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1.
Sacrocolpopexy, be it laparoscopic or abdominal, is associated with a risk of mesh extrusion. We report an interesting case
of mesh extrusion with subsequent removal of the mesh from the vagina by the patient. We take this opportunity to review the
literature regarding incidence, predisposing factors and complications of sacrocolpopexy mesh extrusion with specific reference
to this case. 相似文献
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The authors report on a 13-year-old boy who, after exercise, had respiratory distress and left upper quadrant abdominal pain. Initially, a mistaken diagnosis of pneumothorax was made, and a chest tube was inserted. A nasogastric tube was then visualized on chest x-ray in the left hemithorax. He underwent a laparotomy and had herniation of spleen, stomach, and large and small bowel in the left pleural space passing through a traumatic defect in the hemidiaphragm. The laparoscopic Nissen fundoplication 3 years prior was felt to have contributed. A timely and correct diagnosis is essential to avoid the sequelae associated with these injuries and with inappropriate tube thoracostomy. 相似文献
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We describe a case of a desmoid tumour occurring 15 months following an uncomplicated fracture of the left distal radius. The occurrence of a desmoid tumour after fracture is extremely rare and a Medline search revealed only two previous reports. The correlation between the site of trauma and the tumour and the time interval between trauma and presentation strongly supports a causal role of the fracture in the occurrence of this tumour. 相似文献
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Nosé Y 《Artificial organs》1992,16(3):233-234
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Stone CA 《Aesthetic plastic surgery》2000,24(3):185-191
Plastic surgeons require a three-dimensional appreciation of form and function in order to meet reconstructive challenges.
The popular perception that plastic surgeons must be artistic was tested in an observational study of sketch illustrations
in plastic surgery case notes. Only in the trunk and breast category of illustrations could career plastic surgeons demonstrate
superior artistic skill to non-career plastic surgeons and there was little correlation between the artistic merit of a diagram
and the likelihood of its meaning being understood by an independent observer. Simple but accurate outline sketches are as
capable of leading an observer to the correct diagnosis as complex works of art, while illustrations with low diagnostic scores
are not only misleading but may also have medico-legal implications. 相似文献
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Studies have shown no benefit of a subcutaneous fat stitch when closing hip wounds, but all have been in the presence of a drain. Our aim was to determine whether, in the absence of a drain, suturing or not of the subcutaneous fat layer in hip hemiarthroplasty wounds had any significant effect on wound complication rate. We performed a prospective cohort study of 45 hip hemiarthroplasty patients who had a fat stitch and 40 who did not. No drains were used in either group. There were 44 patients in the fat stitch group and 35 in the no fat stitch group after six patients were excluded. The infection rate was 2% for the fat stitch group, and 20% for the no fat stitch group (p=0.02). There were no cases of deep dehiscence in the fat stitch group, but four cases (11%) in the no fat stitch group (p=0.035). The overall complication rate in the fat stitch group was 6.8% compared to 33% in the no fat stitch group (p=0.007). In the absence of a drain, we have found a significant increase in hip hemiarthroplasty wound complications when the subcutaneous fat is not sutured. 相似文献
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Development of a solitary bone cyst – a report of a case suggesting its pathogenesis 总被引:1,自引:0,他引:1
The origin and natural course of solitary bone cysts (SBC) still remain controversial. Knowledge of the process of cyst formation
and enlargement would be helpful for investigating its pathogenesis. Only two papers have described a radiodense nidus of
the diaphysis as a precursor. Their cases were unique in that the initial lesions were in the diaphysis and that the cysts
did not abut onto the epiphyseal line. This study reports a case in a patient with a tiny erosive lesion in the endosteal
surface of the humeral metaphysis, which developed expansively into a typical large cyst over 6 years. Serial roentgenograms
taken every year demonstrated the process of cyst enlargement. This is the first longitudinal study of a case with SBC documented
from its onset.
