Prosthetic valve thrombosis-case report and literature review

Prosthetic valve thrombosis (PVT) is a dreaded complication of patients with mechanical valves, particularly those in the mitral position. The diagnosis is based on the clinical presentation, supported by echocardiography. As it provides a sustained benefit with low rates of embolization, thrombolyic therapy is a good non-invasive alternative to surgical therapy for carefully selected patients.     

Laparoscopic pyelolithotomy: Is the retroperitoneal route a better approach?

Objectives:   To compare the outcome of laparoscopic pyelolithotomy (LP) using the transperitoneal and the retroperitoneal routes.
Methods:   Demographics, intraoperative and postoperative clinical parameters were evaluated in 48 laparoscopic pyelolithotomies performed in patients with renal pelvic calculi of diameter >30 mm. The differences between the transperitoneal and retroperitoneal routes were analyzed.
Results:   Twenty-seven LP were performed using the transperitoneal approach (TLP), and 21 using the retroperitoneal approach (RLP). Apart from weight, the patients' demographics and stone size were similar in the two groups. Between the RLP and the TLP routes, the operative time was 112.1 versus 93.2 min ( P  = 0.01), mean time for oral intake was 1.9 versus 1.2 days ( P  < 0.01), and mean hospital stay was 5.2 versus 3.8 days ( P  < 0.01). The mean postoperative analgesic requirement (2.4 vs 2.2 days, P  = 0.41), mean convalescence days (9.7 vs 10 days, P  = 0.56), and mean estimated blood loss (57.2 vs 62.9 ml, P  = 0.5) were similar between RPL and TPL respectively. The stone-free rate at 3 months follow-up was comparable (88.9% vs 90.5%, P  = 0.86). The postoperative complications were not significantly different.
Conclusions:   Compared with the TLP approach, RLP for large renal pelvic stone resulted in a shorter operative time, a shorter resumption time for normal oral intake, and a shorter hospital stay. As the other clinical outcomes are similar, including the stone-free rate, we recommend the RLP route for LP.     

Fecally loaded inguinoscrotal hernia masquerading as testicular mass

An 88-year-old man presented with clinical signs suggestive of a testicular mass. The initial ultrasound examination was inconclusive however regional computed tomography eloquently distinguished a large indirect inguinoscrotal hernia with a hernia sac containing a loop of fecally loaded sigmoid colon.     

Differential optical spectropolarimetric imaging system assisted by liquid crystal devices for skin imaging

Skin cancer diagnosis depends not only on histopathological examination but also on visual inspection before and after the excision of suspected lesion. Neoplasm is accompanied with changes in birefringence of collagen, pleomorphicity, and hyperchromatic state of epithelial nuclei. These phenomena can be measured by spectral and polarization changes of light backscattered by the examined tissue. A new differential spectropolarimetric system is proposed using liquid crystal devices, one as a tunable filter and the other as a polarization rotator, both operating at wide spectral ranges from the visible to the near-infrared. Since collagen's fibrils texture orientation depends on its location in the skin and since it is not well organized, our system scans the bipolarization states by continuously rotating the linearly polarized light incident on a skin lesion, and collecting differential contrasts between sequenced images when simultaneously averaging the statistical readout of a video camera. This noninvasive method emphasizes areas on skin where the neoplasm, or tumor, minimizes the statistical polarization change of the scattered light from the lesion. The module can be considered as an assistant tool for epiluminescence microscopy. Images of skin tumors were captured in vivo before the patients having their surgery and compared to histopathological results.