scholarly journals MULTIPLE LYMPHATIC-VENOUS ANASTOMOSES (MLVA) FOR MICROSURGICAL DRAINAGE OF PRIMARY PENO-SCROTAL LYMPHEDEMA: A CASE REPORT

Lymphology ◽  
2020 ◽  
Vol 52 (3) ◽  
Author(s):  
PG di Summa ◽  
M Guiotto ◽  
P Zaugg ◽  
A Van Der Gucht ◽  
M Ryan ◽  
...  
Keyword(s):  
Case Report ◽  
Complete Remission ◽  
Laser Treatment ◽  
Lower Limb ◽  
Lymphatic Drainage ◽  
Complication Rates ◽  
Recurrent Infections ◽  
Lymphatic Flow ◽  
Genital Lymphedema

Single site Multiple Lymphatic-Venous Anastomoses (MLVA) provides optimal functional and cosmetic results with low complication rates in treatment of lower limb lymphedema. However, no evidence exists in literature concerning the use of this technique in treatment of peno-scrotal lymphedema. We report a case of a 44-year-old male patient who developed secondary peno-scrotal lymphedema with severe lymphorrhea, following a laser treatment for scrotal pustolosis, leading to recurrent infections and finally an established peno-scrotal lymphedema. Utilizing MLVA, a complete remission of scrotal lymphedema was achieved with significant volume reduction of the penile lymphedema. The post-operative course was uneventful with clear improvement in lymphatic flow demonstrable on lymphoscintigraphy (6 months) and no recurrence of scrotal lymphedema at 2 years follow-up. This article reports very promising results of a novel application of MLVA in the treatment of genital lymphedema and suggests that MLVA provides the possibility to shunt both superficial and deep lymphatics to improve the lymphatic drainage from the peno-scrotal area using a single surgical site.

scholarly journals Effects of physical therapy on hyaluronan clearance and volume regulating hormones in lower limb lymphedema patients: A pilot study

2021 ◽  
Vol 104 (1) ◽  
pp. 003685042199848
Author(s):  
Bianca Brix ◽  
Gert Apich ◽  
Andreas Rössler ◽  
Sebastian Walbrodt ◽  
Nandu Goswami
Keyword(s):  
Pilot Study ◽  
Lower Limb ◽  
Time Course ◽  
Plasma Renin ◽  
Lymphatic Drainage ◽  
Invasive Treatment ◽  
Lymphatic Flow ◽  
Compression Bandaging ◽  
Complete Decongestive Therapy ◽  
Total Plasma Protein

Lymphedema is manifested as a chronic swelling arising due to stasis in the lymphatic flow. No cure is currently available. A non-invasive treatment is a 3 week complete decongestive therapy (CDT), including manual lymphatic drainage and compression bandaging to control swelling. As CDT leads to mobilization of several liters of fluid, effects of CDT on hyaluronan clearance (maker for lymphatic outflow), volume regulating hormones, total plasma protein as well as plasma density, osmolality and selected electrolytes were investigated. In this pilot study, we assessed hyaluronan and volume regulating hormone responses from plasma samples of nine patients (three males, six females, aged 55 ± 13 years) with lower limb lymphedema stage II-III, before - and after - CDT. A paired non-parametric test (Wilcoxon) was used to assess hormonal and plasma volume changes. Correlation was tested using Spearman’s correlation. The main findings of this novel study are that lymphedema patients lost volume and weight after therapy. Hyaluronic acid did not significantly change pre- compared to post-CDT. Aldosterone increased significantly after therapy, while plasma renin activity increased, but not significantly. Plasma total protein, density, osmolality and sodium and chloride did not show differences after CDT. To our knowledge, no study has previously investigated the effects of CDT on volume regulating hormones or electrolytes. To identify the time-course of volume regulating hormones and lymphatic flow changes induced by CDT, future studies should assess these parameters serially over 3 weeks of therapy.

scholarly journals Long-term follow-up of complete remission of advanced hepatocellular carcinoma following sorafenib therapy: A case report

2017 ◽  
Vol 14 (4) ◽  
pp. 4853-4856 ◽  
Author(s):  
Jung Gil Park ◽  
Won Young Tak ◽  
Soo Young Park ◽  
Young Oh Kweon ◽  
Se Young Jang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Case Report ◽  
Complete Remission ◽  
Advanced Hepatocellular Carcinoma ◽  
Sorafenib Therapy ◽  
Long Term Follow Up

