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Brachioradialis tendon transfer and palmaris longus tendon graft for thumb avulsion:A case report and review of literature

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World Journal of Clinical Cases 2025年第4期13卷 48-55页

作者： Pierre Curings Sonia Ramos-Pascual Kinga Michalewska Nicolas Gibert Lionel Erhard Mo Saffarini AlexisNogier department of Hand Surgery Clinique TrenelSainte-Colombe 69560France Medical Research ReSurg SANyon 1260VaudSwitzerland department of Hand Surgery Hand and Upper Limb Surgical InstituteVilleurbanne 69100France department of Orthopaedics Clinique TrenelSainte-Colombe 69560France

BACKGROUND Thumb replantation following complete traumatic avulsion requires complex techniques to restore function,especially in cases of avulsion at the level of the metacarpophalangeal joint(MCP I)and avulsion of the flexor pollicis longus(FPL)at the musculotendinous *** treatments include direct tendon suture or tendon transfer,most commonly from the ring *** optimize function and avoid donor finger complications,we performed thumb replantation with flexion restoration using brachioradialis(BR)tendon transfer with palmaris longus(PL)tendon *** SUMMARY A 20-year-old left-handed male was admitted for a complete traumatic left thumb amputation following an accident while sliding from the top of a *** patient presented with skin and bone avulsion at the MCP I,avulsion of the FPL tendon at the musculotendinous junction(zone 5),avulsion of the extensor pollicis longus tendon(zone T3),and avulsion of the thumb’s collateral arteries and *** patient was treated with two stage thumb *** first intervention consisted of thumb replantation with MCP I arthrodesis,resection of avulsed FPL tendon and implantation of a silicone tendon *** second intervention consisted of PL tendon graft and BR tendon ***-up at 10 months showed good outcomes with active interphalangeal flexion of 70°,grip strength of 45 kg,key pinch strength of 15 kg and two-point discrimination threshold of 4 *** Flexion restoration after complete thumb amputation with FPL avulsion at the musculotendinous junction can be achieved using BR tendon transfer with PL tendon graft.

关键词： Brachioradialis tendon transfer Flexor pollicis longus Palmaris longus tendon graft Replantation Thumb amputation Thumb avulsion Case report

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Evaluation of the Effectiveness and Nature of Analgesia in the Medical-surgical Emergency department of CHU-Donka

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Open Journal of Emergency Medicine 2023年第4期11卷 155-161页

作者： Amadou Yalla Camara Abdoulaye Touré Almamy Bangoura M’mah Lamine Camara Thierno Sadou Diallo Boubacar Atigou Dramé Joseph Donamou department of Medical and surgical Emergency CHU-Donka National Hospital Conakry Guinea anesthesia and Intensive Care Unit Ignace Deen National Hospital Conakry Guinea department of Anaesthesia and Intensive Care Donka National Hospital Conakry Guinea

Introduction: Pain assessment is an essential step towards pain relief. In our context, however, it is insufficient in emergency departments. The aim was to assess the nature and effectiveness of the analgesia used in the emergency department of the CHU-Donka. Method: This was a single-centre prospective observational study conducted over one month (November 2020) in the medical-surgical emergency department of CHU-Donka. All patients aged 18 or over admitted to the emergency department with moderate to severe acute pain were included. Results: We enrolled 880 patients, 615 of whom (69.88%) were in pain. Males predominated (65.2%), with a sex ratio of 1.87. The average age was 44.78 ± 16.41 years, with extremes ranging from 18 to 85 years. The most represented age group was 18 - 34 years, with 66.18%. Initial assessment of pain by nursing staff in 3 cases. Initial assessment of pain by the investigator was 100%, 74% moderate and 26% severe. No reassessment of pain by nursing staff. Reassessment by the interviewer was 100% and found 5% no pain, 61% mild pain, 24% moderate pain and 10% severe pain. With an average numerical scale of 3.77 ± 2.61 and extremes from 0 to 10. Average length of stay was 2.85 ± 1.48 hours, with extremes ranging from 45 minutes to 8 hours. Analgesia was administered with paracetamol alone (43.58%), combined with tramadol or nefopam. No patient received morphine. Conclusion: This study revealed a lack of pain assessment in our department.

