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Outcomes and efficacy of magnetic resonance imaging-compatible sacral nerve stimulator for management of fecal incontinence: A multi-institutional study

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World Journal of Radiology 2024年第2期16卷 32-39页

作者： Binit katuwal Amy Thorsen kunal kochar Ryba Bhullar Ray king Ernesto Raul Drelichman vijay k mittal Jasneet Singh Bhullar Department of Surgery Ascension Providence HospitalMichigan State University College of Human MedicineSouthfieldMI 48075United States Department of Colon and Rectal surgery Alina Health Abbott Northwestern HospitalMinneapolisMN 55407United States Colon and Rectal Surgery Advocate Illinois MasonicPark RidgeIL 60068United States Volunteer Student Department of ResearchAscension Providence HospitalSouthfieldMI 48075United States Colon and Rectal Surgery University of WisconsinMadisonWI 53715United States General and Colorectal Surgery Ascension Providence HospitalMichigan State University College of Human MedicineSouthfieldMI 48075United States Department of Surgery Department of Medical EducationAscension Providence HospitalMichigan State University College of Human MedicineSouthfieldMI 48075United States

BACkGROUND Fecal incontinence(FI)is an involuntary passage of fecal matter which can have a significant impact on a patient’s quality of *** modalities of treatment exist for *** nerve stimulation is a well-established treatment for *** the increased need of magnetic resonance imaging(MRI)for diagnostics,the In-terStim which was previously used in sacral nerve stimulation was limited by MRI *** MRI-compatible InterStim was approved by the United States Food and Drug Administration in August 2020 and has been widely *** To evaluate the efficacy,outcomes and complications of the MRI-compatible *** Data of patients who underwent MRI-compatible Medtronic InterStim placement at UPMC Williamsport,University of Minnesota,Advocate Lutheran General Hospital,and University of Wisconsin-Madison was pooled and *** demographics,clinical features,surgical techniques,complications,and outcomes were *** the Reporting of Observational studies in Epidemiology(STROBE)cross-sectional reporting guidelines were *** Seventy-three patients had the InterStim *** mean age was 63.29±12.2 ***-seven(78.1%)patients were females and forty-two(57.5%)patients had *** addition to incontinence,overlapping symptoms included diarrhea(23.3%),fecal urgency(58.9%),and urinary incontinence(28.8%).Fifteen(20.5%)patients underwent Peripheral Nerve Evaluation before proceeding to definite implant ***-two(43.8%)patients underwent rechargeable InterStim ***(4.1%)patients needed removal of the *** of the external lead connection was observed in 7(9.6%)patients after the stage I *** explanation for one patient was due to ***(9.6%)patients had other complications like nerve pain,hematoma,infection,lead fracture,and *** mean follow-up was 6.62±3.5 ***-eight(93.2%)patients reported significant improvement of symptoms on

关键词： Fecal incontinence Sacral nerve stimulation InterStim Magnetic resonance imaging Sacral neuromodulation

Animal models of human colorectal cancer:Current status, uses and limitations

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World Journal of Gastroenterology 2015年第41期21卷 11854-11861页

作者： vijay k mittal Jasneet Singh Bhullar kumar Jayant Department of Surgery Providence Hospital and Medical Centers Department of Colorectal Surgery University of MinnesotaMN 55114 United States

AIM: To make orthotopic colon cancer murine modelsa more clearly understood subject. The orthotopic tumor models have been found to be more relevant in replicating the human disease process as compared to heterotopic models, many techniques for making orthotopic colorectal murine models have been ***: We evaluated the current literature for various reported orthotopic colon cancer models to understand their techniques, advantages and limitations. An extensive literature review was performed by searching the National Library of Medicine Database(Pub Med) using Me SH terms animal model; colon cancer; orthotopic model; murine model. Twenty studies related to colon cancer orthotopic xenograft model were evaluated in detail and discussed here. RESULTS: The detailed analysis of all relevant reports on orthotopic model showed tumor take rate between 42%-100%. While models using the enema technique and minimally invasive technique have reported development of tumor from mucosa with tumor take rate between 87%-100% with metastasis in 76%-90%.CONCLUSION: Over the years, the increased understanding of the murine models of human colon cancer has resulted in the development of various models. Each reported model has some limitations. These latest models have opened up new doors for continuing cancer research for not only understanding the colon cancer pathogenesis but also aid in the development of newer chemotherapeutic drugs as they mimic the human disease closely.