Initial Treatment of CD20+ Lymphocyte Predominant Hodgkin Lymphoma with Chemotherapy and the Monoclonal Antibody Rituximab-Mabthera Is Effective and Well Tolerated - Case Report.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 4696-4696
Author(s):  
Sonja G. Genadieva-Stavrik ◽  
Lubomir Ivkovski ◽  
Aleksandra Pivkova ◽  
Lidija Cevreska
Keyword(s):  
Case Report ◽  
Complete Remission ◽  
Patient Population ◽  
Mediastinal Mass ◽  
Early Stage ◽  
Cervical Lymphadenopathy ◽  
Malignant Cells ◽  
Limited Information ◽  
Patients Experience

Abstract Patients with lymphocyte-predominant Hodgkin disease (LPHD) often present at an early stage with slow disease progression. Although 96% of LPHD patients experience a complete remission (CR) upon first line treatment, many relapses occur. CD20+ is strongly expressed by malignant cells in LPHD, but so far there is limited information regarding the efficacy of rituximab in this patient population. We report 46-year-old woman who presented in 2004 with left cervical lymphadenopathy and weight loss. Case report: Biopsy confirmed a diagnosis of LPHD(stage IIB disease), immunohistochemistry revealed that >30% of malignant cells were CD20+, and a bulky mediastinal mass was observed by computer tomography (CT). Blood counts, erythrocyte sedimentation rate, albumin and lactate dehydrogenate were normal. The patient was treated with rituximab and ABVD (doxorubicin 25mg/m2, bleomycin 10mg/m2, vinbalstine 6mg/m2, dacarbazine 375mg/m2, six cycles). Rituximab was administered (375mg/m2) one day before chemotherapy (50mg/h for one hour and gradually escalated to a maximum of 400mg/h). Treatment was well tolerated and there were no complications. The patient was assessed immediately following treatment and every three months for the following year, by physical examination, CT, bone marrow biopsy and routine analyses. A detectable tumor mass was no observed by CT for the follow up of 2 years, the patient remains in complete remission. Conclusion: Our case report suggests that Rituximab is both safe and effective in patients with CD20+ LPHD. Further studies with Rituximab are warranted in this patient population.

Primary Granulocytic Sarcoma:A Allo-Transplantation Case Report and Literature Review.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4368-4368
Author(s):  
Xiaolin Li ◽  
Jie Fu ◽  
Yan Xue ◽  
Yang Yang ◽  
Yang Wang ◽  
...  
Keyword(s):  
Case Report ◽  
Complete Remission ◽  
Literature Review ◽  
Conflicts Of Interest ◽  
Granulocytic Sarcoma ◽  
Allogeneic Transplantation ◽  
Radical Operation ◽  
Matched Sibling ◽  
Granulocytic Leukemia

Abstract Abstract 4368 Objective To investigate the effect of allogeneic transplantation in treating primary granulocytic sarcoma. Methods We report the diagnosis and treatment of one patient with primary granulocytic sarcoma and review the related articles. Results Firstly appeared as one isolated tumor in breast, the disease was diagnosed by pathological methods with immunochemistry positive stain in MPO, CD68(KP-1) and bacteriolysis enzyme. After radical operation on sick breast, the patient was treated with four courses chemotherapy according to that of acute granulocytic leukemia,then followed by matched sibling transplantation. After 6 months follow-up, the patients is still in complete remission. Conclusion If having suitable donor, patient with primary granulocytic sarcoma shoud be treated with allogeneic transplantation. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Use of Stimulan absorbable calcium sulphate beads in revision lower limb arthroplasty

2018 ◽  
Vol 7 (10) ◽  
pp. 570-579 ◽  
Author(s):  
R. Kallala ◽  
W. Edwin Harris ◽  
M. Ibrahim ◽  
M. Dipane ◽  
E. McPherson
Keyword(s):  
Lower Limb ◽  
Safety Profile ◽  
Revision Arthroplasty ◽  
Bone Substitutes ◽  
Calcium Sulphate ◽  
Complication Rates ◽  
Number Of Patients ◽  
Total Knee ◽  
Hip Arthroplasties

