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Liver trauma (management in 105 consecutive cases).  [cached]
Gupta S,Ahluwalia S,Anantharam P
Journal of Postgraduate Medicine , 1990,
Abstract: One hundred and five consecutive patients who sustained liver trauma during the period from Jan 1986 to Dec 1988 are reviewed. Of these, 82 cases suffered from blunt abdominal injury while the rest had penetrating trauma. Simple hepatorrhaphy and use of topical hemostatic agents were the only modes of treatment for 76 cases, hepato-omentorrhaphy was used in 12 cases and hepatotomy with selective vascular ligation and resectional debridement were carried out in remaining 17 cases. Mortality was 36.2% (38/105), 30 patients died of shock in the perioperative period. Uncomplicated recovery occurred in 50 cases.
Symptomatic Non-parasitic benign hepatic cyst: Evaluation of Management by Deroofing in Ten Consecutive Cases
KA Ismail, GI Mousa, OH El Khadrawy, HA Mohamed
Annals of Pediatric Surgery , 2010,
Abstract: Background/Purpose: Solitary non-parasitic cysts of the liver are commonly asymptomatic and do not require treatment. Rarely, however, the cysts become symptomatic and are then best treated surgically. The optimal surgical treatment is debatable. The aim of this study was to evaluate the role of deroofing as a safe and effective approach in the management of simple non-parasitic hepatic cysts. Materials & Methods: From January 2002 to October 2008, 10 patients (8 females and 2 males) with histologically proven non-parasitic, benign, simple hepatic cysts underwent deroofing at Tanta University Hospital. Deroofing was achieved by open surgery in 3 cases and by laparoscopic surgery in 7 patients. The principle of both open and laparoscopic approaches was to remove as much as possible of the cyst wall, destroy the endothelial lining and pack the residual cavity with omentum. Results: All of our patients had a solitary cyst with a mean diameter of 12.5 cm (range; 9-18 cm) and all were symptomatic. The most common complaint was upper abdominal pain (n=7, 70%). Age ranged from 1 - 72 year with a median of 15 years. Three patients (30%) were treated with open deroofing while 7 patients (70%) underwent laparoscopic deroofing. One out of these 7 patients was converted to open surgery. Recurrence occurred in 2 patients but was asymptomatic and discovered on follow up because of the small diameter of recurrent cysts (3-4 cm). The follow up period ranged between 12 – 72 months (median 20 months). Conclusion: with proper selection of patients, laparoscopic deroofing of symptomatic, benign, solitary, non-parasitic hepatic cysts is safe, effective and offers all the advantages of minimally invasive surgery. Open deroofing should be reserved for cysts inaccessible by laparoscopy, when the diagnosis is in doubt and for difficulties encountered at laparoscopy. Index Word: hepatic cyst, laparoscopy.
Tight lower bound of consecutive lengths for QC-LDPC codes with girth at least ten
GuoHua Zhang,JuHua Wang,XueYuan Li,XinMei Wang
Chinese Science Bulletin , 2011, DOI: 10.1007/s11434-010-4049-8
Abstract: For an arbitrary (3,L) quasi-cyclic(QC) low-density parity-check (LDPC) code with girth at least ten, a tight lower bound of the consecutive lengths is presented. For an arbitrary length above the bound the corresponding LDPC code necessarily has a girth at least ten, and for the length equal to the bound, the resultant code inevitably has a girth smaller than ten. This new conclusion can be well applied to some important issues, such as the proofs of the existence of large girth QC-LDPC codes, the construction of large girth QC-LDPC codes based on the Chinese remainder theorem, as well as the construction of LDPC codes with the guaranteed error correction capability.
