The Epidemiology of Gender Dysphoria in Iran: The First Nationwide Study

Archives of Sexual Behavior - Gender dysphoria (GD) is defined as a persistent and distressful incongruence between one’s gender identity and one’s at-birth-assigned sex. Sex...     

A rare metastasis in the hand: a case of cutaneous metastasis of choriocarcinoma to the small finger

Gestational choriocarcinoma is a malignant epithelial neoplasm of trophoblastic cells derived from any form of a previously normal or abnormal pregnancy. Choriocarcinoma is a rapidly invasive, widely metastasizing, malignant neoplasm. Hand and cutaneous metastases are rare and only one other report describing hand involvement was found in the literature. A 33-year-old woman was referred for evaluation of a papular lesion (6 x 4 mm) at the junction of the hyponychium and the nail bed of the dominant right small finger. At the time, she was being treated for choriocarcinoma with lung and brain metastases. Histopathology studies showed that the soft-tissue lesion from the patient's finger was a cutaneous metastasis of choriocarcinoma.     

“Tie over ring” sutureless compression based gastrointestinal anastomotic method: experimental rat model

Introduction

Giving the ever-rising trend of pediatric minimally invasive surgery besides early neonatal surgical interventions, intestinal anastomosis turns out to be a time consuming stage due to several anatomical as well as technical difficulties. A perfect bowel anastomosis method should be easy, rapid, safe and reliable in creation of bowel continuity with minimal tissue damage. In this light, sutureless anastomotic methods have been introduced, using compression based anastomosis with biofragmentable rings or powerful magnets. Accordingly, this experimental animal model study has evaluated the result of an easy, rapid intestinal sutureless anastomotic technique via simple tying over an intraluminal ring, in comparison with conventional handsewn bowel anastomosis.

Methodology

Thirty Wistar–Albino male rats were enrolled and small bowel was transected via a midline laparotomy. A grooved plastic ring was inserted into the ileal lumen and both intestinal cutting ends were fixed over the ring with a simple tie in the first group. On the other hand, enteroenterostomy was performed by the conventional method of handsewn anastomosis in the second group. After 14 days, rats were sacrificed to evaluate for intraperitoneal adhesion and abscess formation in addition to other evidences of anastomotic leakage. Furthermore, the anastomotic site integrity, tensile strength and healing stage were assessed microscopically.

Results

The mean operative time and intraoperative bleeding in the tie over ring group were significantly less than those in the handsewn anastomosis group. Anastomotic stricture was more common in the conventional anastomosis group while the anastomotic tensile strength was significantly higher in the tie over ring group. Histopathological healing parameters and final healing score were almost similar in both groups but mean inflammatory cell infiltration in handsewn anastomosis was significantly higher.

Conclusion

“Tie over ring” is a simple method of anastomosis that is feasible, fast, safe and functionally effective for bowel reconstruction in animal models that could be reconsidered in human bowel anastomosis.     

Right-sided reverse T composite arterial grafting to complete revascularization of the right coronary artery

Complete arterial revascularization for the right coronary artery is underused mainlydue to technical issues. Herein we report on a new approach for complete arterialrevascularization of arterial revascularization for the right coronary arterybranches. Complete arterial revascularization for the right coronary arteryrevascularization was performed in 8 patients using a reverse T composite arterialgraft. None of the patients suffered perioperative myocardial infarction. Allpatients underwent noninvasive coronary imaging, displaying an early patency rate of100%. Complete arterial arterial revascularization for the right coronary arteryrevascularization using a reverse T graft offers a new paradigm with enhancedtechnical flexibility in performing all arterial myocardial completerevascularizations in selected patients.