关键词： Murine model Colon cancer Colon cancer murine mode

Improved Outcomes in Gallbladder Cancer with Early Diagnosis and Negative Nodal Status

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Journal of Cancer Therapy 2012年第2期3卷 137-145页

作者： Lauren Smithson Christopher keto Lorenzo Ferguson Sumet Silapaswan Michael J. Jacobs Ramachandra kolachalam Jeffrey C. Flynn vijay k. mittal Department of Surgery Providence Hospital and Medical Centers Southfield USA Department of Surgery Providence Hospital and Medical Centers Southfield USA.

Background: Gallbladder cancer (GBC) is a rare disease of the hepatobiliary tract characterized by silent presentation, poor prognosis, and limited therapy. Current imaging modalities, clinical symptoms and laboratory values are of limited value in diagnosis and tumour markers are used as a clinical adjunct. Five year survival is 5% - 12% and a majority of patients survive less than 1 year. Early identification, negative nodal status, and extended cholecystectomy improve survival;adjuvant therapy does not appear to play a role. Objective: To evaluate the effects of stage and nodal status of GBC on survival by analyzing clinical and radiological factors leading to preoperative diagnosis and appropriate subsequent management. Results: Forty-three patients (31 female, 12 male) had primary GBC. Average age was 69 years. The most common presenting symptom was pain (65%). Fifteen (35%) patients presented with acute cholecystitis;9 were suspicious for a mass. Ultrasound and computed tomography were the imaging modalities most often used. Preoperative diagnoses were made in only 7 (16%) patients, whereas 16 (37%) patients were diagnosed intra-operatively and 20 (47%) post-operatively. Adjuvant chemotherapy was offered in 16 (37%) patients. Average survival was 28 months (range 0.5 - 238 months), with a 5-year survival of 13% across all stages. Early GBC (stages 1 - 2) had a 5-year survival of 43%, and late GBC (stages 3 - 4) had no survival at 5 years, with an average survival of 9 months. Positive nodes decreased survival. Conclusion: Our results mirror what has been reported in the literature. Most patients presented with acute cholecystitis, with confounding clinical data, but few were preoperatively diagnosed with GBC. Imaging was rarely diagnostic. Late stage GBC, as well as node-positive status, had dismal outcomes with low 1-year and 5-year survival rates. Improved preoperative suspicion of early GBC would allow for more intentional curative resections, before nodes

关键词： Gallbladder Carcinoma Node Status Survival

Gastric remnant twist in the immediate post-operative period following laparoscopic sleeve gastrectomy

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World Journal of Gastrointestinal Surgery 2015年第11期7卷 345-348页

作者： Gokulakkrishna Subhas Anupam Gupta Mubashir Sabir vijay k mittal Department of Surgery Providence Hospital and Medical Centers

Twist of stomach remnant post sleeve gastrectomy is a rare entity and difficult to diagnose pre-operatively. We are reporting a case of gastric volvulus post laparoscopic sleeve gastrectomy, which was managed conservatively. A 38-year-old lady with a body mass index of 54 underwent laparoscopic sleeve gastrectomy. Sleeve gastrectomy was performed over a 32 French bougie using Endo-GIA tri-stapler. On post-operative day 1, patient had nausea and non-bilious vomiting. An upper gastrointestinal gastrografin study on postoperative days 1 and 2 revealed collection of contrast in the fundic area of stomach with poor flow distally, and she vomited gastrograffin immediately post procedure. With the suspicion of a stricture in the mid stomach as the cause, the patient was taken back for a exploratory laparoscopy and intra-operative endoscopy. We found a twist in the gastric tube which was too tight for the endoscope to pass through. This was managed conservatively with a long stent to keep the gastric tube straight and patent. The stent was discontinued in 7 d and the patient did well. In laparoscopic sleeve gastrectomy the stomach is converted into a tube and is devoid of its supports. If the staples fired are not aligned appropriately, it can predispose this stomach tube to undergo torsion along its long axis. Such a twist can be avoided by properly aligning the staples and by placing tacking sutures to the omentum and new stomach tube. This twist is a functional obstruction rather than a stricture; thus, it can be managed by endoscopy and stent placement.