Aims Calcium sulphate has traditionally been used as a filler of dead space arising during surgery. Various complications have been described following the use of Stimulan bio-absorbable calcium sulphate beads. This study is a prospective observational study to assess the safety profile of these beads when used in revision arthroplasty, comparing the complication rates with those reported in the literature. Methods A total of 755 patients who underwent 456 revision total knee arthroplasties (TKA) and 299 revision total hip arthroplasties (THA), with a mean follow-up of 35 months (0 to 78) were included in the study. Results A total of 32 patients (4.2%) had wound drainage, and this was higher with higher bead volumes and in McPherson grade C patients. There was also a significantly higher bead volume in the 41 patients who developed hypercalcaemia, two of which were symptomatic (p < 0.0001). A total of 13 patients (1.7%) had heterotopic ossification (HO). There was no statistically significant relationship between the development of HO and bead volume (p > 0.05). Conclusion The strength of this study lies in the large number of patients and the detailed data collection, making it the most comprehensive report available in the literature on the use of calcium sulphate-based bone substitutes. Cite this article: R. Kallala, W. Edwin Harris, M. Ibrahim, M. Dipane, E. McPherson. Use of Stimulan absorbable calcium sulphate beads in revision lower limb arthroplasty: Safety profile and complication rates. Bone Joint Res 2018;7:570–579. DOI: 10.1302/2046-3758.710.BJR-2017-0319.R1.

scholarly journals A Case Report of Melanoma as Acute Mastoiditis in a 10-Month-Old Female Child

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Konstantina Chrysouli ◽  
Michael Tsakanikos ◽  
Sofia Stamataki
Keyword(s):  
Case Report ◽  
Complete Remission ◽  
Histological Examination ◽  
Rare Case ◽  
Female Child ◽  
Metastatic Lesion ◽  
Radiological Assessment ◽  
Acute Mastoiditis ◽  
Bone Metastatic Lesion

We present a rare case of transplacental-transmitted maternal melanoma to the placenta and foetus during the pregnancy of a 34-year-old woman. She was diagnosed with a melanoma at the age of 25, for which she was treated with chemotherapy. During her pregnancy, she presented with a recurrence of the disease and died 3 months after delivery. The 10-month-old female child presented with a recurrent retroauricular oedema on the left side. A trephination of mastoid apophysis followed. Multiple fragments of dark-coloured tissue were sent for histological examination, and the immunophenotype showed a melanocytic tumour in the mastoid. A full radiological assessment showed no sign of metastasis. The child remained without treatment. Complete remission of bone metastatic lesion has been confirmed by follow-up; now, the child is 4 years old, alive, and without evidence of disease.

scholarly journals Tuberculous lumbar spinal epidural abscess in a young adult (case report)

SICOT-J ◽  
2018 ◽  
Vol 4 ◽  
pp. 5
Author(s):  
Ghazwan Abdulla Hasan ◽  
Saif Mohammed Kani ◽  
Ahmed Alqatub
Keyword(s):  
Case Report ◽  
Lower Limb ◽  
Epidural Abscess ◽  
Spinal Epidural Abscess ◽  
Mri Scan ◽  
Limb Weakness ◽  
Lower Limb Weakness ◽  
Lumbar Spinal ◽  
Spinal Epidural

Introduction: Spinal Epidural abscess (SEA) is an uncommon pathology that needs an urgent intervention to decompress the pressure on the spinal epidural sac, cord, and roots. The authors report a rare case of a young adult with lumbar spinal epidural tuberculous abscess occupying the spinal canal from L2–L5 vertebrae with extesion to the posterior paraspinal muscles and presenting with bilateral progressive lower limb weakness.   Case report: A 42 years old male teacher presented with a 15-day history of progressive difficulty to walking and bilateral lower limb weakness associated with fever, malaise and later on urinary incontinence. A magnetic resonance imaging (MRI) scan revealed a paraspinal intermuscular abscess and an abscess occupying the spinal canal compressing the dural sac from L2–L4/5, without any signs of vertebral involvement. Surgery was done by a posterior midline incision. Pus was evacuated from multiple pockets through the paraspinal muscle layers. Laminectomy for L3/4, and hemilaminectomy for L2/3, and L4/5 were performed. Pus and bone specimens were negative for acid-fast bacilli. However, both histopathological studies and Polymerase Chain Reaction (PCR) testing confirmed the presence of tuberculosis (TB). The patient received TB antibiotics, and a follow-up MRI scan at 2 months showed complete evacuation of the abscess. However, signs of L5 spondylitis were evident. No further surgery was needed as there was no vertebral collapse or neural compression and the patient's clinical condition was improving. He had normal right lower limb power and sensation and grade 4+ motor power of the left lower limb. Bowels and bladder function was normal. Conclusion: Isolated tuberculous spinal epidural abscess is a rare disease and should be treated urgently with evacuation and decompression. Signs of spondylitis or spondylodiscitis may appear later and therefore long follow up is recommended in tuberculous cases presenting with an isolated epidural abscess.

