Quinnmcguire2744
The conclusions drawn from the literature reviewed in this article indicate that changes in expression of Syndecan protein can have profound effects on tumor size, metastatic capability, and overall patient survival rate. Further, while data regarding the therapeutic targeting of Syndecan proteins is sparse, the available literature does demonstrate promise for their use in cancer treatment going forward.
Bezoars result from undigested material having an incidence of 0.4-1% (Gunner et al., 2012). Impaired gastrointestinal motility is one of the risk factors. The aim of this article is to highlight the importance of this commonly disregarded entity as well as the different treatment modalities available.
A 68-year-old female presented to our emergency department complaining of colicky lower left abdominal pain associated with vomiting and absence of bowel movements for the past 4 days. She had a previous history of a subtotal gastrectomy due to gastric cancer. The physical examination revealed a lower left quadrant palpable mass. Abdominopelvic CT scan showed distension of the gastric remnant with anastomotic obstruction caused by a bezoar. Attempted endoscopic dissolution of the bezoar was unsuccessful. The patient then underwent surgery enterotomy proximal to the obstruction with extraction of the mass.
Bezoars are responsible for 0.4%-4% of cases of mechanical gastrointestinal obstruction (Dikicier et al., 2015). Contrast-enhanced CT scan is the best diagnostic test with a sensitivity and specificity of 90% and 57%, respectively (Kim et al., 2003). Treatment options differ according to the type, size and location of the bezoar as well as clinical presentation. Conservative measures such as chemical dissolution and endoscopic fragmentation and extraction can be used with surgery being usually required for a bezoar-induced gastrointestinal obstruction.
The clinical findings of bezoar-induced ileus do not differ from the other different causes of mechanical intestinal obstruction. Hence, a high grade of suspicion and an early radiological exam are the keys for a prompt diagnosis and treatment.
The clinical findings of bezoar-induced ileus do not differ from the other different causes of mechanical intestinal obstruction. Hence, a high grade of suspicion and an early radiological exam are the keys for a prompt diagnosis and treatment.
Hypothyroidism reduces the recruitment, maturation, and activity of bone cells, decreasing bone resorption and formation. Several investigations have reported that T4 replacement therapy is associated with a significant decrease in bone mineral density in various skeletal parts, while others have failed to corroborate these results. The present study describes both a literature review and our own experience with dental implants in patients with hypothyroidism undergoing T4 replacement therapy.
The study included two parts a literature review and case series. The literature review included 12 articles documenting the success rate of osseointegrated dental implants in patients with hypothyroidism. The clinical cases were chosen from King Saud University Dental College, Riyadh. The patients' identity was only available to the main researcher. The inclusion criteria for the clinical cases were T4-treated hypothyroidism, age 20-60 years, and use of dental implants with a follow-up period of 6-12 months after lceived dental implants fulfilled the criteria for successful implants.
Diagnosis and treatment of rare diseases are challenging because experience and evidence are limited. Primary tracheal tumors have a low prevalence but awareness of these is important to avoid misdiagnoses. We present a first case of a tracheal microcystic reticular schwannoma in which diagnosis and treatment recommendations were revised several times resulting in months of anxious uncertainty for the patient before complete resection and extensive histopathologic examination were performed.
A 65-year old woman complained about coughing and cervical pain. Tomographies revealed a tumor of the dorsolateral trachea. After repeated biopsies pathologists and tumorboards in different hospitals could not agree on diagnosis or treatment recommendation, so the impatient patient opted for a complete resection for definite treatment.
Neoplasms of the posterior mediastinum are mainly neurogenic. In rare cases they may originate in the trachea and can be difficult to differentiate from other tumor entities if only b option for definitive treatment with very low recurrence rates.
Tunneled CVC is being increasingly used worldwide as a mean of vascular access for hemodialysis. Among these, one of the emerging complications is that of the "embedded" or stuck catheter. There have been registered cases of vasomotor collapse, non-ST-elevation myocardial infarction (NSTEMI), avulsion of the vena cava, damage to the tricuspid valve having fatal consequences, and breakage of the CVC (Lodi et al., 2016).
A 63-year-old female with mature AV fistula came to the clinic for removal of a tunnelled 15 fr double lumen dialysis catheter (Medical Components, Harleysville, Pensylvania) that had been inserted into the left internal jugular vein 15 months prior to this visit. In the OR, our surgical attempt to remove the catheter failed. The first few dilation procedures were performed using 0.035-inch guidewire and balloon catheters. The technique was subsequently modified as follows. In this case we use a 6 × 60 mm Scoreflex balloon. Endoluminal dilation was repeated along the length of the catheter up to the cuff. Once the catheter has been removed, pressure was applied using sterile gauze to aid hemostasis. find more The procedure was successful without any observed complication.