关键词： Gastric remnant Stent Sleeve gastrectomy Volvulus

Management of enterocutaneous fistulae:A 10 years experience

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World Journal of Gastrointestinal Surgery 2010年第7期2卷 242-246页

作者： Deepa Taggarshe Daniel Bakston Michael Jacobs Alasdair Mckendrick vijay k mittal Department of Surgery Providence Hospital and Medical Centers16001 West Nine Mile RoadSouthf ieldMI 48075United States

AIM:To compare the outcomes of conservative vs surgical treatment of enterocutaneous fistulae(ECF) in a community teaching hospital over a ***:All cases of ECF between 1997 and 2007 were reviewed for management ***:Of the 83 patients with ECF,60(72%) were ***-six patients(79.5%) were treated initially with conservative *** patients failed to respond to conservative treatment and required later(secondary) exploration;this group consisted of an equal number of low vs high output ***(20.5%) patients underwent initial(primary) def initivesurgery secondary to anastomotic leak and *** procedures included resection of ECF with anastomosis(24),exclusion(6) and direct-drainage(4).No signif icant difference was seen in the recurrence rate for conservative(10%) vs operative-treatment(20%).role as an initial management in both low and high output *** selective cases only,early primary exploration is recommended.

关键词： Low-output High-output Enterocutaneous fistulae

Excess mortality in elderly hip fracture patients:An Indian experience

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Chinese Journal of Traumatology 2023年第6期26卷 363-368页

作者： Jaiben George vijay Sharma kamran Farooque Vivek Trikha Samarth mittal Rajesh Malhotra Department of Orthopedic Surgery JPNA Trauma CentreAll India Institute of Medical SciencesNew DelhiIndia

Purpose:Hip fractures in elderly have a high ***,there is limited literature on the excess mortality seen in hip fractures compared to the normal *** purpose of this study was to compare the mortality of hip fractures with that of age and gender matched Indian ***:There are 283 patients with hip fractures aged above 50 years admitted at single centre prospectively enrolled in this *** were followed up for 1 year and the follow-up record was available for 279 *** was assessed during the follow-up from chart review and/or by telephonic ***-year mortality of Indian population was obtained from public *** mortality ratio(SMR)(observed mortality divided by expected mortality)was ***-Meir analysis was ***:The overall 1-year mortality was 19.0%(53/279).Mortality increased with age(pkely to die than the general *** mortality rates increased with age,the highest excess mortality was seen in relatively younger *** fracture mortality was even higher than that of myocardial infarction,breast cancer,and cervical cancer.

关键词： Hip fracture Mortality Excess mortality Indian Population Age Gender

Spontaneous atraumatic dislocation of sternoclavicu- lar joint in Reiter＇s syndrome

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Chinese Journal of Traumatology 2012年第4期15卷 251-253页

作者： vijay kumar Digge Sanjay Meena Shah Alam khan Ravi mittal Department of Orthopaedics All India Institute of Medi-cal Sciences(AIIMS)Ansari NagarNew Delhi 110029India

Abstract：Reactive arthritis or Reiter's syndrome characteristically affects the joint of the lower limb in an asymmetrical *** it does not affect the axial skeleton or upper *** cases of atraumatic atlantoaxial subluxations have been reported,no case of spontaneous sternoclavicular dislocation in Reiter's syndrome has been *** paper describes a case of a 26 year old male patient who developed a spontaneous posterior sternoclavicular joint *** attempt of reduction was made and the patient was managed conservatively with good results。

关键词：综合征创伤性关节炎保守治疗非对称综合症反应性

Management and Outcomes in Primary Tumors of the Appendix

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Journal of Cancer Therapy 2010年第4期1卷 174-180页

作者： Englehardt Richard Durrani Noreen mittal vijay Department of Surgery Providence Hospital and Medical Centers SouthfieldMIUSA Department of Surgery Providence Hospital and Medical Centers SouthfieldMIUSA.

