BACKGROUND: Few series have examined follow-up risks of the David reimplantation operation in patients with connective tissue disorder. Hence, we assessed its midterm safety and effectiveness for Marfan syndrome and other connective tissue disorders, such as Ehlers-Danlos, Loeys-Dietz, and marfanoid syndromes. METHODS: Of 313 patients who underwent modified David reimplantation, ...

We report a case in an inoperable patient with the hilar malignant biliary obstruction treated palliatively by the use of a newly designed Y-shaped covered stent without interfering contra-lateral bile duct. We percutaneously inserted a newly designed Y-shaped covered stent into a biliary tree in an inoperable patient with Bismuth ...

We report a unique case of persistent scleral ulceration in a 68-year-old woman who developed eye redness, pain, and photophobia 2 days following external levator advancement with nonabsorbable suture. Slit-lamp biomicroscopy revealed an area of scleral ulceration superonasal to the limbus. The patient was treated with 6 months of topical ...

Total intravenous anesthesia (TIVA) is the mainstay of short-term (up to 60 minutes) and field anesthesia in horses. This article discusses the pros and cons of TIVA, commonly used TIVA protocols, and their use, monitoring during, and recovery from, TIVA.

BACKGROUND: Proximal gastrectomy (PG) has been widely accepted as treatment for early gastric cancer located in the upper third of the stomach. Reconstruction by jejunal interposition has been known to reduce reflux esophagitis for PG patients. The aim of this study was to compare the long-term outcomes of patients who ...

The durability of valve-sparing aortic root replacement with or without cusp repair in patients with bicuspid aortic valve (BAV) disease is questioned. We analyzed the results of 75 patients with a BAV undergoing Tirone David reimplantation valve-sparing aortic root replacement. Average age was 45 ± 10 years; 80% were male; ...

Exchange of the HeartWare HVAD made necessary by thrombosis or cable damage is rare, but it is a complex procedure associated with morbidity. Less invasive exchange procedures may contribute to faster postoperative recovery and early mobilization. Between September 2009 and April 2012, 225 patients (median age 55.4 years, range 7-82 ...

Meniscal repair offers the potential to avoid the long-term articular cartilage deterioration that has been shown to result after meniscectomy. Failure of the meniscal repair can occur several years postoperatively. Limited evidence on the long-term outcomes of meniscal repair exists. We performed a systematic review of studies reporting the outcomes ...

BACKGROUND: Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease leading to cirrhosis and cholangiocellular carcinoma. Inhibitors of the renin-angiotensin system or the sympathetic nervous system delay liver fibrogenesis in animal models. AIMS: We investigated the antifibrotic potential of telmisartan, an angiotensin II type 1 receptor antagonist, and the ...

BACKGROUND:: Results of vascular anatomy studies of the lower limb in the past have been primarily descriptive in nature and are therefore less useful in directing the design of local perforator-based flaps. The purpose of this study is to document the three-dimensional anatomy of the cutaneous perforators arising from the ...

Objective: To determine the feasibility and effectivity of allogenic frozen-thawed bladder mucosa for urethroplasty. Methods: Bladder mucosa was harvested from 6 New Zealand rabbits. Changes in the bladder mucosa as seen by histological and electron microscope examination were compared between the frozen-thawed and fresh groups. Twelve urethral stricture models were ...

OBJECTIVES: The purpose of this study was to investigate the 5-year outcome following transcatheter aortic valve implantation (TAVI). BACKGROUND: Little is known about long-term outcomes following TAVI. METHODS: Five-year outcomes following successful TAVI with a balloon-expandable valve were evaluated in 88 patients. Patients who died within 30 days after TAVI ...

PURPOSE: To investigate the effect of the low central venous pressure (LCVP) technique on postoperative pulmonary complications in patients undergoing liver transplantation. METHODS: Sixty-five adult patients were randomly divided into a LCVP group (n = 33) and a control group (n = 32). The CVP was maintained below 5 mmHg or 40 % lower than baseline ...