Spectrum of perforation peritonitis in India-review of 504 consecutive cases
Rajender Jhobta, Ashok Attri, Robin Kaushik, Rajeev Sharma, Anupam Jhobta
World Journal of Emergency Surgery , 2006, DOI: 10.1186/1749-7922-1-26
Abstract: Five hundred and four consecutive cases of perforation peritonitis over a period of five years were reviewed in terms of clinical presentation, operative findings and postoperative course retrospectively at GMCH, Chandigarh.The most common cause of perforation in our series was perforated duodenal ulcer (289 cases) followed by appendicitis (59 cases), gastrointestinal perforation due to blunt trauma abdomen (45 cases), typhoid fever (41 cases) and tuberculosis (20 cases). Despite delay in seeking medical treatment (53%), the overall mortality (10%) was favourably comparable with other published series though the overall morbidity (50%) was unusually high.In contrast to western literature, where lower gastrointestinal tract perforations predominate, upper gastrointestinal tract perforations constitute the majority of cases in India. The increasing incidence of post-traumatic gastro-enteric injuries may be due to an increase in high speed motor vehicle accidents which warrant early recognition and prompt treatment to avoid serious complications and death.Perforation peritonitis is the most common surgical emergency in India. Despite advances in surgical techniques, antimicrobial therapy and intensive care support, management of peritonitis continues to be highly demanding, difficult and complex. The spectrum of etiology of perforation continues to be different from that of western countries[1] and there is paucity of data from India regarding it's etiology, prognostic indicators, morbidity and mortality patterns[2]. Our study was designed to highlight the spectrum of perforation peritonitis as encountered by us at Government Medical College and Hospital (GMCH) Chandigarh.A retrospective analysis of 504 patients of perforation peritonitis was done over a period of last five years at GMCH Chandigarh.All cases found to have peritonitis as a result of perforation of any part of gastrointestinal tract at the time of surgery were included in the study.All cases with either
Frictional amyloidosis in Oman - A study of ten cases  [cached]
Mysore Venkataram,Bhushnurmath Shivayogi,Muirhead David,Al - Suwaid Abdul Raouf
Indian Journal of Dermatology, Venereology and Leprology , 2002,
Abstract: Macular amyloidosis is an important cause for cutaneous pigmentation, the aetiology of which is poorly understood. Friction has recently been implicated the causation of early lesions, referred to as frictional amyloidosis. Confirmation of diagnosis by the detect on of amyloid using histochemical stains is inconsistent. Ten patients with pigmentation suggestive of macular amyloidosis were studied with detailed history, clinical examination, biopsy for histochemistry and electron microscopy. Nine out of ten patients had a history of prolonged friction with various objects such as bath sponges, brushes, towels, plant sticks and leaves. Amyloid was demonstrated by histochemical staining in only six out of ten cases. In the remaining four cases, amyloid was detected by electron microscopy. These consisted of aggregates of non-branching, extracellular, intertwining fibres measuring between 200-500 nm in length and between 20-25 nm in diameter. The study confirms the role of friction in the causation of this condition. Histochemical stains are not always successful in the detection of amyloid and electron microscopy is helpful for confirming its presence. The term frictional amyloidosis aptly describes the condition.
Childhood herpes zoster: A clustering of ten cases  [cached]
Prabhu Smitha,Sripathi H,Gupta Sanjeev,Prabhu Mukhyaprana
Indian Journal of Dermatology , 2009,
Abstract: Herpes zoster occurs due to reactivation of the latent varicella zoster virus and is usually a disease of the elderly. Childhood herpes zoster is believed to be rare, though recent studies suggest increasing incidence in children. Here we report ten cases of childhood herpes zoster, seven of which occurred within a short span of six months, at a tertiary care level hospital in Pokhara, Nepal. Only three of the ten children reported previous history of varicella infection and none was immunized against varicella. Though childhood herpes zoster accounted for less than 1% of the total zoster cases in the past, recent reports show an increase in the number of cases in apparently healthy children. So far, no studies have been done linking childhood herpes zoster with HIV, though there are many studies linking it with other immunocompromised conditions.
