scholarly journals Percutaneous Holmium Laser Fulguration of Calyceal Diverticula

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Amjad Alwaal ◽  
Raed A. Azhar ◽  
Sero Andonian
Keyword(s):  
Technical Difficulty ◽  
Holmium Laser ◽  
Percutaneous Technique ◽  
Safe Alternative ◽  
Electrolyte Disturbances ◽  
Calyceal Diverticulum ◽  
Irrigation Solution ◽  
Calyceal Diverticula ◽  
Hypotonic Fluids ◽  
First Time

Introduction. Calyceal diverticular stones are uncommon findings that represent a challenge in their treatment, due to the technical difficulty in accessing the diverticulum, and the high risk of their recurrence. Current percutaneous technique for calyceal diverticular stones involves establishing a renal access, clearing the stone, and fulguration of the diverticular lining with a roller-ball cautery electrode using hypotonic irrigation solution such as sterile water or glycine solution which may be associated with the absorption of hypotonic fluids with its inherent electrolyte disturbances.Case Report. In this paper, we present for the first time percutaneous holmium laser fulguration of calyceal diverticula in 2 patients using normal saline. Their immediate postoperative sodium was unchanged and their follow-up imaging showed absence of stones. Both patients remain asymptomatic at 30 months post-operatively.Conclusion. This demonstrates that holmium laser is a safe alternative method to fulgurate the calyceal diverticulum after clearing the stone percutaneously.

scholarly journals Brugada-like electrocardiogram pattern in a young man taking a proton-pump inhibitor

2020 ◽  
pp. 17-20
Author(s):  
Michel de Lorgeril ◽  
Mikael Rabaeus
Keyword(s):  
Proton Pump ◽  
Ventricular Arrhythmias ◽  
Bundle Branch Block ◽  
St Segment Elevation ◽  
Electrolyte Disturbances ◽  
St Segment ◽  
Electrical Heart Disease ◽  
Complex Inheritance ◽  
Electrocardiogram Ecg ◽  
First Time

The Brugada syndrome (BrS) is an electrical heart disease with complex inheritance (some cases with SCN5A mutations), characterized by specific electrocardiogram (ECG) markers and high risk of associated lethal ventricular arrhythmias [1]. The ECG signature of BrS consists of right precordial ST-segment elevation (≥2 mm) followed by negative T waves [1]. It sometimes includes the findings of right bundle branch block (RBBB). In certain cases, the typical ECG pattern is present intermittently which creates a potential problem for reaching the diagnosis of BrS. Another problem in diagnosing BrS is the presence of so-called Brugada phenocopies (BrPs), i.e. an acquired Brugada-like ECG pattern that are visually identical and indistinguishable from true BrS [2]. This ECG pattern can be caused by other conditions including ischemia of the ventricular septum and/or right ventricle or by taking certain medications [2]. Proton-pump inhibitors (PPIs) are widely prescribed, often for prolonged use, and have been associated with electrolyte disturbances and cardiac arrhythmias [3,4]. We hereby present for the first time the case of a patient with an ECG suggestive of BrS while taking PPI; but no other medication known to cause BrS. The BrS ECG pattern disappeared a few months after stopping the medication.

scholarly journals Case Report: Suprasellar Pituitary Adenoma Presenting With Temporal Lobe Seizures

2020 ◽  
Vol 7 ◽  
Author(s):  
Christopher S. Hong ◽  
Ramana Gorrepati ◽  
Adam J. Kundishora ◽  
Aladine A. Elsamadicy ◽  
Patricia R. Peter ◽  
...  
Keyword(s):  
Temporal Lobe ◽  
Seizure Activity ◽  
Mass Effect ◽  
Left Temporal Lobe ◽  
Endoscopic Endonasal ◽  
Electrolyte Disturbances ◽  
Surgical Debulking ◽  
Temporal Lobe Seizures ◽  
First Time ◽  
Pituitary Macroadenomas

Seizures in patients with pituitary pathology are uncommon and typically secondary to electrolyte disturbances. Rarely, seizures have been described from mass effect related to large prolactinomas undergoing medical treatment. We describe a 54 year-old male who presented with a first-time generalized seizure, secondary to a pituitary macroadenoma compressing the left temporal lobe. His seizures abated after endoscopic endonasal debulking of the tumor. This report highlights isolated seizures as a potential sole presenting symptom of pituitary macroadenomas without visual or endocrine dysfunction. Prompt surgical debulking to relieve mass effect on the temporal lobe may effectively prevent further seizure activity.

