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Clinical outcome after surgery on schwannomas in the extremities

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World Journal of Orthopedics 2021年第10期12卷 760-767页

作者： Andreas Saine Granlund Michala Skovlund Sørensen Claus Lindkær Jensen Birthe Højlund Bech Michael Mørk Petersen Musculoskeletal Tumor section Department of Orthopedic SurgeryCopenhagen University HospitalRigshospitaletCopenhagen 2100Denmark Department of Orthopedic surgery Copenhagen University HospitalCopenhagen 2200Denmark Musculoskeletal Tumor section Department of Orthopedic SurgeryUniversity of CopenhagenCopenhagen 2100Denmark Department of Radiology RigshospitaletUniversity of CopenhagenCopenhagen 2100Denmark

BACKGROUND Schwannoma is a benign,encapsulated and slowly growing tumor originating from Schwann cells and is rarely seen in the peripheral nerve *** symptoms are soreness,radiating pain and sensory loss combined with a soft tissue *** To evaluate pre-and postoperative symptoms in patients operated for schwannomas in the extremities and investigate the rate of malignant *** In this single center retrospective study design,all patients who had surgery for a benign schwannoma in the extremities from May 1997 to January 2018 were *** location of the tumor in the extremities was divided into five groups;forearm,arm,shoulder,thigh and leg including *** locations of the tumor in the nerves were also categorized as either;proximal,distal,minor or major *** the pre-and postoperative clinical evaluation,symptoms were classified as paresthesia,local pain,radiating pain,swelling,impairment of mobility/strength and asymptomatic tumors that were found incidentally(with magnetic resonance imaging).The patients were evaluated after surgery using the following categories:Asymptomatic or symptomatic patients(radiating and/or local pain)and those with *** follow up period was from the time of surgery until last examination of the particular *** logistic regression analysis was performed to identify independent prognostic factors for postoperative significant symptoms at *** We identified 858 cases from the institutional pathology *** excluded cases with duplicate diagnoses(n=407),pathology not including schwannomas(n=157),lesions involving the torso,spine and neck(n=150)leaving 144 patients for further *** this group 99 patients underwent surgery and there were five complications recorded:2 infections(treated with antibiotics)and 3 nerve palsies(2 involving the radial nerve and one involving the median nerve)that recovered *** the end of follow-up,1.4

关键词： Schwannoma Extremities surgery Removal Symptoms Outcome

Host factors are dominant in the development of post-liver transplant non-alcoholic steatohepatitis

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World Journal of Hepatology 2016年第15期8卷 659-664页

作者： Salih Boga Armando Salim Munoz-Abraham Manuel I Rodriguez-Davalos Sukru H Emre Dhanpat Jain Michael L Schilsky Division of Digestive Diseases Section of Transplantation and Immunology Department of Medicine and Surgery Yale University School of Medicine Department of surgery Section of Transplantation and Immunology Yale-New Haven Transplantation Center Yale University School of Medicine Department of Pathology Yale University School of Medicine

Non-alcoholic fatty liver disease(NAFLD) is a recognized problem in patients after orthotopic liver transplantation and may lead to recurrent graft injury. As the increased demand for liver allografts fail to match the available supply of donor organs, split liver transplantation(SLT) has emerged as an important technique to increase the supply of liver grafts. SLT allows two transplants to occur from one donor organ, and provides a unique model for observing the pathogenesis of NAFLD with respect to the role of recipient environmental and genetic factors. Here we report on two recipients of a SLT from the same deceased donor where only one developed non-alcoholic steatohepatitis(NASH), suggesting that host factors are critical for the development of NASH.

关键词： Liver Split graft Steatohepatitis Host factors Transplant

Lymphangiogenesis, Lymphatic Endothelial Cells and Lymphatic Metastasis in Head and Neck Cancer—A Review of Mechanisms

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International Journal of Oral Science 2010年第1期2卷 5-14页

作者： Zhuang Zhang Joseph I. Helman Long-jiang Li State Key Laboratory of Oral Diseases West China Hospital of Stomatology Sichuan University Chengdu China Department of Oral and Maxillofacial surgery the Medical School Hospital of Qingdao University Qingdao China section of Oral and Maxillofacial surgery University of Michigan Ann Arbor USA

Lymphatic metastasis is a continuous and complicated process. The detailed mechanisms of lymphatic metastasis are still not very clear, despite considerable research efforts in recent years. Previously, it was commonly accepted that there were no lymphatic vessels in the primary tumor. However, recent studies have demonstrated that lymphatic vessels are detectable in certain types of cancer, and more and more evidence has shown that cancer cells invade into local lymph nodes mainly via peritumoral lymphatic vessels, Moreover, activated endothelial cells may also be important, having an influence on lymphatic metastasis of cancer cells. This article, based on recent research findings, provides an in-depth discussion of the relationship between lymphangiogenesis, tumor-derived lymphatic endothelial cells and lymphatic metastasis in head and neck cancer.

