Infected congenital urethral diverticulum in an adult male.

Congenital anterior urethral diverticulum is a rare anomaly. The majority present in infancy with urinary obstruction. Those who present beyond infancy do so on account of recurrent urinary tract infection or dribbling. We present a case of congenital anterior urethral diverticulum manifesting in adulthood with suppuration in the diverticulum.     

Screening for prostate cancer

This article provides a review of present evidence that suggests that screening achieves a reduction in prostate cancer mortality. Aspects of quality of life and cost effectiveness are reviewed, as well as present test performance. The questions addressed in this article include the following: Is screening in its present form acceptable as a public health instrument? What changes are needed to improve the screening procedure? What are the research priorities in this field, assuming that the present evidence of prostate cancer mortality reduction is eventually confirmed by ongoing randomized controlled trials?     

Radiation treatment of bladder squamous cell carcinoma in a patient with spina bifida: A case report

Bladder cancer is the sixth most common cancer in Canada. While most patients present with transitional cell carcinoma, few present with squamous cell carcinoma (SCC). Risk factors for SCC include a history of chronic urinary tract infection, urothelial inflammation and indwelling catheters. We present the management of a patient with locally advanced SCC of the bladder.     

Congenital Urethrocutaneous Fistula—Our Experience with Nine Cases

Congenital urethrocutaneous fistula is a very rare anomaly with about 40 odd cases reported in literature till 2008 .We present here 9 such cases all of whom were uncircumcised at presentation.7 out of 9 cases had a fistula in the distal shaft and the rest 2 cases had a fistula in the mid-shaft of the penis with an associated chordee.Associated congenital anomaly was present in only one case which had an associated imperforate anus . When the fistula was present distally , we did a primary repair of the fistula which was reinforced by a Bayer's Flap. When the fistula was present in the mid shaft we did a Primary repair of the fistula & reinforced it by a Tunica Vaginalis Flap.     

Congenital bronchoesophageal fistula in an elderly lady

We present a case report of a congenital bronchoesophageal fistula presenting late in life. Bronchoesophageal fistulae commonly present in neonates, but sometimes, as in the present case they may be clinically silent till old age. She had a relatively short symptomatic period of around eighteen months. She was diagnosed on the basis of contrast computed tomography (CT), bronchoscopy and esophagoscopy, and underwent resection.     

A Numerical Investigation for a Model of the Solid-Gas Phase in a Crystal Growth Apparatus

We present discretization and solver methods for a model of the solid-gas phase in a crystal growth apparatus. The model equations are coupled Eulerian and heat-transfer equations with flux boundary conditions. For a more detailed discussion we consider simpler equations and present time- and space-decomposition methods as solver methods to decouple the multi-physics processes. We present the error analysis for the discretization and solver methods. Numerical experiments are performed for the Eulerian and heat-transfer equation using decomposition methods. We present a real-life application of a crystal growth apparatus, based on underlying stationary heat conduction. Finally we discuss further error analysis and application to a more complex model of crystal growth.     

Fractured retained ureteral stent in a patient lost to follow-up

Retained ureteral stents in patients lost to follow-up present a challenge to urologists. Patients may present with recurrent flank pain, pyelonephritis, stent migration or encrustation, and ureteral obstruction, with resultant renal failure. Rarely, a long-indwelling period may result in stent fragmentation. Herein, we present a case of a fractured retained ureteral stent noted in a patient lost to follow-up for five years and resurfaced only after complaints of contralateral renal colic.     

Large aneurysm of innominate vein: extremely rare cause of mediastinal mass

Aneurysms of the innominate vein are extremely rare. Fifteen such cases have been reported in literature. They may be asymptomatic or may present as a mediastinal mass with compression of adjacent structures or may present with vascular complications like thromboembolism or rupture. We present a case of large innominate vein aneurysm presenting as a mediastinal mass that was surgically excised through a left thoracotomy without use of cardiopulmonary bypass.     

