Ewing sarcoma in a geriatric patient

Ewing Sarcoma has been the second most common primary osseous malignancy in childhood and adolescence. It has been described as a highly aggressive neoplasm. This is the oldest case report in the literature with Ewing Sarcoma.     

A new and safe technique for removing cervical esophageal foreign body.

Despite the recent advances in instrumentation and anesthesia, removal of esophageal foreign bodies remains a challenge. Endoscopic removal of foreign bodies has yielded a success rate of 80%. Surgical removal of these foreign bodies is necessary when the endoscopic manipulations fail. Localization and size of the bodies play a critical role in the method of treatment. Here we present a patient with a large stone with sharp edges located in the cervico-thoracic region which was removed after being pushed into the hypopharynx through the esophagus rather than being pushed into the stomach. The technique used proved to be effective and safe; this may be the first use of the procedure in the literature.     

Bronchial asthma associated with intestinal parasites

Fifty patients with bronchial asthma and 50 normal controls were studied in Hacettepe University Medical Center. Forty per cent of the patients with bronchial asthma and 14% of the controls had ascarides in the stool examinations. The significant difference in these two groups indicates that intestinal parasites, should be looked for in the patients with bronchial asthma.     

Myocardial revascularization after pretreatment with the GPIIb/IIIa receptor blocker abciximab

AIM: The present prospective study analysis whether preoperative abciximab treatment 1) increases perioperative risks, 2) alters the quality of the surgical treatment, 3) whether secondary organ complications occur and 4) whether and how the perioperative surgical management has to be modified. METHODS: The perioperative results of patients operated upon after preoperative abciximab treatment (n = 31, 1/1994-4/2000) were compared with an optimal control group (elective patients and no preoperative intervention in the hemostaseological system) and with other patients (elective, urgent, emergency operations) receiving different strategies of preoperative hemostaseological interventions (n = 926, 1/1994-4/2000). All patients were operated upon with a well-defined strategy (one surgeon). 1100 perioperative items/patient were prospectively recorded and analyzed. The 30-day and 6 month follow-up was complete. RESULTS: The mean time interval between end of abciximab therapy and onset of operation was 4.3 h (range: 36-0.5 h, median: 2 h). As compared with the optimal control group (n = 81), perioperative blood loss and the need for substitution of blood and blood products was increased. However, as compared with those patients receiving any type of preoperative intervention in the hemostaseological system (the majority of the patients), no difference was observed regarding intraoperative parameters (duration of extracorporeal circulation and of the operation) and postoperative results (neurological, renal complications, myocardial infarction, psychiatric disturbances, etc.) when abciximab patients were compared with the reference populations. No patient of the abciximab group died within 30 days or during the 6 month follow-up period. CONCLUSION: The data show that coronary artery bypass grafting can be performed with similar results in abciximab-pretreated patients as in patients with other types of preoperative anticoagulation. Only slight modifications of the surgical management are recommended. As indicated by similar use IMA-grafts the quality of surgical treatment was not reduced.     

The use of deferoxamine infusions to enhance the response rate to interferon-α treatment of chronic viral hepatitis B

Summary An individual's iron status may affect the response rate achieved with the use of interferon (IFN) as therapy for chronic viral hepatitis. A total of 27 patients with chronic hepatitis B viral infection, who had elevated serum ferritin levels, were randomized to receive either IFN 5 MU, three times weekly by subcutaneous injection alone ( n = 14) or in combination with cycles of deferoxamine at a dose of 80 mg kg^-1 per cycle ( n = 13) administered over 3 consecutive days, to reduce their iron and maintain a serum ferritin level less than 250 ng ml^-1. All deferoxamine-treated patients were on a low iron-containing diet. An IFN response was defined as a normalization of the serum alanine aminotransferase (ALT) level and seroconversion from hepatitis B e antigen (HBeAg) positivity to hepatitis B e antibody (HBeAb) positivity. The deferoxamine-treated group experienced a reduction in their serum ferritin level to 226 ± 73 ng ml^-1 as a result of the deferoxamine treatment. Six of the 13 (46%) deferoxamine-treated patients and two of the 14 (14%) control patients normalized their ALT levels. Seven of the 13 (54%) deferoxamine but only 14% of the IFN-treated group seroconverted to HBeAb positivity. A greater rate of histological improvement and loss of hepatitis B virus (HBV) DNA was seen in the deferoxamine-treated group. Two of the deferoxamine-treated patients were treated only once, two were treated twice, seven were treated three times and two were treated four times to achieve a ferritin level below 250 ng ml^-1.     

Choroid plexus arteriovenous malformation (AVM) in a newborn. Case report

We report here on an unusual case of AVM with intraventricular hemorrhage in a full-term newborn infant. Clinical and radiological findings are discussed in the light of the recent literature.     

Ruptured chronic encapsulated intracerebral hematoma in infancy: review of the literature with a case report

Objectives We report a case of a 2-month-old boy with chronic encapsulated intracerebral hematoma (EICH) and discuss clinical, radiological and pathological features of the case.Conclusions Chronic EICH in infants is extremely rare in the literature. Only two cases have been previously reported. One of the cases reported in the literature was supratentorial and the other was infratentorial.     

Pr?operative Aufkl?rung über neue Operationsstrategien: Interaktive Software zur Verbesserung der Patienteninformation

Hintergrund   

Im Kontext innovativer klinischer Forschung müssen Patienten in angemessener Form über neuartige chirurgische Strategien informiert werden. Bereits unter Alltagsbedingungen wurde die Qualität der chirurgischen Aufklärung in empirischen Studien als wesentliche Schwachstelle identifiziert. Die Bedeutung der präoperativen Aufklärung in zivilrechtlichen Verfahren zwingt zur Elimination dieser Schwachstelle gerade dann, wenn durch Anwendung neuer chirurgischer Konzepte die Unsicherheit und Unüberschaubarkeit der perioperativen Situation für den Patienten zunimmt.