关键词： lymphangiogenesis lymphatic endothelial cell lymphatic metastasis head and neck cancer

Impact of body mass index on short-term outcomes of laparoscopic gastrectomy in Asian patients: A meta-analysis

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World Journal of Clinical Cases 2018年第15期6卷 985-994页

作者： Heng-Kai Chen Guang-Wei Zhu Yong-Jian Huang Wei Zheng Shu-Gang Yang Jian-Xin Ye Department of Gastrointestinal surgery 2 section the First Hospital Affiliated to Fujian Medical University Key Laboratory of Ministry of Education for Gastrointestinal Cancer Fujian Medical University

AIM To perform a meta-analysis to investigate the correlation between body mass index(BMI) and the shortterm outcomes of laparoscopic gastrectomy(LG) for gastric cancer(GC) in Asian patients. METHODS The Pub Med, Cochrane, EMBASE, and Web of Science databases were searched for studies that focused on the impact of obesity on the short-term outcomes of LG for GC in Asian patients who were classified into a high BMI(BMI ≥ 25 kg/m^2) or low BMI group(BMI < 25 kg/m^2). The results are expressed using the pooled odds ratio(OR) for binary variables and standard mean difference(SMD) for continuous variables with 95%confidence interval(CI), and were calculated according to the fixed-effects model while heterogeneity was not apparent or a random-effects model while heterogeneity was *** Nine studies, with a total sample size of 6077, were included in this meta-analysis. Compared with the low BMI group, the high BMI group had longer operative time(SMD = 0.26, 95%CI: 0.21 to 0.32, P < 0.001), greater blood loss(SMD = 0.19, 95%CI: 0.12 to 0.25, P < 0.001), and fewer retrieved lymph nodes(SMD =-0.13, 95%CI: 0.18 to 0.07, P < 0.001). There was no significant difference between the high and low BMI groups in postoperative complications(OR = 1.12, 95%CI: 0.95 to 1.33, P = 0.169), the duration of postoperative hospital stay(SMD = 0.681, 95%CI:-0.05 to 0.07, P = 0.681), postoperative mortality(OR = 1.95, 95%CI: 0.78 to 4.89, P = 0.153), or time to resuming food intake(SMD = 0.00, 95%CI:-0.06 to 0.06, P = 0.973).CONCLUSION Our meta-analysis provides strong evidence that despite being associated with longer operative time, greater blood loss, and fewer retrieved lymph nodes, BMI has no significant impact on the short-term outcomes of LG for GC in Asian patients, including postoperative complications, the duration of postoperative hospital stay, postoperative mortality, and time to resuming food intake. BMI may be a poor risk factor for shortterm outcomes of LG. Other indic

关键词： Obesity Body mass index Laparoscopic gastrectomy Gastric cancer Meta-analysis

Relevance of fecal calprotectin and lactoferrin in the postoperative management of inflammatory bowel diseases

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World Journal of Gastrointestinal surgery 2016年第3期8卷 193-201页

作者： Roberta Caccaro Imerio Angriman Renata D'Incà Department of surgery Oncology and Gastroenterology Gastroenterology Section University Hospital of Padua Department of surgery Oncology and Gastroenterology Surgery Section University Hospital of Padua

The role of fecal lactoferrin and calprotectin has been extensively studied in many areas of inflammatory bowel disease(IBD) patients' management. The postoperative setting in both Crohn's disease(CD) and ulcerative colitis(UC) patients has been less investigated although few promising results come from small, crosssectional studies. Therefore, the current post-operative management still requires endoscopy 6-12 mo after intestinal resection for CD in order to exclude endoscopic recurrence and plan the therapeutic strategy. In patients who underwent restorative proctocolectomy, endoscopy is required whenever symptoms includes the possibility of pouchitis. There is emerging evidence that fecal calprotectin and lactoferrin are useful surrogate markers of inflammation in the post-operative setting, they correlate with the presence and severity of endoscopic recurrence according to Rutgeerts' score and possibly predict the subsequent clinical recurrence and response to therapy in CD patients. Similarly, fecal markers show a good correlation with the presence of pouchitis, as confirmed by endoscopy in operated UC patients. Fecal calprotectin seems to be able to predict the short-term development of pouchitis in asymptomatic patients and to vary according to response to medical treatment. The possibility of both fecal markers to used in the routine clinical practice for monitoring IBD patients in the postoperative setting should be confirmed in multicentric clinical trial with large sample set. An algorithm that can predict the optimal use and timing of fecal markers testing, the effective need and timing of endoscopy and the cost-effectiveness of these as a strategy of care would be of great interest.

