Rare aneurysmal bone cysts: multifocal,extraosseous, and surface variants

European Journal of Orthopaedic Surgery & Traumatology - Multifocal, extraosseous, and surface aneurysmal bone cysts are rare variants of the primary lesions. The clinicopathological features...     

Laparoscopic vs. Open Liver Resection for Hepatocellular Carcinoma of Cirrhotic Liver: A Case–Control Study

Background

Laparoscopic liver resection is considered a safe and feasible alternative to open surgery for malignant liver lesions. However, laparoscopic surgery in cirrhotic patients remains challenging. The aim of this retrospective case–control study was to compare morbidity, mortality, and long-term patient survival between laparoscopic liver resections (LLR) and open liver resections (OLR) for hepatocellular carcinoma (HCC) in patients with histologically proven cirrhosis.

Methods

A total of 45 patients treated with LLR were matched by cause of cirrhosis, Child-Pugh score, type of surgical resection (subsegmentectomy, segmentectomy, and bisegmentectomy), tumor number, tumor size, and alpha-fetoprotein value with 45 patients treated with OLR. Pre-, intra-, and post-operative variables were compared between groups.

Results

Compared with OLR, the LLR group displayed a significantly shorter operative time (140 vs. 180 min; p = 0.02), shorter hospital stay (7 vs. 12 days; p < 0.0001), and lower morbidity rate (20 vs. 45 % of patients; p = 0.01). A higher rate of R0 resection was observed in the LLR group than in the OLR group (95 vs. 85 %; p = 0.03). Postoperative ascites was more frequently observed in the OLR group (18 vs. 2 %; p = 0.01). Mortality, patient, and disease-free survival rates were similar between groups. The 1-, 5-, and 10-year survival rates were 88, 59, and 12 %, respectively, in the LLR group and 63, 44, and 22 % in the OLR group (p = 0.27).

Conclusions

Significantly shorter operative times, better resection margins, lower postoperative complications, and shorter hospital stay were observed in the LLR group compared with the OLR group. LLR and OLR have similar overall and disease-free survival rates in cirrhotic HCC patients.     

Use of half‐normal saline irrigant with cooled radiofrequency ablation within the great cardiac vein to ablate premature ventricular contractions arising from the left ventricular summit

A 62‐year‐old man was referred to our institution for high‐density, symptomatic premature ventricular contractions (PVCs) with resultant decrease in left ventricular (LV) function having failed prior ablation attempts. Successful, durable ablation of the patient's mid‐myocardial PVC arising from the LV summit region was achieved through the proximal great cardiac vein with ablation depth augmented by use of half‐normal saline irrigant. Though standard ablation of ventricular arrhythmias using normal saline irrigation from the coronary venous system has been well‐reported, this may be of limited value in addressing mid‐myocardial sites of origin. This novel case describes the safe use of cooled radiofrequency ablation with use of half‐normal saline irrigant from the distal coronary sinus as an option to address complex sites of PVC origin such as the LV summit.     

Isolation and characterization of fifteen microsatellite loci in Leopard grouper (Mycteroperca rosacea) via 454 pyrosequencing

Leopard grouper (Mycteroperca rosacea) are distributed from Bahía Magdalena, through the Gulf of California and as far south as Jalisco, Mexico. They are listed as Vulnerable on the IUCN Red List due to significant fishing-induced declines over the past decade. Microsatellite loci were isolated by constructing a shotgun genomic library and sequencing using 454 XL + titanium chemistry. We characterized 15 polymorphic loci in 120 samples from three geographic locations. Genotyping yielded 15–60 alleles per locus with observed levels of heterozygosity ranging from 0.575 to 0.975.