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The Application of Improved Position for Lower Limb full Length DR Radiograph in Hip/Knee Arthroplasty
Huige Hou,
Jinguo Lai,
Xiufang Yan,
Zhichao Lin
Issue:
Volume 6, Issue 2, April 2018
Pages:
33-35
Received:
16 January 2018
Accepted:
31 January 2018
Published:
15 March 2018
Abstract: Aim Compared with the traditional position, we tried to explore the application of improved position for lower limb DR radiograph in hip and knee arthroplasty. Method Retrospective analysis of the traditional and improved DR radiographs from 60 cases for hip and knee arthroplasty, by comparing the division angle, lower limb mechanical axis length, mechanical deviation between the lower limb mechanical axis and the center of the tibial plateau. Results (1) Preoperative data from twenty cases of improved and 15 cases of traditional lower limb DR radiographs showed the mechanical deviations between the lower limb mechanical axis and the center of the tibial plateau were 28.18, 4.71, 30.66, 11.92; postoperative data from fifty cases of improved and 33 cases of traditional DR radiographs showed the mechanical deviations between the lower limb mechanical axis and the center of the tibial plateau were 5.04, 11.03 (P < 0.05). (2) Improved position much more clearly showed the full length of the lower limb, compared with traditional position. (3) Values preoperative correction angle of 31 cases of improved and 19 cases of traditional position were 5.9°, 6.7° (P < 0.05). Conclusion DR radiographs of improved position can realistically show the pre- and post-operative status of hip and knee. The data of correction angle, lower limb mechanical axis length, mechanical deviations between the lower limb mechanical axis and the center of the tibial plateau can be more accurate. It is more convenient for the selection of operation procedure and for the assessment of surgery and rehabilitation.
Abstract: Aim Compared with the traditional position, we tried to explore the application of improved position for lower limb DR radiograph in hip and knee arthroplasty. Method Retrospective analysis of the traditional and improved DR radiographs from 60 cases for hip and knee arthroplasty, by comparing the division angle, lower limb mechanical axis length, ...
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Gastric Mucosal Changes and Ghrelin Expression and Their Relation to Weight Reduction After Sleeve Gastrectomy
Sabry Ahmed Mahmoud,
Ahmed Fadaly Hussein,
Waleed Omar,
Emad Abdallah,
Wagdi Elkashef,
Mohamed Anwar,
Sameh Emile
Issue:
Volume 6, Issue 2, April 2018
Pages:
36-42
Received:
6 February 2018
Accepted:
24 February 2018
Published:
19 March 2018
Abstract: Background: Weight loss after laparoscopic sleeve gastrectomy (LSG) is usually attributed to the volume restrictive effect of the procedure in addition to specific hormonal changes. Objective: The present study aimed to investigate the changes in plasma ghrelin levels, the number of ghrelin producing cells and histopathological changes in the remaining pouch after LSG. Methods: The present study included 27 patients with morbid obesity. The plasma ghrelin levels were measured before and six months after LSG and the change in their levels was assessed in relation to body mass index (BMI) after LSG. Immunohistochemical staining of cellular ghrelin was used to evaluate the number and distribution of ghrelin producing cells in the resected specimen and the mucosal changes in the remaining gastric pouch after LSG were assessed at 6 months postoperatively. Results: The mean age of patients was 33.9± 21.9 years. At six months after LSG, BMI decreased from 52.6± 12.8 to 40.8± 7.2 Kg/m2 (p= 0.0001). The plasma ghrelin level decreased significantly from 564.1± 15 to 434.7± 22.6 at six months after LSG. There was strong positive correlation between BMI after LSG and plasma ghrelin level (R= 0.906, p= <0.0001). A significant improvement in the inflammatory parameters was noticed by histopathologic examination. The mean ghrelin positive cell per specimen decreased significantly from 25.37± 3.5 to 13.7 ± 2.12. Conclusion: There was good positive correlation between weight loss and lowering of plasma ghrelin level, also complete removal of the fundus was associated with more weight loss.