Die konservative Therapie des Hallux rigidus

Hallux rigidus is a common pathology in foot and ankle surgery. Despite its clinical relevance there are only few studies regarding the conservative treatment of Hallux rigidus. The present review illustrates the present literature. The present literature supports the use of foot orthoses and insoles as well as physiotherapy with mobilization in cases of stage I-II Hallux rigidus.     

Epididymo‐orchitis due to Brucella melitensis: A case report in a nonendemic area and review of the literature

Brucella epididymo‐orchitis (BEO), first described by Hardy in 1928, is a focal genitourinary complication of human brucellosis. This disease is endemic in many parts of the world, but might present as a diagnostic and therapeutic challenge to practicing physicians in nonendemic areas, such as Hong Kong. In the present study, we describe a case of BEO and present a literature review of the aetiology, diagnosis and management of this rare clinical condition.     

Adult malrotation: a case report and review of the literature

Midgut malrotation is an anomaly of fetal intestinal rotation that usually presents in the first month of life. It is rare for malrotation to present in adulthood. Symptomatic patients present either acutely with bowel obstruction and intestinal ischemia with a midgut or cecal volvulus, or chronically with vague abdominal pain. Chronic symptoms can often make the diagnosis difficult. Findings diagnostic of malrotation are described using several modalities such as barium studies, computed tomography (CT) scans, angiography, and often emergent laparotomy. Treatment remains the Ladd procedure originally described by Dr. Ladd in 1936. Complete resolution of acute obstruction or chronic abdominal pain is the result of a high index of suspicion for malrotation, appropriate diagnostic studies, and aggressive definitive surgical treatment. We present a case of malrotation in an adult who presented with chronic abdominal pain. Midgut malrotation is a congenital anomaly referring to either lack of or incomplete rotation of the fetal intestines around the axis of the superior mesenteric artery during fetal development. Most patients present with bilious vomiting in the first month of life because of duodenal obstruction or a volvulus. It is rare for this condition to present in adulthood. The true incidence in adults is difficult to estimate because most patients who remain are asymptomatic and their conditions are, therefore, never diagnosed. A literature review by von Flue et al cites 40 cases from 1923 to 1992. Patients who are symptomatic often present either acutely with bowel obstruction and intestinal ischemia with a midgut or cecal volvulus or chronically with vague abdominal pain. These symptoms are caused by peritoneal bands first described by Ladd in 1932. These bands run from the cecum to the right lateral abdominal wall. We present a case of malrotation in an adult who presented with chronic abdominal pain.     

Trussed structure using ‘LOCK’ technique septal reconstruction in contracted nose with severe septal deficiency. A retrospective review on 57 cases

We present a short communication on the use of a retrograde approach in the DMCA Perforator flap in cases of reconstruction post SCC excision of the hand. We illustrate the anatomy, and present intra- and post-operative findings.     

一例狼疮样抗凝物和抗磷脂抗体综合征患者在非体外循环下行冠状动脉旁路移植术时Hepcon(R)系统的应用

狼疮样抗凝物(LAC)血清抗体阳性,伴或不伴抗磷脂综合征患者的心脏手术是一项特殊的挑战.其中首要的难题是如何处理狼疮样抗凝抗体对抗凝监测的干扰.本文报道了这样一例拟行冠状动脉旁路移植术(CABG)的患者,并对狼疮样抗凝物、抗磷脂综合征作了综述,以及在以往的研究基础上提出了一套在心脏手术中充分抗凝的方案.     

Appendiceal carcinoid tumor with lymph node metastasis in a child: case report and review of the literature

Most appendiceal carcinoids (ACs) in children present without lymph node metastasis. Lymph node metastasis is rarely present when primary tumor diameter exceeds 1 cm. We present the extraordinary case of an AC with a primary tumor diameter of 0.7 cm and infiltration of the mesentery, as well as 1 positive lymph node of the mesentery in a 14-year-old boy. Besides adding a rare case, we review the data published in the current literature on AC with lymph node metastasis in children and summarize up-to-date guidelines for diagnostic workup, therapy, and follow-up.     