scholarly journals Laparoscopic-assisted Appendectomy in Children with Uncomplicated Appendicitis

2021 ◽  
Vol 18 (1) ◽  
pp. 34-38
Author(s):  
Saeed Al Hindi ◽  
Husain Al Aradi ◽  
Mohamed Mubarak ◽  
Noor AlHashimi
Keyword(s):  
Acute Appendicitis ◽  
Operative Time ◽  
Pediatric Population ◽  
Intraoperative Complications ◽  
Open Appendectomy ◽  
Safe Alternative ◽  
Surgical Emergencies ◽  
Uncomplicated Appendicitis ◽  
Laparoscopic Assisted ◽  
First Time

Background: Acute appendicitis is one of the common surgical emergencies in the pediatric population. In 1990, laparoscopic-assisted  appendectomy was used in children for the first time. In this study, we present our initial experience with laparoscopic-assisted appendectomy in children, using two trocar sites, and assess it for safety and outcome. Methods: 76 cases with acute appendicitis underwent laparoscopic-assisted appendectomy at Salmaniya Medical Complex (SMC), Kingdom of Bahrain, between January 2012 and December 2015. These cases were reviewed prospectively. Results: 76 patients between 5 and 12 years underwent laparoscopic-assisted appendectomy at SMC. Operative time ranged from 25 to 45 min  (mean 33.93 min). Postoperative hospitalization ranged from 2 to 5 days (mean 2.88 days). One patient developed wound infection which  subsequently subsided with conservative treatment. One case was converted to open appendectomy, but without any intraoperative complications. All patients were followed up for 2 weeks, 1 month, and 3 months postoperatively. Conclusion: Laparoscopic-assisted appendectomy in children is a safe alternative to the open technique. The operative time in this technique and the length of hospitalization are both less and shorter than the open counterpart. No major intra-operative or postoperative complications were documented. Recovery was excellent. Keywords: Appendicitis, Laparoscopic-assisted appendectomy, Open appendectomy

V9-07 INFUNDIBULOPLASTY OF CALYCEAL DIVERTICULA USING MODIFIED PERCUTANEOUS TECHNIQUE

2014 ◽  
Vol 191 (4S) ◽  
Author(s):  
Matthew J. Pagano ◽  
Gina M. Badalato ◽  
Ruslan Korets ◽  
Mantu Gupta
Keyword(s):  
Percutaneous Technique ◽  
Calyceal Diverticula

Comparison of Tracheal Intubation Conditions in Operating Room and Intensive Care Unit

2018 ◽  
Vol 129 (2) ◽  
pp. 321-328 ◽  
Author(s):  
Manuel Taboada ◽  
Patricia Doldan ◽  
Andrea Calvo ◽  
Xavier Almeida ◽  
Esteban Ferreiroa ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Tracheal Intubation ◽  
Success Rate ◽  
Operating Room ◽  
Direct Laryngoscopy ◽  
Technical Difficulty ◽  
Time Frame ◽  
Lehane Grade ◽  
First Time

Abstract What We Already Know about This Topic What This Article Tells Us That Is New Background Tracheal intubation is a common intervention in the operating room and in the intensive care unit. The authors hypothesized that tracheal intubation using direct laryngoscopy would be associated with worse intubation conditions and more complications in the intensive care unit compared with the operating room. Methods The authors prospectively evaluated during 33 months patients who were tracheally intubated with direct laryngoscopy in the operating room, and subsequently in the intensive care unit (within a 1-month time frame). The primary outcome was to compare the difference in glottic visualization using the modified Cormack-Lehane grade between intubations performed on the same patient in an intensive care unit and previously in an operating room. Secondary outcomes were to compare first-time success rate, technical difficulty (number of attempts, operator-reported difficulty, need for adjuncts), and the incidence of complications. Results A total of 208 patients met inclusion criteria. Tracheal intubations in the intensive care unit were associated with worse glottic visualization (Cormack-Lehane grade I/IIa/IIb/III/IV: 116/24/47/19/2) compared with the operating room (Cormack-Lehane grade I/IIa/IIb/III/IV: 159/21/16/12/0; P < 0.001). First-time intubation success rate was lower in the intensive care unit (185/208; 89%) compared with the operating room (201/208; 97%; P = 0.002). Tracheal intubations in the intensive care unit had an increased incidence of moderate and difficult intubation (33/208 [16%] vs. 18/208 [9%]; P < 0.001), and need for adjuncts to direct laryngoscopy (40/208 [19%] vs. 21/208 [10%]; P = 0.002), compared with the operating room. Complications were more common during tracheal intubations in the intensive care unit (76/208; 37%) compared with the operating room (13/208; 6%; P < 0.001). Conclusions Compared with the operating room, tracheal intubations in the intensive care unit were associated with worse intubation conditions and an increase of complications.