关键词： Calprotectin Lactoferrin Fecal markers Inflammatory bowel disease Post-operative surgery Crohn’s disease Ulcerative colitis

Magnetic resonance imaging in rectal cancer:A surgeon's perspective

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World Journal of Gastroenterology 2014年第8期20卷 2030-2041页

作者： Avanish P Saklani Sung Uk Bae Amy Clayton Nam Kyu Kim section of Colon and Rectal surgery Department of SurgeryYonsei University College of MedicineSeoul 120527South Korea Radiology Department University Hospital of WalesCF14 4XW CardiffUnited Kingdom Department of Colorectal surgery Severance HospitalSeoul 120527South Korea

Magnetic resonance imaging(MRI)in rectal cancer was first investigated in 1999 and has become almost mandatory in planning rectal cancer *** has a high accuracy in predicting circumferential resection margin involvement and is used to plan neoadjuvant *** accuracy of MRI in assessing mesorectal lymph nodes remains moderate,as there are no reliable criteria to assess nodal *** seems to be good in assessing peritoneal involvement in upper rectal cancer;this however has been assessed in only a few studies and needs further *** low rectal cancers,mesorectum is thin at the level of levator ani especially in relation to prostate;so predicting circumferential resection margin involvement is not *** high spatial resolution coronal imaging shows levator muscles,sphincter complex and intersphincteric plane *** is used to stage low rectal tumors and plan plane of surgery(standard surgery,intersphincteric resection,Extralevator abdominoperineal resection).While most centres perform MRI post chemoradiotherapy,its role in accurate staging post neoadjuvant therapy remains *** role of Diffusion weighted MRI post neoadjuvant therapy is being evaluated in research settings.

关键词： Magnetic resonance imaging Rectal cancer Surgeon

The neck burn scar contracture:a concept of effective treatment

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Burns & Trauma 2017年第3期5卷 140-147页

作者： Sadanori Akita Kenji Hayashida Satoshi Takaki Yoshihisa Kawakami Takuto Oyama Hiroyuki Ohjimi Department of Plastic surgery Wound Repair and Regeneration School of Medicine Fukuoka University 7-45-1 Nanakuma Jonan ku Fukuoka 8140180 Japan section of Plastic surgery School of Medicine Shimane University Shimane Japan Department of Plastic surgery School of Medicine Fukuoka University Fukuoka Japan

A neck scar contracture can severely and negatively affect the function of mastication, phonic, or breathing and result in neck pain and issues with esthetics. The best way is of course to avoid such contracture by means of non-surgical treatment such as use of a growth factor. The basic fibroblastic growth factor is clinically well proven in decreasing scar formation and improving healing. There are numerous reconstructive methods for neck contracture, especially when the lesions are relatively limited in part of the neck. However, a very severe and full circumferential scar contracture requires extensive reconstruction. The thin groin flap is one of the answers and well matches with the tissue texture and maintains the flexibility. Even with extensive burns and delayed reconstructions due to resuscitation first, the groin area is well preserved and can be safely harvested by dual vasculature systems of the superficial circumflex iliac artery and superficial epigastric artery, which warrant more reliability compared to the perforator flaps in this area. More demanding and stringent forms of the neck burn scar contracture are the sequelae of radiation. A radiation burn or radiation injury can be progressing and hard to heal. Adipose-derived stem cells can reverse the scar contracture as the surrounding tissue is softened and can accelerate wound healing. In this review, different types of neck burn scar contracture and reconstructive methods are summarized, including innovative use of bFGF and ADSCs in the management of difficult wound healing and scar contracture.

关键词： Neck scar contracture Anatomical locations Prophylaxis Severe scar contracture Thin groin flap Radiation injury Adipose-derived stem cell

Magnetic resonance imaging:Is there a role in clinical management for acute ischemic colitis?