Surgical treatment of isolated and syndromic craniosynostosis: Results and complications in 283 consecutive cases
Esparza,J.; Hinojosa,J.; García-Recuero,I.; Romance,A.; Pascual,B.; Martínez de Aragón,A.;
Neurocirugía , 2008, DOI: 10.4321/S1130-14732008000600003
Abstract: objective. to review the results and complications of the surgical treatment of craniosynostosis in 283 consecutive patients treated between 1999 and 2007. patients and methods. our series consisted of 330 procedures performed in 283 patients diagnosed with scaphocephaly (n=155), trigonocephaly (n=50), anterior plagiocephaly (n=28), occipital plagiocephaly (n=1), non-syndromic multi-suture synostosis (n=20), and with diverse craniofacial syndromes (n=32; 11 crouzon, 11 apert, 7 pfeiffer, 2 saethre-chotzen, and 2 clover-leaf skull). we used the classification of whitaker et al. to evaluate the surgical results. complications of each technique and time of patients'hospitalization were also recorded. the surgeries were classified in 12 different types according to the techniques used. type i comprised endoscopic assisted osteotomies for sagittal synostosis (42 cases). type ii included sagittal suturectomy and expanding osteotomies (46 cases). type iii encompassed procedures similar to type ii but that included frontal dismantling or frontal osteotomies in scaphocephaly (59 cases). type iv referred to complete cranial vault remodelling (holocranial dismantling) in scaphocephaly (13 cases). type v belonged to fronto-orbital remodelling without fronto-orbital bandeau in trigonocephaly (50 cases). type vi included fronto-orbital remodelling without fronto-orbital bandeau in plagiocephaly (14 cases). in type vii cases of plagiocephaly with frontoorbital remodelling and fronto-orbital bandeau were comprised (14 cases). type viii consisted of occipital advancement in posterior plagiocephaly (1 case). type ix included standard bilateral fronto-orbital advancement with expanding osteotomies (30 cases). type x was used in multi-suture craniosynostosis (15 cases) and consisted of holocranial dismantling (complete cranial vault remodelling). type xi included occipital and suboccipital craniectomies in multiple suture craniosynostosis (10 cases) and type xii instances of fronto-orb
The Role of Large-Format Histopathology in Assessing Subgross Morphological Prognostic Parameters: A Single Institution Report of 1000 Consecutive Breast Cancer Cases  [PDF]
Tibor Tot
International Journal of Breast Cancer , 2012, DOI: 10.1155/2012/395415
Abstract: Breast cancer subgross morphological parameters (disease extent, lesion distribution, and tumor size) provide significant prognostic information and guide therapeutic decisions. Modern multimodality radiological imaging can determine these parameters with increasing accuracy in most patients. Large-format histopathology preserves the spatial relationship of the tumor components and their relationship to the resection margins and has clear advantages over traditional routine pathology techniques. We report a series of 1000 consecutive breast cancer cases worked up with large-format histology with detailed radiological-pathological correlation. We confirmed that breast carcinomas often exhibit complex subgross morphology in both early and advanced stages. Half of the cases were extensive tumors and occupied a tissue space ≥40?mm in its largest dimension. Because both in situ and invasive tumor components may exhibit unifocal, multifocal, and diffuse lesion distribution, 17 different breast cancer growth patterns can be observed. Combining in situ and invasive tumor components, most cases fall into three aggregate growth patterns: unifocal (36%), multifocal (35%), and diffuse (28%). Large-format histology categories of tumor size and disease extent were concordant with radiological measurements in approximately 80% of the cases. Noncalcified, low-grade in situ foci, and invasive tumor foci <5?mm were the most frequent causes of discrepant findings. 1. Introduction Breast cancer is a heterogeneous group of diseases which deviate from each other in natural history, morphology, molecular phenotype, clinical and radiological manifestations, and prognosis. Prognostic parameters are essential for predicting the outcome and response to therapy in individual cases. The long list of more or less powerful prognostic parameters that includes patient age, mode of detection, tumor size, histologic grade, lymph node status, and presence or absence of distant metastases was recently widened with molecular tumor phenotypes assessed with either genetic tests or immunohistochemistry. Since the number of therapeutic options is rather limited, the parameters for which assessment is routinely required for therapeutic decisions are also few. Whereas hormone receptor status, HER-2 status, and proliferative activity are the major determinants of oncological therapy, proper characterization of the subgross morphology of breast carcinoma is essential for planning appropriate surgery and radiation therapy [1–4]. The prognostic significance of subgross parameters is also observed [1,
