfully recovered.

Surgery is one of the most effective interventions for GG. Total mastectomy is preferred due to lesser risk of recurrence in subsequent pregnancies. Reduction mammoplasty offers the breastfeeding option if conducted before the delivery, but poses higher risk of recurrence in future pregnancies.

The patient's gestational gigantomastia condition was complicated by several ulcerations and infections. Surgery was conducted alongside antibiotic treatment. This report also highlights the importance of follow ups in managing complications.

The patient's gestational gigantomastia condition was complicated by several ulcerations and infections. Surgery was conducted alongside antibiotic treatment. This report also highlights the importance of follow ups in managing complications.Chronic cold stress has long-term dramatic effects on the animal immune and neuroendocrine systems. As one of the important regions of the brain, the hippocampus is the main region involved in response to stressors. Nevertheless, the impact to the hippocampus following cold exposure and the underlying mechanism involved are not clear. To evaluate the response of the hippocampus during chronic cold stress, male C57BL/6 mice were exposed to 4 °C, 3 h per day for 1 week, after which neuroinflammation and the molecular and signaling pathways in the hippocampus response to cold stress were investigated. To confirm the potential mechanism, BV2 cells were treated with γ-aminobutyric acid (GABA) and BAY 11-7082 and MCC950, then the activation of microglia and key proteins involved in the regulation of inflammation were measured. We demonstrated that chronic cold stress induced the activation of microglia, the emergence of neuroinflammation, and the impairment of neurons in the hippocampus, which might be the result of GABA-mediated activation of nod-like receptor protein 3 (NLRP3) inflammasome and the nuclear factor kappa B (NF-κB) signaling pathway.In this study, we investigated the ability of children with developmental language disorder (DLD) to extend nouns referring to different categories of novel objects. In a word extension task, we used several types of object entities (solid, animate, nonsolid, functional, and spatial relations) for which children needed to attend to diverse properties (shape, texture, role, or spatial relation) to decide category membership. We compared 15 school-aged children with DLD with typically developing (TD) children matched on either age or vocabulary. Our results indicate that children with DLD were impaired in extending novel words for nonsolid substances and relational objects, whereas age-matched TD children performed well for all object classes. Similar to children with DLD, TD children matched on language had difficulty in extending spatial relation categories. We also show that children with DLD needed more learning exemplars and relied more on shape-based information than TD children, especially for spatial configuration objects. Overall, our findings suggest that children are able to learn regularities between object properties and category organization and to focus on diverse features according to the object presented when extending novel nouns. They also provide clear evidence linking DLD to deficits in novel name generalization and word learning.

In India, Neuromyelitis optica spectrum disorders (NMOSD) can often be misdiagnosed as multiple sclerosis (MS) leading to wrong or delayed treatment. Although diagnostic criteria exist it is important to flag certain highlights in the phenotype by direct comparison which will prompt investigation in the right direction. The aim was to identify distinguishing features, especially differences in disability status and frequency of the optico-spinal syndrome.

This study was designed as a multicentric, hospital based, ambispective, observational study of patients with primary demyelination due to either NMOSD or MS. Various variables were collected using a data extraction proforma and were compared using statistical means.

A total of 212 patients, 166 (78.3%) with MS and 46 (21.7%) with NMOSD, were included from six different cities across India. The male to female ratio was 11.3 in MS group and 12.3 in NMOSD group. Significant differences on logistic regression included patients with NMOSD were more disable patient if the course is relatively short; disability is out of proportion and progression index is ≥0.39 or the patient has had recurrent optico-spinal relapses. It is important to distinguish early in the course NMOSD from MS as timely specific treatment may prevent future disability.