Primary tumors of the appendix are rare, comprising 1.1% of all appendectomy specimens. Nevertheless, it often presents in an emergent fashion, creating a need for a well-defined management algorithm that will ensure proper acute management. We performed a retrospective review of medical charts from 1982-2007 on all charts with a diagnosis of appendiceal neoplasm. A cohort of 41 patients was diagnosed with a primary appendiceal neoplasm from a total of 8560 appendectomies over the 25-year period. Several tumors were identified: adenocarcinomas (n = 16), carcinoid tumors (n = 15), mucinous cystadenocarcinoma (n = 7), and a combination of adenocarcinoma and goblet cell carcinoid of the appendix (n = 3). Twenty-one patients presented with an acute abdomen. Tumors were discovered intraoperatively in eighteen patients while performing other procedures. At diagnosis, metastatic disease was found in 41.5% of patients (n = 17);average survival ranged from 6 to 21 months based on tumor type. For patients with non-metastatic disease at diagnosis, all survived longer than 2 years and there were no cases of recurrence or post-operative metastasis. We devised an operative strategy dictated by initial presenting characteristics of the tumor. The presence of carcinoma should be suspected and searched for in patients over 40 presenting with acute appendicitis. Intraoperatively any suspicious mass should undergo frozen sectioning as the finding of a malignancy often necessitates a larger or repeat operation. The propensity of these neoplasms for presentation in the guise of acute appendicitis mandates that the surgeon be familiar with the appropriate management algorithm, both in and out of the operating room.

关键词： Appendix Cancer Gastrointestinal Malignancy Malignant Neoplasms of the Appendix

The Corpse Is a Silent Witness Who Never Lies—A Case Report

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Forensic Medicine and Anatomy Research 2014年第3期2卷 43-47页

作者： vijay Pal Pawan mittal Jitender k. Jakhar Yogesh kumar Vashist A. D. Aggarwal Bhavesh Bohra Department of Forensic Medicine Government Medical College Patiala India Department of Forensic Medicine Jhalawar Medical College Jhalawar India Department of Forensic Medicine Pt. B. D. Sharma PGIMS Rohtak Pt. Bhagwat Dayal Sharma University of Health Sciences Rohtak India Department of Forensic Medicine Pt. B. D. Sharma PGIMS Rohtak Pt. Bhagwat Dayal Sharma University of Health Sciences Rohtak India Pt. Bhagwat Dayal Sharma University of Health Sciences Rohtak India

There are two very common sayings about corpse (dead body). The first common saying is that “the corpse is a silent witness who never lies” and the other common saying is that “the dead body is extremely eloquent and honestly informative, if one exercises patience in listening to it.” Both these sayings were proved in one of our cases. In the present case, decomposed body of an unidentified female individual aged about 25 - 26 years was recovered from the bank of western Yamuna canal in Haryana. The police made the efforts for establishing the identity of the deceased but could not succeed. The body was forwarded to the district hospital for autopsy along with the inquest report. However, the body being in advanced stage of decomposition so it was referred from the district hospital to the department of Forensic Medicine, PGIMS, Rohtak (Haryana) for the examination and the expert opinion regarding the cause of death. The findings observed on examination of the body helped to deduce the cause, time and manner of death whereas certain important objective features of identification were also observed and ultimately proper identity of the deceased could be established beyond the reasonable doubt by DNA profile of the samples preserved at autopsy. The autopsy findings, DNA profile and the results of examination of other materials (exhibits) taken from the body not only revealed the truth from the silent witness—the corpse, but also provided objective and scientific evidence to establish the corpus delicti in this case.

关键词： Corpus Delicti Rape Throttling Murder Putrefaction DNA Profile