关键词： Pain Assessment Emergencies Numerical Scale CHU-Donka

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Corticosteroid-free immunosuppression in liver transplantation: An evidence-based review

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World Journal of Gastroenterology 2014年第31期20卷 10703-10714页

作者： George Sgourakis Georgia Dedemadi 2~(nd) surgical department and surgical Oncology Unit "Korgialenio-Benakio" Red Cross Hospital surgical department of "Amalia Fleming" General Hospital

Thirty-six randomized controlled trials and two metaanalyses were reviewed. With respect to adult patients undergoing first orthotopic liver transplantation(OLT), steroid replacement resulted in fewer cases of overall acute rejection in the corticosteroid free-immunosuppression arm. Initial steroid administration for two weeks and early tacrolimus monotherapy is a feasible immunosuppression regimen without steroid replacement, although further investigations are needed in view of chronic rejections. No significant differences were noted between the treatment groups in terms of patient and graft survival independently of steroid replacement. Renal insufficiency, de novo hypertension, neurological disorders and infectious complications did not differ significantly among steroid and steroidfree groups. Diabetes mellitus, cholesterol levels and cytomegalovirus infection are more frequent in patients within the steroid group. With respect to diabetes mellitus and hypercholesterolemia, the difference was independent of steroid replacement. In relation to transplanted hepatitis C virus patients, mycophenolate mofetil does not appear to have a significant antiviral effect despite early reports. Male gender of donors and recipients, living donors, cold ischemia times, acute rejection, and early histological recurrence were related to the development of advanced hepatitis. There is sufficient scientific clinical evidence advocating avoidance of the ab initio use of steroids in OLT.

关键词： Meta-analysis Evidence based Hepatitis C virus recurrence Liver transplantation Steroid withdrawal Orthotopic liver transplantation

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Antioxidant and lipoxygenase inhibitory properties of a novel flavonoid from Pistacia chinensis Bunge and its molecular docking analysis

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Traditional Medicine Research 2025年第2期10卷 30-36页

作者： Abdur Rauf Zuneera Akram Naveed Muhammad Najla AlMasoud Taghrid Saad Alomar Saima Naz Abdul Wadood Chandni Hayat Marcello Iriti department of Chemistry University of SwabiAmbar 23561Pakistan department of Pharmacology Faculty of Pharmaceutical SciencesBaqai Medical UniversityKarachi 74600Pakistan department of Pharmacy Abdul Wali Khan University MardanMardan 23200Pakistan department of Chemistry College of SciencePrincess Nourah bint Abdulrahman UniversityRiyadh 11671Saudi Arabia department of Biotechnology BKUC-Bacha Khan University CharsaddaCharsadda 24620Pakistan department of Biochemistry Abdul Wali Khan University MardanMardan 23200Pakistan department of Biomedical Surgical and Dental SciencesUniversity of MilanMilan 20129Italy National Interuniversity Consortium of Materials Science and Technology(INSTM) Firenze 50121Italy

Background:Pistacia chinensis Bunge has been traditionally used to manage various conditions,including asthma,pain,inflammation,hepatoprotection,and *** study was conducted to investigate the antioxidant and anti-lipoxygenase(LOX)properties of the isolated compound 2-(3,4-dihydroxyphenyl)-5,7-dihydroxy-4H-chromen-4-one from Pistacia ***:LOX assay and antioxidant activity using 2,2-diphenyl-1-picrylhydrazyl(DPPH)assay were *** docking studies were conducted using a molecular operating ***:The LOX assay revealed significant inhibitory effects at 0.2µM concentration,with an IC50 value of 37.80µ*** antioxidant effect demonstrated dose-dependency across 5 to 100µg/mL concentrations,reaching 93.09%at 100µg/mL,comparable to ascorbic acid’s 95.43%*** docking studies highlighted strong interactions with the lipoxygenase enzyme,presenting an excellent docking score of-10.98 kcal/***:These findings provide valuable insights into Pistacia chinensis’chemical components and biological effects,reinforcing its traditional medicinal applications.