Endoluminal dilatation technique is considered as the easiest and safest technique to remove hemodialysis catheter. Our case is the first stuck hemodialysis catheter reported in Indonesia and probably the first case that happen and treat with endoluminal dilatation technique in our country.
Endoluminal dilatation technique is considered as the easiest and safest technique to remove hemodialysis catheter. Our case is the first stuck hemodialysis catheter reported in Indonesia and probably the first case that happen and treat with endoluminal dilatation technique in our country.
Segmental aganglionosis (the absence of ganglions) is a rare presentation of Hirschsprung's disease, whereby only limited segment/segments of aganglionic bowel is interposed between segments of innervated bowel, or "skip area of normal innervations is present within an area of aganglionosis.
We reported a case of a 3 day old male newborn who presented with failure to pass meconium along with progressive abdominal distension. There were skip lesions present in between. Mikulicz double barrel enterostomy was carried out, which was followed by an uneventful postoperative period. Four months later, the patient was admitted for levelling biopsies which revealed the absence of ganglions in the terminal ileum as well as in the rectosigmoid junction. But the ganglions were present in between and proximal to the terminal ileum where the previously dilated small bowel segment was resected. This presentation was contradicted the most accepted migration theory of Hirschsprung's disease.
As seen in our case, and in21 other cases published between 1954-2016, we highly recommend that leveling/mapping biopsies should definitely include the cecal pole and the small bowel segments proximal to the ileocecal valve as well as the multilevel colonic biopsies down till the rectum.
Reporting of these cases brings out interesting questions with respect to the pathogenesis and serves to highlight the existence of several variants within the spectrum of Hirschsprung's disease.
Reporting of these cases brings out interesting questions with respect to the pathogenesis and serves to highlight the existence of several variants within the spectrum of Hirschsprung's disease.
Flexor Pollicis Longus (FPL) lies in the volar compartment of the forearm and is responsible for the flexion of the distal phalanx of the thumb. The innervation of FPL is provided by an isolated motor branch of the anterior interosseus nerve (AIN), a branch of the median nerve. AIN disfunction causes symptoms of exclusive motor involvement concerning the FPL muscle. Solitary paralysis of the FPL is very uncommon in clinical practice.
We report the case report of a bilateral isolated paralysis of Flexor Pollicis Longus (FPL) that occurred after a trauma. Two years after the injury, no organic lesions were found and instrumental exams did not suggest any diagnosis. Surgical exploration of FPL and its innervation allowed to diagnose a pure post-traumatic bilateral neuroapraxia sustained by the presence of post traumatic connective fibrous bands.
Diagnostic and therapeutic bands release allowed the immediate functional recovery of the nerve function and the consequent restoration of FPL function. The surgical exploration of the suspected injured nerve was the resolutive procedure for diagnosis and treatment of the disease. During the surgical exploration, the cause of FPL palsy was identified and removed with a complete recovery of the neuromuscular unit function.
This case is very peculiar because of the clinical presentation with an important bilateral functional limitation of FPL. The release allowed the complete restoration of FPL function. No similar cases were described in literature.
This case is very peculiar because of the clinical presentation with an important bilateral functional limitation of FPL. The release allowed the complete restoration of FPL function. No similar cases were described in literature.
Long-level intramedullary astrocytomas complicated with spine scoliosis are rare. Surgical treatment of such tumors becomes more complicated and challenging when spinal scoliosis is present. However, studies describing the treatment of long segmental intramedullary spinal cord astrocytomas complicated with severe spine scoliosis have been rarely reported.
Two cases of long-level intramedullary astrocytomas complicated with severe spine scoliosis were surgically treated with one-stage operation of tumor resection and scoliosis correction in this report. Case 1 A 16-year-old boy presented to our hospital with a five-month progressive paresthesia, weakness of the left lower limb, and a long-time abnormal body appearance. MRI showed a T4-T12 intramedullary tumor combined with spinal scoliosis. Case 2 A 14-year-old boy presented at our service with a 6-year history of visible spine scoliosis and a 1-year progressive motor disability of bilateral lower limbs. Spine MRI indicated a long-level abnormal syringomyelia signal from C4 to L1 and there was irregular enhancement after intravenous contrast medium administration at C7-T2 and T9-T12 level.
We performed a laminectomy over the whole length of the tumor and corrected the scoliosis with trans-pedicle screws. The patients exhibited a long-time tumor free with largely neurological function preservation. One-stage operation did not generate severe short- or long-term complications. The correction of the scoliosis prevented the progression of the spinal deformity and facilitated the recovery of normal life.
This case report demonstrates that the one-stage resection of long-level intramedullary astrocytoma and correction of the complicated scoliosis might be a feasible option.
This case report demonstrates that the one-stage resection of long-level intramedullary astrocytoma and correction of the complicated scoliosis might be a feasible option.