Received: 2 June 1998 相似文献
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In general, aortic stenosis and regurgitation are the 2 main aortic valve diseases which require surgical treatment. Surgical indication for each has been described in detail in the guidelines established by the Japanese Circulation Society and American Heart Association/American College of Cardiology (AHA/ACC). Most of the cases we daily encounter in clinical practice can be managed within the guideline, although the patient's many other factors are needed to be taken into consideration. On the contrary, in those cases with the conditions which are not mentioned in the guidelines, diagnosis and decisions are always difficult to make. In this article, we are to discuss how to manage cases within and without the guidelines. 相似文献
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Raza SM Lang FF Aggarwal BB Fuller GN Wildrick DM Sawaya R 《Neurosurgery》2002,51(1):2-12; discussion 12-3
OBJECTIVE: Two main forms of cell death are encountered in biology: apoptosis (i.e., programmed cell death) and necrosis (i.e., accidental cell death). Because necrosis and apoptosis can lead to cell removal, one might intuit that they are both desirable in cancer treatment. However, in the setting of glioblastoma multiforme, a malignant brain tumor for which the presence of necrosis is an important diagnostic feature, clinical studies indicate that as the degree of necrosis advances, the patient's prognosis worsens. Despite the apparent importance of this form of cell death, the mechanism of development of necrosis in glioblastomas remains unelucidated. The purpose of this article is to try to resolve this dilemma by hypothesizing the mechanism of necrosis formation in these tumors. METHODS: On the basis of an extensive review of the literature, we present a hypothesis for the mechanism of necrosis formation in glioblastoma multiforme. RESULTS: One of the many possible pathways leading to necrosis formation may involve increased tumor cell secretion of tumor necrosis factor. Procoagulation and antiapoptotic mechanisms resulting from certain pathways could prevent the completion of tumor necrosis factor-induced apoptosis and could promote necrosis as the final mode of cell death. Such a hypothesis would explain the inverse correlation that exists between tumor necrosis and the survival of patients with glioblastomas, because the hypoxia that results from procoagulation selects for tumor cells that are more aggressive and more resistant to apoptosis-inducing therapies. CONCLUSION: A complete understanding of the series of events surrounding necrosis development in glioblastomas that is evidence-based is likely to provide targets for future therapies. On the basis of the potential mechanisms of development of necrosis described in this article, we postulate that effective therapies may have to be directed against the pathways that result in the formation of necrosis. 相似文献
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F. Costea A. R. Pontin J. F. Botha J. A. Halkett D. Kahn 《Transplant international》1999,12(3):229-230
In our study we describe a renal transplant from a living related donor who was found to have a retrocaval ureter. The retrocaval
ureter is a rare congenital anomaly resulting from a defect in the embryological development of the ureter and the inferior
vena cava (IVC). The compression of the ureter between the IVC and the vertebrae can result in progressive hydronephrosis.
The non-dilated segment of the ureter was used for the uretero-neocystostomy. The patient presented with ureteric obstruction
in the immediate post-transplant period, and at surgical exploration the uretero-neocystostomy was revised using the dilated
portion of the ureter. We recommend that when transplanting a kidney with a retrocaval ureter, caution should be exercised
in using the non-dilated portion of the ureter, since either the blood supply may be compromised or the peristalsis may be
interrupted.
Received: 30 June 1998 Received after revision: 26 January 1999 Accepted: 26 February 1999 相似文献
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Background
The importance of the radial head to elbow function and stability is increasingly apparent. Although preservation of the native radial head is preferred, severely comminuted fractures may necessitate resection or arthroplasty. Silastic radial head arthroplasty has been condemned on the basis of several sporadic reports of silicone synovitis. However, problems of “overstuffing,” cartilage wear, and motion loss are becoming apparent with metal prostheses, indicating this also is not an ideal solution. Thus, the choices remain controversial. 相似文献20.
J.C. Parodi 《Acta chirurgica Belgica》2013,113(5):289-291
Background: Retrorectal tumours are lesions with a wide range of histological differentiation that are often diagnostic and clinical challenges due to their rare occurrence. Many cases of this pathology are treated in regional hospitals, which results in serious complications because physicians fail to recognize this pathology. We present our experience in treating these tumours.Methods: A retrospective analysis of a prospectively maintained database was performed using the Vilnius University Hospital Santaros Clinics patient database. Thirty-five cases were identified.Results: Occurrence of retrorectal tumours was higher in women than in men and accounted for 82.86% and 17.14%, respectively. Computer tomography and magnetic resonance imaging were the main methods used to confirm diagnosis and plan surgical treatment. We have used a laparotomy, perineal or combined approach for tumour extirpation. The laparotomy approach was the most used, followed by perineal extirpation. The most common histological type was cystic hamartoma, accounting for 20% of cases. In 80% of cases, the histological findings greatly varied. Hospital stays varied from 3 to 21 days with a mean of 11.6?±?5.83 days. The postoperative complication rate was 17.14% and was present in six cases. Overall survival was 85.17%, with an average follow-up period of 71.83 months. There were no recurrent tumours diagnosed during follow-up.Conclusion: Retrorectal tumours are a very rare pathology with high histological heterogeneity and problematic diagnostics. Patients should be referred to a tertiary centre that has experience and diagnostic capabilities for the best diagnostic and treatment options. 相似文献