关键词： Pistacia chinensis Bunge antioxidant DPPH assay antilipoxygenase docking analysis

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Problem of living liver donation in the absence of deceased liver transplantation program:Mansoura experience

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World Journal of Gastroenterology 2014年第37期20卷 13607-13614页

作者： Mohamed Abdel Wahab Hosam Hamed Tarek Salah Waleed Elsarraf Mohamed Elshobary Ahmed Mohamed Sultan Ahmed Shehta Omar Fathy Helmy Ezzat Amr Yassen Mohamed Elmorshedi Mohamed Elsaadany Usama Shiha Gatrointestinal Surgery Liver Transplantation Unit Gastrointestinal Surgical Center Mansoura University Daqahlia 35516 Egypt anesthesia Intensive Care department Gastrointestinal Surgical Center Mansoura Faculty of Medicine Mansoura University Daqahlia 35516 Egypt Internal Medicine department Mansoura Faculty of Medicine Mansoura University Daqahlia 35516 Egypt Radiology department Gastrointestinal Surgical Center Mansoura University Daqahlia 35516 Egypt

We report our experience with potential donors for living donor liver transplantation(LDLT), which is the first report from an area where there is no legalized deceased donation program. This is a single center retrospective analysis of potential living donors(n = 1004) between May 2004 and December 2012. This report focuses on the analysis of causes, duration, cost, and various implications of donor exclusion(n = 792).Most of the transplant candidates(82.3%) had an experience with more than one excluded donor(median = 3). Some recipients travelled abroad for a deceased donor transplant(n = 12) and some died before finding a suitable donor(n = 14). The evaluation of an excluded donor is a time-consuming process(median = 3 d, range 1 d to 47 d). It is also a costly process with a median cost of approximately 70 USD(range 35 USD to 885 USD). From these results, living donor exclusion has negative implications on the patients and transplant program with ethical dilemmas and an economic impact. Many strategies are adopted by other centers to expand the donor pool; however, they are not all applicable in our locality. We conclude that an active legalized deceased donor transplantation program is necessary to overcome the shortage of available liver grafts in Egypt.

关键词： Living donor Liver transplantation Excluded donors Deceased donor Liver disease

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Helicobacter pylori and pregnancy-related disorders

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World Journal of Gastroenterology 2014年第3期20卷 654-664页

作者： Simona Cardaropoli Alessandro Rolfo Tullia Todros department of surgical Sciences University of Turin

Helicobacter pylori (H. pylori) infection is investigated in gastric diseases even during pregnancy. In particular, this Gram-negative bacterium seems to be associated with hyperemesis gravidarum, a severe form of nausea and vomiting during pregnancy. During the last decade, the relationship among H. pylori and several extra-gastric diseases strongly emerged in literature. The correlation among H. pylori infection and pregnancy-related disorders was mainly focused on iron deficiency anemia, thrombocytopenia, fetal malformations, miscarriage, pre-eclampsia and fetal growth restriction. H. pylori infection may have a role in the pathogenesis of various pregnancy-related disorders through different mechanisms: depletion of micronutrients (iron and vitamin B12) in maternal anemia and fetal neural tube defects; local or systemic induction of pro-inflammatory cytokines release and oxidative stress in gastrointestinal disorders and pre-eclampsia; cross-reaction between specific anti-H. pylori antibodies and antigens localized in placental tissue and endothelial cells (pre-eclampsia, fetal growth restriction, miscarriage). Since H. pylori infection is most likely acquired before pregnancy, it is widely believed that hormonal and immunological changes occurring during pregnancy could activate latent H. pylori with a negative impact not only on maternal health (nutritional deficiency, organ injury, death), but also on the fetus (insufficient growth, malformation, death) and sometime consequences can be observed later in life. Another important issue addressed by investigators was to determine whether it is possible to transmit H. pylori infection from mother to child and whether maternal anti-H. pylori antibodies could prevent infant’s infection. Studies on novel diagnostic and therapeutic methods for H. pylori are no less important, since these are particularly sensitive topics in pregnancy conditions. It could be interesting to study the possible correlat

