Medial meniscal cyst: a case report

Meniscal cysts are a rare disease constantly combined with a horizontal meniscal lesion. Currently, nuclear magnetic resonance (MRI) is the main diagnostic tool, because of its high sensitivity and specificity, and decompression arthroscopy combined with selective meniscectomy is the treatment of choice. The Authors report a case of a voluminous medial meniscal cyst where instrumental examination, MRI, was fundamental for the preoperative diagnosis of the horizontal meniscal lesion causing the cystic degeneration of the meniscus. The treatment performed was selective meniscectomy of the body and posterior horn of the medial meniscus and decompression of the voluminous cyst by arthroscopy. Physical examination after six months showed the complete resolution of swelling at the medial hemirima, no walking pain and normal range of motion.     

Colitis cystica profunda of the rectum: report of a case and review of the literature

Colitis cystica profunda is a rare intestinal lesion. Because of its clinical expression (rectorrhagia, mucorrhea and abdominal pain) and the way it appears to current imaging techniques this disease presents features which can be associated with colon neoplasm. Its diagnosis has to be confirmed histologically, and its etiology remains unclear. The following is a case report of colitis cystica profunda recurring 20 years after a first episode in a white woman, who had had an anterior resection of the sigmoid colon and upper rectum to deal with a colitis cystica profunda-induced stenosis of the sigmoid colon and at 41 underwent the transanal removal of a polypoid lesion. A review of 20 cases in the literature showed that colitis cystica profunda has a predilection for the male and generally affects the medial and lower rectum and the sigmoid colon. The literature also confirmed the association with ulcerative rectocolitis, Crohn's disease and rectal prolapse. The type of treatment varies from surgical, medical, and endoscopic to no treatment at all.     

Radiation-induced intracranial meningiomas: review of six operated cases

It is well known that radiation can induce meningiomas. These tumors usually arise in patients with a history of low-dose radiation to the scalp for treatment of tinea capitis or high-dose radiation for a previous brain tumor. Radiation-associated meningiomas (RAMs) morphologically resemble their spontaneously arising counterparts. However, RAMs frequently present a more malignant phenotype and, as such, are diagnosed as atypical or aggressive meningiomas and occur predominantly in younger patients. This paper describes six cases of radiation-associated intracranial meningiomas in patients previously treated with low-dose radiation to the scalp for tinea capitis.     

Inferior approach for the isolation of the left-middle hepatic veins in liver resections: a safe way

BACKGROUND: Control of blood outflow from the liver has become mandatory to reduce back-bleeding and prevent air emboli in difficult liver resections when dealing with the hepatic veins. Selective control of the major hepatic veins rather than unselective vena cava clamping is preferable in most of these cases. Extrahepatic isolation of the left-middle hepatic veins has been considered for a long time to be a hazardous maneuver, and there is no general agreement about the technique that should be used. HYPOTHESIS: The purpose of this article is to describe a technique used by us for the isolation of the left-middle hepatic veins so that total or selective (hemihepatic) vascular exclusion of the liver can be performed without vena cava clamping. METHODS: The inferior approach is easily accomplished soon after the exposure of some anatomical landmarks, and a triangle is described in which a clamp is inserted or, alternatively, when one uses a superior approach, when the instrument tip exits to enable the veins' looping. CONCLUSION: Compared with other techniques, this approach is easier and safer to perform in nearly all cases, providing that there is no tumor located close to the vena cava or hepatic vein junction that contraindicates this maneuver.     

Improving mandibular contour: A pilot study for indication of PPLA traction thread use

Background: The request for less-aggressive procedures to improve mandibular contour is increasing. Several kinds of threads have been used for this purpose. Nevertheless, PLLA (poly-L-Lactic acid) traction thread procedure has not been previously described. Aim: To investigate the role of PLLA traction threads in improving mandibular contour. Methods: Twenty women were enrolled in the study. They were differentially classified for skin laxity. Patients were treated in a single session with two PLLA traction threads per side. Specific post-procedure instructions were given to patients, and complications occurred after the procedures were estimated. A Fisher’s t-test was performed to identify criteria related to longevity of results. Results: We found longevity of results to be associated with younger age (p = 0.001), absence of severe skin laxity of jawline and neck (p = 0.001), and aesthetic satisfaction (p = 0.024). Edema, swelling, and temporary skin contour irregularities were found in most cases (N = 16; 80%), whereas paresthesia resolving without sequelae in 2–4 weeks was found in two cases (10%). Conclusions: Our results show that selected patients, younger than 51 and showing a mild-moderate degree of skin laxity of jawline and neck angle represent ideal candidates for PLLA traction thread treatment. Further studies will be performed to confirm our results.     

Experimental study of colonic anastomoses. Comparison of different suture methods in the rat

A comparative experimental study was conducted on three different suture techniques for end-to-end colonic anastomoses. The development of stenosis, perivisceral adhesions and resistance to endoluminal pressure were assessed. The results show that the one layer all-coat interrupted stitch anastomosis displays less resistance to endoluminal pressure during the first seven days but is followed by fewer complications.     

Retinal blood flow autoregulation after dynamic exercise in healthy young subjects

PURPOSE: To evaluate the retinal blood flow before and after the increase in systemic blood pressure to assess the autoregulation in healthy young subjects. METHODS: Twenty eyes of 20 healthy volunteers were examined. The retinal blood flow was assessed by a Heidelberg retina flowmeter (HRF), while the systemic pressure was assessed by a portable electronic sphygmomanometer. Furthermore intraocular pressure (IOP) was always measured by a Goldmann tonometer immediately after HRF assessments. All measurements of physiological and flow parameters were performed with the subjects seated at rest and then immediately after stair climbing. RESULTS: The IOP decreased significantly after dynamic exercise, while the heart rate and the systemic artery pressure increased significantly. At the baseline, the mean retinal blood flow was 276.8 +/- 80.7 arbitrary units (AU) in the superotemporal area, 243.4 +/- 63.68 AU in the superonasal area, 258.2 +/- 67.37 AU in the inferotemporal area and 243.9 +/- 72.24 AU in the inferonasal area. After dynamic exercise the mean retinal blood flow was 249.8 +/- 86.78 AU in the superotemporal area, 248.7 +/- 63.87 AU in the superonasal area, 245.4 +/- 83.85 AU in the inferotemporal area and 228.8 +/- 62.53 AU in the inferonasal area. No significant change in retinal blood flow was found. CONCLUSION: Our data support the hypothesis that in normal subjects autoregulation is sufficient to compensate the increase in blood pressure and maintain a stable retinal blood flow after exercise.     

Prediction of clinical outcomes in Crohn’s disease by using confocal laser endomicroscopy: results from a prospective multicenter study

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