Abstract: Background: Weight loss after laparoscopic sleeve gastrectomy (LSG) is usually attributed to the volume restrictive effect of the procedure in addition to specific hormonal changes. Objective: The present study aimed to investigate the changes in plasma ghrelin levels, the number of ghrelin producing cells and histopathological changes in the remai...
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Evaluation of Weight Reduction, Diabetic State and Satiety Hormones After Laparoscopic Greater Curvature Plication in Morbidly Obese Diabetic Patients
Waleed Omar,
Mohammad Hamed,
Sabry Ahmed Mahmoud,
Hosam Elbanna,
Mahmoud Abdelnaby,
Sameh Emile,
Mohamed Anwar
Issue:
Volume 6, Issue 2, April 2018
Pages:
43-49
Received:
6 February 2018
Accepted:
24 February 2018
Published:
19 March 2018
Abstract: Bariatric surgery proved effective in the treatment of morbid obesity and its associated comorbidities. The aim of this study was to assess weight loss and changes in glucose homeostasis and satiety hormones and to evaluate improvement in diabetic status in morbidly obese patients with type two diabetes mellitus (T2DM) at 6 and 12 months after laparoscopic greater curvature plication (LGCP). Twenty patients with morbid obesity with T2DM were operated upon with LGCP. Weight loss was assessed by the decrease in BMI and percentage of excess weight loss at 6 and 12 months after LGCP. Fasting and postprandial blood glucose levels, HbA1c, fasting serum insulin, serum ghrelin and glucagon-like peptide 1 (GLP-1) levels were measured before and at 6 and 12 months postoperatively. The mean age of patients was 37.6 years. There was significant decrease in BMI from 45.4 to 40.1 at 6 months (p= 0.0008) and then to 36.4 at 12 month (p< 0.0001). The mean fasting blood glucose decreased significantly from 134.8 preoperatively to 120.8 at 6 months (p< 0.0001) and then to 109.5 at 12 months (p< 0.0001). The mean preoperative HbA1c declined from 6.8 before LGCO to 6.3 at 6 months (p< 0.0001) then to 5.9 at 12 months (p< 0.0001). The mean fasting insulin level decreased from 20.5 preoperatively to 17.4 at 6 months (p< 0.0001) then to 16.7 at 12 months (p< 0.0001). The mean baseline ghrelin level decreased significantly from 551.7 preoperatively to 441.5 at 6 months (p< 0.0001) then to 422.5 at 12 months (p< 0.0001). The mean GLP-1 declined from 33.7 before surgery to 33.5 at 6 months (p= 0.76) then to 33.1 at 12 months (p= 0.36). LGCP is an effective bariatric procedure that achieved satisfactory weight loss and significant improvement in the glycemic control as demonstrated by improvement in laboratory markers as serum glucose, insulin, and ghrelin hormone levels.
Abstract: Bariatric surgery proved effective in the treatment of morbid obesity and its associated comorbidities. The aim of this study was to assess weight loss and changes in glucose homeostasis and satiety hormones and to evaluate improvement in diabetic status in morbidly obese patients with type two diabetes mellitus (T2DM) at 6 and 12 months after lapa...
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Bilateral Anesthesia Mumps After Robot-Assisted Hysterectomy Under General Anesthesia: Two Case Reports
Jung Min Lee,
Eun Young Park,
Kyung Mi Kim,
Jong Chan Won,
You Jung Kim,
Soo Kyung Lee
Issue:
Volume 6, Issue 2, April 2018
Pages:
50-52
Received:
19 February 2018
Accepted:
8 March 2018
Published:
28 March 2018
Abstract: Acute post-operative parotid gland swelling or “anesthesia mumps” is a rare complication that occurs after general or regional anesthesia. While the exact mechanism underlying this condition is not fully understood, mechanical obstruction of Stensen’s duct due to incorrect head positioning, peri-operative medication, dehydration, and retrograde passage of air into the parotid gland have all been implicated in post-operative parotid swelling. Here we present two cases of parotid swelling after robot-assisted hysterectomy, both of which are thought to have been caused by compression due to shoulder braces. Careful attention to the head and neck position is required to avoid mechanical obstruction of the parotid duct, and by extension, parotid gland swelling.