关键词： Helicobacter pylori Pregnancy Hyperemesis gravidarum Iron deficiency anemia Pre-eclampsia Fetal growth restriction Gastrointestinal disorders

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Conversion of laparoscopic colorectal resection for cancer: What is the impact on short-term outcomes and survival?

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World Journal of Gastroenterology 2016年第37期22卷 8304-8313页

作者： Marco E Allaix Edgar JB Furnée Massimiliano Mistrangelo Alberto Arezzo Mario Morino department of surgical Sciences University of Torino

Laparoscopic resection for colon and rectal cancer is associated with quicker return of bowel function, reduced postoperative morbidity rates and shorter length of hospital stay compared to open surgery, with no differences in long-term survival. Conversion to open surgery is reported in up to 30% of patients enrolled in randomized control trials comparing open and laparoscopic colorectal resection for cancer. In this review, reasons for conversion are anatomical-related factors, disease-related-factors and surgeon-related factors. Body mass index, local tumour extension and co-morbidities are independent predictors of conversion. The current evidence has shown that patients with converted resection for colon cancer have similar outcomes compared to patients undergoing a laparoscopic completed or open resection. The few studies that have assessed the outcomes after conversion of laparoscopic rectal resection reported significantly higher rates of complications and longer length of hospital stay in converted patients compared to laparoscopically treated patients. No definitive conclusions can be drawn when converted and open rectal resections are compared. Early and pre-emptive conversion appears to have more favourable outcomes than reactive conversion; however, further large studies are needed to better define the optimal timing of conversion. With regard to long-term oncologic outcome, overall and disease-free survival in the case of conversion in laparoscopic colorectal cancer surgery seems to be worse than those achieved in patients in whom resection was successfully completed by laparoscopy. Although a worse long-term oncologic outcome has been suggested, it remains difficult to draw a proper conclusion due to the heterogeneity of the long-term outcomes as well as the inclusion of both colon and rectal cancer patients in most of the studies. Therefore, we discuss the currently available evidence of the impact of conversion in laparoscopic resection for colon an

关键词： Conversion Laparoscopy Open surgery Colon cancer Rectal cancer Morbidity Mortality Predictors Recurrence Survival

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Laparoscopic revolution in bariatric surgery

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World Journal of Gastroenterology 2014年第41期20卷 15135-15143页

作者： Magnus Sundbom department of surgical Sciences Uppsala University

The history of bariatric surgery is investigational. Dedicated surgeons have continuously sought for an ideal procedure to relieve morbidly obese patients from their burden of comorbid conditions, reduced life expectancy and low quality of life. The ideal procedure must have low complication risk, both in short- and long term, as well as minimal impact on daily life. The revolution of laparoscopic techniques in bariatric surgery is described in this summary. Advances in minimal invasive techniques have contributed to reduced operative time, length of stay, and complications. The development in bariatric surgery has been exceptional, resulting in a dramatic increase of the number of procedures performed world wide during the last decades. Although, a complex bariatric procedure can be performed with operative mortality no greater than cholecystectomy, specific procedure-related complications and other drawbacks must be taken into account. The evolution of laparoscopy will be the legacy of the 21st century and at present, day-care surgery and further reduction of the operative trauma is in focus. The impressive effects on comorbid conditions have prompted the adoption of minimal invasive bariatric procedures into the field of metabolic surgery.