scholarly journals COMPARISON OF ANTIFUNGAL EFFECT OF XANTHORRHIZOL (CURCUMA XANTHORRHIZA ROXB.) AND 2% CHLORHEXIDINE AGAINST CANDIDA ALBICANS AMERICAN TYPE CULTURE COLLECTION 10231 BIOFILM

2020 ◽  
pp. 80-84
Author(s):  
SANNY TULIM ◽  
KAMIZAR NAZAR ◽  
ANGGRAINI MARGONO ◽  
RATNA MEIDYAWATI ◽  
ERMI YANTI
Keyword(s):  
Candida Albicans ◽  
Culture Collection ◽  
Host Cells ◽  
Plate Count ◽  
Optimum Dose ◽  
Safe Alternative ◽  
Antifungal Effect ◽  
Significant Difference ◽  
Irrigation Solution ◽  
Curcuma Xanthorrhiza

Objective: Several studies suggest that 2% chlorhexidine (CHX), an effective irrigation solution against Candida albicans biofilm, is toxic to host cells,thus an effective and safe alternative irrigation solution is needed. Java turmeric (Curcuma xanthorrhiza Roxb.) containing xanthorrhizol (XNT) hasbeen reported to have an antifungal effect, yet no studies to date have reported the optimum dose of XNT in inhibiting C. albicans biofilm, so the aimof this study was to determine the optimum dose of XNT against C. albicans biofilm.Methods: C. albicans American Type and Culture Collection (ATCC) 10231 biofilm was exposed to XNT for 15 min. Then, the antifungal effect wastested using 3-[4,5-dimethyl-thiazol-2-yl]-2,5-diphenytetrazolium bromide reduction assay and total plate count (TPC).Results: There was no statistically significant difference between the percentage of biofilm eradication and TPC results following exposure ofC. albicans ATCC 10231 biofilm to 1% XNT, 1.25% XNT, and 2% CHX.Conclusion: Our results suggest that 1% XNT and 1.25% XNT have an antifungal effect against C. albicans ATCC 10231 biofilm equivalent to that of2% CHX.

scholarly journals Rupture of a Calyceal Diverticulum Secondary to Ureteroscopy: A Rare Complication

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Tomoya Yamasaki ◽  
Takashi Yoshioka ◽  
Masaya Imoto ◽  
Hiroshi Aoki ◽  
Kei Fujio ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pain Relief ◽  
Renal Cortex ◽  
Rare Complication ◽  
Flank Pain ◽  
High Fever ◽  
Antibiotic Administration ◽  
Risk Of Rupture ◽  
Calyceal Diverticulum ◽  
Calyceal Diverticula

We present a case of a 45-year-old female who experienced rupture of a right calyceal diverticulum caused by ureteroscopy. Fifteen hours after the operation, she had severe right flank pain and a high fever (38.9°C). Computed tomography revealed perinephric extravasation of urine and bleeding inside the diverticulum. We diagnosed rupture of a calyceal diverticulum; therefore, we continued antibiotic administration and pain relief medication. She became afebrile on postoperative day 4 and was discharged from the hospital on postoperative day 7. Owing to renal cortex thinning in the diverticula, ureteroscopy is associated with a risk of rupture of calyceal diverticula.

scholarly journals The First Study on Nuclear Polyhedrosis Virus Histopathological and Morphological Effects on the Strawberry Pest, Pentodon Algerinum (coleoptera: Scarabaeidae)

2021 ◽  
pp. 81-94
Author(s):  
Samah, M.M. Abd El-Aziz ◽  
Magda, H. Rady ◽  
Bouthaina, A. Merdan ◽  
Abd El-Salam A.M.E ◽  
Hany, M. Hussein ◽  
...  
Keyword(s):  
Energetic Materials ◽  
Nuclear Polyhedrosis Virus ◽  
Insect Pest ◽  
Alternative Control ◽  
Safe Alternative ◽  
Polyhedrosis Virus ◽  
Fat Bodies ◽  
Nuclear Polyhedrosis ◽  
First Time ◽  
Cuticular Layer