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World Journal of Gastroenterology 2013年第8期19卷 1256-1263页

作者： Maria Antonietta Mazzei Susanna Guerrini Nevada Cioffi Squitieri Giusi Imbriaco Raffaele Chieca Serenella Civitelli Vinno Savelli Francesco Giuseppe Mazzei Luca Volterrani Department of Human Pathology and Oncology Section of Radiological SciencesUniversity of Siena53100 SienaItaly Oncologic Department UOC Gastroenterology and Digestive EndoscopyAzienda Ospedaliera Universitaria Senese53100 SienaItaly Division of surgery Azienda Ospedaliera Universitaria SeneseUniversity of Siena53100 SienaItaly Department of surgery and Bioengineering Section of SurgeryUniversity of Siena53100 SienaItaly Department of Diagnostic Imaging Azienda Ospedaliera Universitaria Senese53100 SienaItaly

AIM:To validate the utility of magnetic resonance imaging(MRI) for the clinical management of acute ischemic colitis(IC).METHODS:This is a magnetic resonance(MR) prospective evaluation of 7 patients who were proved to have acute IC on the basis of clinical,endoscopic and computed tomography(CT) findings and who were imaged in our institution between February 2011 and July *** mean age of the patients was 72.28 *** CTs were obtained using a 64-detector row configuration for all patients with un-enhanced and contrast-enhanced scans,in the late arterial phase(start delay 45-50 s) and in the portal venous phase(start delay 70-80 s).The MR examinations were performed using a 1.5T superconducting magnet,using Fast Imaging Employing Steady State Acquisition and T2-weighted fast-recovery fast-spin echo sequences in axial and coronal *** and MRI examinations were analysed for the presence of colonic abnormalities and associated ***:Segmental involvement was seen in 6 patients(85.71%),with a mean length of involvement of 412 mm(range 145.5-1000 mm).Wall thickness varied between 6 mm and 17.5 mm(mean 10.52 mm) upon CT examinations and from 5 to 15 mm(mean 8.8 mm) upon MR *** MRI appearance of the colonic wall varied over the time:TypeⅠappearance with a 3 layer sandwich sign was seen in 5 out of 12 examinations(41.66%),patients underwent MR within a mean of 36 h(ranging from 1 to 54 h) after the CT *** Ⅱ and Ⅲ appearance with a 2 layer sign,was seen in 4 examinations(33.33%),patients underwent MR within a mean of 420.5 h(ranging from 121 to 720 h) after the CT *** the remaining three MRI examinations,performed within a mean of 410 h(ranging from 99.5 to 720 h) the colonic wall appeared ***:MRI,only using precontrast images,may be used as a substitute for invasive procedures in diagnosis and follow-up of acute IC.

关键词： Ischemic colitis Magnetic resonance imaging Medical management Colon Computed tomography

Benign penile skin anomalies in children:a primer for pediatricians

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World Journal of Pediatrics 2015年第4期11卷 316-323页

作者： Marco Castagnetti Mike Leonard Luis Guerra Ciro Esposito Marcello Cimador section of Pediatric Urology Urology UnitUniversity Hospital of PadovaPaduaItaly Department of surgery Division of Pediatric UrologyChildren's Hospital of Eastern OntarioUniversity of OttawaOttawaONCanada Department of Pediatrics Federico II University of NaplesItaly section of Pediatric Urology and Pediatric surgery Unit Department for Mother&Child Care and UrologyUniversity of PalermoPalermoItaly

Background:Abnormalities involving the skin coverage of the penis are diffi cult to defi ne,but they can significantly alter penile appearance,and be a cause of parental *** sources:The present review was based on a non-systematic search of the English language medical literature using a combination of key words including"penile skin anomalies"and the specific names of the different ***:Conditions were addressed in the following order,those mainly affecting the prepuce(phimosis,balanitis xerotica obliterans,balanitis,paraphimosis),those which alter penile configuration(inconspicuous penis and penile torsion),and lastly focal lesions(cysts,nevi and vascular lesions).Most of these anomalies are congenital,have no or minimal influence on urinary function,and can be detected on clinical *** improvement is *** the majority of cases undergoing surgery,the potential psychological implications of genital malformation on patient development are the main reason for treatment,and the age generally recommended for surgery is after 12 months of ***:This review provides the pediatrician with a handy tool to identify the most common penile skin anomalies,counsel parents adequately,make sensible and evidence based choices for management,and recognize complications or untoward outcomes in patients undergoing surgery.

关键词： balanitis xerotica obliterans foreskin penis phimosis