Cerebral Hydatid Disease: Clinical Analysis of Ten Cases  [PDF]
G?k?in ?ENGüL,Murteza ?AKIR,?a?atay ?ALIKO?LU,Sencer DUMAN
Journal of Neurological Sciences , 2012,
Abstract: Objective: Cerebral hydatid disease is a rare manifestation of echinococcosis but it constitutes a significant part of all intracranial mass lesions. This study aims to determine the clinical, radiological and surgical features of brain hydatidosis and share our experience.Method: Medical records of ten patients with cerebral hydatid disease were retrospectively reviewed. Clinical presentations, radiological examinations, treatment modalities and outcomes of the patients were analyzed.Results: All patients were admitted from the rural areas. Nine patients had E. Granulosus cyst and one patient had E. Multilocularis cyst. The cyst was solitary in nine patients and multiple in one. Multiple organ involvement was found in one patient. Cysts were located in the right cerebral hemisphere in five patients, left cerebral hemisphere in four patients and posterior fossa in one. All patients were treated surgically. Complications related to surgery were observed in four patient. All patients improved after the treatment. There were no recurrences or residual cysts among the patients.Conclusion: Hydatic disease should considered in the differential diagnosis of intracranial space occupying lesions in developing countries. Early diagnosis of cerebral hydatid cysts may prevent serious life-threatening complications of this disease. Outcome is favourable when the cyst is completely removed without rupture.
Microsurgical reconstruction of hepatic artery in A-A LDLT: 124 consecutive cases without HAT  [cached]
Yi Yang, Lu-Nan Yan, Ji-Chun Zhao, Yu-Kui Ma, Bin Huang, Bo Li, Tian-Fu Wen, Wen-Tao Wang, Ming-Qing Xu, Jia-Yin Yang
World Journal of Gastroenterology , 2010,
Abstract: AIM: To retrospectively investigate microsurgical hepatic artery (HA) reconstruction and management of hepatic thrombosis in adult-to-adult living donor liver transplantation (A-A LDLT).METHODS: From January 2001 to September 2009, 182 recipients with end-stage liver disease underwent A-A LDLT. Ten of these patients received dual grafts. The 157 men and 25 women had an age range of 18 to 68 years (mean age, 42 years). Microsurgical techniques and running sutures with back-wall first techniques were performed in all arterial reconstructions under surgical loupes (3.5 ×) by a group of vascular surgeons. Intimal dissections were resolved by interposition of the great saphenous vein (GSV) between the donor right hepatic artery (RHA) and recipient common HA (3 cases) or abdominal aorta (AA) (2 cases), by interposition of cryopreserved iliac vessels between the donor RHA and recipient AA (2 cases).RESULTS: In the 58 incipient patients in this series, hepatic arterial thrombosis (HAT) was encountered in 4 patients, and was not observed in 124 consecutive cases (total 192 grafts, major incidence, 2.08%). All cases of HAT were suspected by routine color Doppler ultrasonographic examination and confirmed by contrast-enhanced ultrasound and hepatic angiography. Of these cases of HAT, two occurred on the 1st and 7th d, respectively, following A-A LDLT, and were immediately revascularized with GSV between the graft and recipient AA. HAT in one patient occurred on the 46th postoperative day with no symptoms, and the remaining case of HAT occurred on the 3rd d following A-A LDLT, and was cured by thrombolytic therapy combined with an anticoagulant but died of multiorgan failure on the 36th d after A-A LDLT. No deaths were related to HAT.CONCLUSION: Applying microsurgical techniques and selecting an appropriate anastomotic artery for HA reconstruction are crucial in reducing the high risk of HAT during A-A LDLT.
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