关键词： Laparoscopy Bariatric surgery Minimal invasive surgery Gastric bypass Duodenal switch Gastric banding Metabolic surgery

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Breakthrough therapy for peritoneal carcinomatosis of gastric cancer:Intraperitoneal chemotherapy with taxanes

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World Journal of Gastrointestinal Oncology 2015年第11期7卷 285-291页

作者： Hironori Yamaguchi Joji Kitayama Hironori Ishigami Shinsuke Kazama Hiroaki Nozawa Kazushige Kawai Keisuke Hata Tomomichi Kiyomatsu Toshiaki Tanaka Junichiro Tanaka Takeshi Nishikawa Kensuke Otani Koji Yasuda Soichiro Ishihara Eiji Sunami Toshiaki Watanabe department of surgical Oncology the University of Tokyo

The effect of chemotherapy on peritoneal carcinomatosis(PC) of gastric cancer remains ***,the intraperitoneal(IP) administration of taxanes [e.g.,paclitaxel(PTX) and docetaxel(DOC)] during the perioperative period has shown promising ***,we summarized the rationale and methodology for using IP chemotherapy with taxanes and reviewed the clinical *** administered taxanes remain in the IP space at an extremely high concentration for 48-72 *** drug directly infiltrates peritoneal metastatic nodules from the surface and then produces antitumor effects,making it ideal for IP *** are two types of perioperative IP chemotherapy with taxanes: neoadjuvant intraperitoneal and systemic chemotherapy and sequential perioperative intraperitoneal chemotherapy(SPIC).In SPIC,patients receive neoadjuvant IP chemotherapy and the same regimen of IP chemotherapy after cytoreductive surgery(CRS) until disease ***,a taxane dissolved in 500-1000 m L of saline at ordinary temperature is administered through an IP access port on an outpatient *** to phase Ⅰ?studies,the recommended doses(RD) are as follows: IP DOC,45-60 mg/m2; IP PTX [without intravenous(IV) PTX],80 mg/m2; and IP PTX(with IV PTX),20 mg/*** Ⅱ studies have reported a median survival time of 14.4-24.6 mo with a 1-year overall survival of 67%-78%.A phase Ⅲ study comparing S-1 in combination with IP and IV PTX to S-1 with IV cisplatin started in *** prognosis of patients who underwent CRS was better than that of those who did not; however,this was partly due to selection *** several phase Ⅱ studies have shown promising results,a randomized controlled study is needed to validate the effectiveness of IP chemotherapy with taxanes for PC of gastric cancer.

关键词： Taxane Paclitaxel Docetaxel Carcinoma Gastric canc

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Parenchyma-sparing pancreatectomies for benign or border-line tumors of the pancreas

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World Journal of Gastrointestinal Oncology 2010年第6期2卷 272-281页

作者： Cosimo Sperti Valentina Beltrame Anna Caterina Milanetto Margherita Moro Sergio Pedrazzoli department of Medical and surgical Sciences IV Surgical Clinic University of Padua

Standard pancreatic resections, such as pancreaticoduodenectomy, distal pancreatectomy, or total pancreatectomy, result in an important loss of normal pancreatic parenchyma and may cause impairment of exocrine and endocrine function. Whilst these procedures are mandatory for malignant tumors, they seem to be too extensive for benign or border-line tumors, especially in patients with a long life expectancy. In recent years, there has been a growing interest in parenchyma-sparing pancreatic surgery with the aim of achieving better functional results without compromising oncological radicality in patients with benign, border-line or low-grade malignant tumors. Several limited resections have been introduced for isolated or multiple pancreatic lesions, depending on the location of the tumor: central pancreatectomy, duodenum-preserving pancreatic head resection with or without segmental duodenectomy, inferior head resection, dorsal pancreatectomy, excavation of the pancreatic head, middle-preserving pancreatectomy, and other multiple segmental resections. All these procedures are technically feasible in experienced hands,with very low mortality, although with high morbidity rate when compared to standard procedures. Pancreatic endocrine and exocrine function is better preserved with good quality of life in most of the patients, and tumor recurrence is uncommon. Careful patient selection and expertise in pancreatic surgery are crucial to achieve the best results.

关键词： Middle pancreatectomy Pancreatic head resection Pancreas Pancreatectomy Limited pancreatectomy

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