Magnetic resonance imaging and preoperative evaluation of cancer of the kidney. The results apropos of 60 cases

Sixty renal carcinomas confirmed at surgery or autopsy were studied. Capsular effraction, present in 17 cases, was well assessed in 8 cases, under staged in 8 cases and over staged in 5 cases (sensitivity 47%, specificity 88%). Renal vein involvement was present in 11 cases. In 8 of these 11 cases, a thrombus was present in the inferior vena cava. MRI detected a thrombus in the renal veins in 10/11 cases and in 7/8 cases of caval invasion. The false negative case was due to a huge right upper pole tumor laminating the inferior vena cava. The false positive case was due to an enlarged lymph node compressing the inferior vena cava. Cranial extension of the thrombus was well assessed in 6 of the 7 cases. One thrombus in the right atrium was missed. Lymph node involvement was present in 10 cases and correctly diagnosed by MRI in 7 cases. Three false negative cases were noted, because of microscopic invasion in non enlarged lymph nodes. Adjacent organ invasion, present in 2 cases, was detected in 1 case of liver invasion. Initial results of MRI seem very promising and at present, the best indications of MRI in pre-operative evaluation of a renal carcinoma are assessment of caval extension and spread to adjacent organs in patients with large tumors.     

Fix and replace:An emerging paradigm for treating acetabular fractures in older patients

Acetabular fractures in older patients are challenging to manage.The "fix and replace" construct may present a new paradigm for the management of these injuries.We present the current challenge of acetabular fractures in older patients.We present this in the context of the current literature.This invited editorial presents early results from our centre and the ongoing challenges are discussed.     

The relationship between weight at birth, anthropometric data and reading age of white schoolchildren

The relationship between weight at birth, reading ability and present weight in a group of 220 junior primary schoolchildren from a predominantly professional-class Westville population, was investigated. No statistical correlation was found between these variables. In view of the high birth weights of the children in this study, it is suggested that the phenomenon of intellectual stunting of low birth weight children (less than 2000 g), which has been reported from Scotland and the USA, may not present a problem in children from affluent populations, such as those of the present study.     

Burkitt lymphoma presenting as colonic ischemia and overwhelming sepsis

Lymphomas may occasionally present as acute surgical emergencies in children, most commonly because of obstruction, intussusception, or direct bowel invasion. We present the case of a 14-year-old adolescent boy who presented with septic shock and was found to have necrosis of the cecum because of a Burkitt lymphoma. The cause of the ischemia appeared to be mesenteric infiltration and subsequent vascular compromise of the bowel. We discuss the management of this patient and present a review of the literature.     

Spigelian–cryptorchidism syndrome in an adult male complaining of primary infertility: Case report

History of cryptorchidism is present in about 10% of infertile patients seeking medical help, whereas 20% of them are azoospermic. Most of the patients with bilateral cryptorchidism have a low testicular volume and high serum FSH level. Ectopic testes are present only in 5% of the patients with cryptorchidism. The anterior abdominal wall is a rare site for ectopic testis where Spigelian hernia is usually accompanied. We present a case of bilateral ectopic anterior abdominal wall testes associated with Spigelian hernia on the left side.     

Consistent Forcing Scheme in the Simplified Lattice Boltzmann Method for Incompressible Flows

Considering the fact that the lattice discrete effects are neglected while introducing a body force into the simplified lattice Boltzmann method (SLBM), we propose a consistent forcing scheme in SLBM for incompressible flows with external forces. The lattice discrete effects are considered at the level of distribution functions in the present forcing scheme. Consequently, it is more accurate compared with the original forcing scheme used in SLBM. Through Taylor series expansion and Chapman-Enskog (CE) expansion analysis, the present forcing scheme can be proven to recover the macroscopic Navier-Stokes (N-S) equations. Then, the macroscopic equations are resolved through a fractional step technique. Furthermore, the material derivative term is discretized by the central difference method. To verify the results of the present scheme, we simulate with multiple forms of external force interactions including the space- and time-dependent body forces. Hence, the present forcing scheme overcomes the disadvantages of the original forcing scheme and the body force can be accurately imposed in the present scheme even when a coarse mesh is applied while the original scheme fails. Excellent agreements between the analytical solutions and our numerical results can be observed.