Comparisons among three approaches—two minimally invasive and one conventional—for total knee arthroplasty: a retrospective cohort study with minimum follow-up of 10 years

2019 ◽  
Author(s):  
Fuzhen Yuan ◽  
Zewen Sun ◽  
Baoshi Fan ◽  
Dong Jiang ◽  
Jiying Zhang ◽  
...  
Keyword(s):  
Lower Limb ◽  
Mechanical Axis ◽  
Reoperation Rate ◽  
Complication Rates ◽  
Clinical Evaluations ◽  
Lateral Patella ◽  
Total Knee ◽  
Medial Parapatellar

Abstract BackgroundFew studies have investigated whether the mini-medial parapatellar (MMP) and quadriceps-sparing (QS) approaches have good long-term results compared to the conventional medial parapatellar (MP) approach in terms of clinical evaluations and radiographic assessments for total knee arthroplasty (TKA). The purpose of this study was to perform comparisons among the MMP, QS and MP approaches with a follow-up at 10 to 17 years.MethodsThis is a retrospective comparative study of 93 patients who underwent MMP TKA (32 TKAs), QS TKA (47 TKAs) or MP TKA (31 TKAs) with the same arthroplasty system. The clinical evaluations were performed according to the new American Knee Society score (KSS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the visual analogue scale (VAS), range of motion (ROM), incidence of anterior knee pain (AKP), the Feller patellofemoral score (PFS), the reoperation rate and the complication rates. Radiographic assessments included observation of the mechanical axis of the lower limb and calculations of the lateral distal femoral angle (LDFA), femoral flexion angle (FFA), medial proximal tibial angle (MPTA), tibial slope angle (TSA), lateral patella displacement (LPD), and lateral patella tilt (LPT).ResultsThere were no differences in the long-term follow-up results of the new KSS, WOMAC score, ROM, VAS, patellofemoral functions, reoperation rate or complication rates among the groups. In addition, no radiographic differences in terms of lower limb mechanical axis or femoral, tibial or patellar position were observed.ConclusionThese results provide conclusive evidence that equivalent, long-term clinical results can be obtained using any one of these three approaches.

PS02.217: CLINICAL RESULTS OF PHOTODYNAMIC THERAPY FOR INOPERABLE ESOPHAGEAL SQUAMOUS CELL CARCINOMA

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 183-184
Author(s):  
Eunjue Yi ◽  
Jae Ho Chung ◽  
Junhee Lee ◽  
Sungho Lee ◽  
Han Kim
Keyword(s):  
Esophageal Cancer ◽  
Photodynamic Therapy ◽  
Complete Remission ◽  
Cancer Patients ◽  
Partial Remission ◽  
Conflicts Of Interest ◽  
Clinical Results ◽  
Esophageal Stenosis ◽  
Complication Rates

Abstract Background Although surgical resection is the best way for curing cancer, there has been a certain portion of patients who could not undergo surgery because of various reasons. We experienced 9 cases of photodynamic therapy for esophageal cancer patients with inoperable conditions, and investigated the feasibility and safety of photodynamic therapy. Methods Medical records of patients of esophageal cancers who received photodynamic therapies in Korea University Anam Hospital were reviewed retrospectively. Survival, complication rates and treatment results were evaluated. Results A total of 9 patients (all men) with esophageal cancer had been received photodynamic therapy between 2007 and 2015. Average age at the time of treatment was 70.9 (± 4.62, ranging 64 to 78) and average follow-up periods were 18.2 (± 16.59, ranging 3.8 to 53.6). The average Charlson Comorbidity Index (CCI) were 7.3 (± 2.29, ranging 4 to 10). During the follow-up periods, 5 patients died, and only one death was related with the distant metastasis progression. There was one case of skin reaction and no other complications were appeared. There were no complication related deaths. Complete remission of esophageal cancer showed in 6 patients (66.7%) and partial remission showed in 3 patients (33.3%). Two patients with partial remission showed loco-recurrence. One patient with complete remission had to undergo surgery because of preexisting esophageal stenosis. In patients with complete remission, no recurrence was observed. Conclusion Photodynamic therapy is feasible and safe with acceptable rates of complications. For esophageal cancer patients with inoperable condition or refusal of surgery, photodynamic therapy could provide alternative way to treatment. Disclosure All authors have declared no conflicts of interest.

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