Abstract: Acute post-operative parotid gland swelling or “anesthesia mumps” is a rare complication that occurs after general or regional anesthesia. While the exact mechanism underlying this condition is not fully understood, mechanical obstruction of Stensen’s duct due to incorrect head positioning, peri-operative medication, dehydration, and retrograde pas...
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Treatment of Multiple Arterial Aneurysms in Patient with Polyaneurysmal Disease: Case Report
Kimã Barbosa Monteiro Meira,
Rodrigo Nóbrega Bandeira,
Tainá Louise Dantas Barreto,
Ranieri Dutra Nogueira,
Felipe Ramalho de Morais,
Caio César Vaz Lacet Gondim,
Amanda Morimitsu,
Sérgio Ricardo Ferreira Vieira,
Francisco Chavier Vieira Bandeira,
Paulo Roberto da Silva Lima
Issue:
Volume 6, Issue 2, April 2018
Pages:
53-57
Received:
19 February 2018
Accepted:
11 March 2018
Published:
3 April 2018
Abstract: Polyneurysmal dystrophy is defined as the clinical entity characterized by the presence of multiple arterial lesions in different sections of the arterial tree in a simultaneous or sequential manner, excluding uniquely bilateral and multilobulated aneurysms [1, 2]. The incidence of multiple aneurysms in the United States is 0.01% [3] to 3.9% [4]. These aneurysms are caused by: atherosclerosis [4, 5], changes in elastic fibers (ectasic medial dystrophy) [6], Polyarteritis Nodosa, Takayasu's arteritis, Behçet's disease, Marfan's syndrome, trauma and infection [7]. We performed a search on the PubMed and Bireme databases, where we found 17 articles from 1963 to 2017. This work is a case report. A 79-year-old male, a former smoker, hypertensive. He was undergoing colored arterial Doppler ultrasonography that revealed fusiform aneurysms in popliteal arteries (AAP) and femoral arteries (AAF) bilaterally. A Computed tomography angiography (CTA) showed Abdominal Aortic Aneurysm (AAA) type IV (Crawford) of 4.5 cm in diameter, iliac arteries and common femoral arteries enlarged. Fifteen days before the starting of studies of this case, the patient presented fungal lesion in right foot evolving with critical ischemia. We opted for conventional surgery. A femoral-pedal bypass with ex-vivo saphenous vein without valves, in the right lower limb, with the exclusion of AAF and AAP, was also performed, in addition to amputation of the 5th right toe. The colored arterial Doppler ultrasonography of the RLL at the 30th day after the surgery evidenced exclusion of AAF, patent bypass, AAP with low flow and thrombi in it. Forty days after the surgery in RLL, he evolved with pain, pallor and hypothermia in Left Lower Limb (LLL). A colored arterial Doppler ultrasonography of the LLL revealed acute occlusion of the left popliteal artery and a Left Femoral Artery Aneurysm. We have performed a femoral-pedal bypass in Left Lower Limb, with exclusion of AAF and left AAP. About 3 (three) months after the last surgery, the patient evolved well, with peripheral pulses preserved. But during preparation for the correction of the thoracic aneurysm the patient developed mesenteric thrombosis due to the mural thrombi of the abdominal aortic aneurysm; he was submitted to exploratory laparotomy and resection of 70 cm of small intestine. During waiting for customized endoprosthesis to treat abdominal aortic aneurysm, the patient had passed away. We cannot waste time in the treatment of this disease, and it is extremely difficult to predict which of the aneurysms needs to be treated first.
Abstract: Polyneurysmal dystrophy is defined as the clinical entity characterized by the presence of multiple arterial lesions in different sections of the arterial tree in a simultaneous or sequential manner, excluding uniquely bilateral and multilobulated aneurysms [1, 2]. The incidence of multiple aneurysms in the United States is 0.01% [3] to 3.9% [4]. T...
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