In Egypt, strawberry is an economically important crop that has recently been destroyed by Pentodon algerinum, a worldwide polyphagous destructive insect pest. This study aimed to distinguish, for the first time, the histopathological and morphological effects of Spodoptera littoralis Nuclear polyhedrosis virus (SpliNPV) and Pentodon algerinum Nuclear polyhedrosis virus (PNPV) on Pentodon algerinum third instar larvae to confirm their success as safe alternative control agents against this pest. The results showed that PNPV and SpliNPV affected Pentodon larvae by the same effects in causing the following: integument deformation and rupture; the destruction of the hypodermal layer resulting in the inhibition of the process of molting into the pupa stage, reducing pest survival; larva leg corrosion, which prevents its spreading; the rupture of fat bodies, which leads to the loss of stored energetic materials; the distortion of muscle sarcolemma and fibers resulting in weakness and softness; the tracheal cuticular layer destruction, which inhibits breathing; midgut rupture with cells detaching from each other; irregular cytoplasm distribution; the loss of the columnar shape of cells; the appearance of vacuoles between cells, which results in their inability to feed or to digest; the swelling, softness, liquefaction, and, lastly, death of the larva.

Surgical treatment of thoracic Pott disease in a 3-year-old child, with vertebral column resection and posterior-only circumferential reconstruction of the spinal column

2012 ◽  
Vol 9 (4) ◽  
pp. 447-451 ◽  
Author(s):  
Leonardo Rangel-Castilla ◽  
Steven W. Hwang ◽  
William E. Whitehead ◽  
Daniel J. Curry ◽  
Thomas G. Luerssen ◽  
...  
Keyword(s):  
Young Children ◽  
Vertebral Column ◽  
Spinal Column ◽  
Technical Difficulty ◽  
Bed Rest ◽  
Cord Compression ◽  
Common Disease ◽  
Vertebral Column Resection ◽  
Safe Alternative ◽  
Very Young Children

Tuberculosis (TB) is a common disease worldwide that is caused by Mycobacterium tuberculosis. Tuberculosis of the spine, also called Pott disease, is the most common site of bony dissemination. Although children are disproportionately affected, spinal TB is nonetheless rare in very young children. Cases involving infants requiring surgical intervention have been previously reported, and they are often associated with greater management challenges given the technical difficulty with instrumentation in very young children. This case involved a 3-year-old girl with TB centered at T-6, who presented with myelopathy from spinal cord compression and a severe kyphotic deformity (> 60°). She underwent a single-stage costotransversectomy for vertebral column resection, followed by reconstruction with an anterior expandable titanium cage and posterior pedicle screw instrumentation. At last follow-up, the patient was clinically and radiographically stable. The authors report on the youngest patient with spinal TB treated surgically with this strategy and review the literature regarding prior cases involving young children. Although limited by the paucity of cases in the literature, surgical debridement and spinal fusion appear to provide a safe alternative to prolonged bed rest or casting and may offer additional benefits of a faster recovery and ambulation.

Annulate lamellae in the Sertoli cells of guinea pig testis after unilateral torsion of the spermatic cord

1984 ◽  
Vol 42 ◽  
pp. 196-197
Author(s):  
J. Chakraborty ◽  
A. P. Sinha Hikim ◽  
J. S. Jhunjhunwala
Keyword(s):  
Sertoli Cells ◽  
Guinea Pigs ◽  
Spermatic Cord ◽  
Present Report ◽  
Cell Types ◽  
Annulate Lamellae ◽  
Spermatogenic Cells ◽  
Electron Microscopic ◽  
Structural Details ◽  
First Time

Although the presence of annulate lamellae was noted in many cell types, including the rat spermatogenic cells, this structure was never reported in the Sertoli cells of any rodent species. The present report is based on a part of our project on the effect of torsion of the spermatic cord to the contralateral testis. This paper describes for the first time, the fine structural details of the annulate lamellae in the Sertoli cells of damaged testis from guinea pigs.One side of the spermatic cord of each of six Hartly strain adult guinea pigs was surgically twisted (540°) under pentobarbital anesthesia (1). Four months after induction of torsion, animals were sacrificed, testes were excised and processed for the light and electron microscopic investigations. In the damaged testis, the majority of seminiferous tubule contained a layer of Sertoli cells with occasional spermatogonia (Fig. 1). Nuclei of these Sertoli cells were highly pleomorphic and contained small chromatinic clumps adjacent to the inner aspect of the nuclear envelope (Fig. 2).

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