BACKGROUND: The feasibility and safety of thoracoscopic lobectomy using anesthesia without tracheal intubation for treatment of geriatric non-small cell lung cancer patients is unclear, although it has been used with success in younger populations. METHODS: From 2009 through 2011, 84 consecutive patients aged 65 years or older with stage I ...

The annual hemorrhage rate of intracranial arteriovenous malformations (AVMs) varies from 2 to 4%. In a patient with decades of life ahead, the cumulative risk of hemorrhage is significant. AVMs exhibiting characteristics such as deep venous drainage, venous stenosis, associated aneurysms and feeders from perforators are associated with an elevated ...

OBJECTIVE: To determine the feasibility of original aortic valve reconstruction, 404 consecutive cases were reviewed. The early results are reported here. METHODS: Aortic valve reconstruction was performed for 404 patients from April 2007 through September 2011. The results for all 404 patients were reviewed retrospectively. There were 289 patients with ...

PURPOSE: To investigate the incidence and presentations of ureteral obstruction following periureteral injection of polyacrylate polyalcohol copolymer (PPC) for the treatment of vesicoureteral reflux (VUR). MATERIALS AND METHODS: From Jan 2010 to Dec 2012, 88 patients (28 male, 60 female) with 128 renal refluxing units (RRU), 131 ureters and a ...

BACKGROUND: Current knowledge in long-term results of tricuspid valve replacement is limited. Present study reviews our experience from a consecutive series. METHODS: We retrospectively studied the early and late results of 32 consecutive patients (7 male and 25 female; mean age 60.2 ± 18.1 years) undergoing bioprosthetic tricuspid valve replacement between 1985 and ...

The durability of total hip arthroplasty in younger patients has been reported to be less than that in older patients. The purpose of this study was to evaluate the results of cementless total hip arthroplasty performed in a consecutive series of patients fifty years of age or younger who were ...

PURPOSE: To evaluate the safety, efficacy, and long-term results of endovascular stent graft placement for ureteroarterial fistula (UAF). METHODS: We retrospectively analyzed stent graft placement for UAF performed at our institution from 2004 to 2012. Fistula location was assessed by contrast-enhanced computed tomography (CT) and angiography, and freedom from hematuria ...

Background and study aims: Endoscopic bilateral drainage for inoperable malignant hilar biliary strictures (HBS) using metal stents is considered to be technically difficult. Furthermore, endoscopic revision of bilateral stenting after occlusion can be challenging. This study was performed to evaluate the long-term efficacy of endoscopic bilateral stent-in-stent placement of cross-wired ...

Narrow-band imaging (NBI) is an optical image enhancement technology Summary that narrows the bandwidth of the light output from the endoscopy system to 415 nm and 540 nm. The aim of the present study is to evaluate the feasibility of NBI transurethral resection of the bladder (TURB NBI) compared to ...

Effect of take-off from prosthetic versus intact limb on transtibial amputee long jump technique by Nolan et al. Prosthetics and Orthotics International 36(3): 297-305, DOI: 10.1177/0309364612448877.

Joint-preserving hip surgery, either arthroscopic or open, increasingly is used for the treatment of symptomatic femoroacetabular impingement (FAI). As a consequence of surgery, thickening of the joint capsule and intraarticular adhesions between the labrum and joint capsule and between the femoral neck and the joint capsule have been observed. These ...

Non-derivative surgical techniques are the treatment of choice for the control of upper digestive tract hemorrhages after schistosomotic portal hypertension. However, recurrent hemorrhaging due to gastroesophagic varices is frequent. To evaluate the outcome of treatment based on embolization of the left gastric vein to control the reoccurrence of hemorrhages caused ...

There is little data evaluating the changes of severity of bladder outlet obstruction after 80 W-potassium-titanyl-phosphate (KTP) photoselective laser vaporization prostatectomy (PVP) by pressure-flow study. We evaluated the efficacy of PVP to relieve the obstruction in benign prostate hyperplasia (BPH) compared with transurethral resection of the prostate (TURP). This is ...

Although postoperative complications are rare, postadenoidectomy hemorrhage is one of the most frequent. The aim of this prospective study was to evaluate the incidence and timing of postadenoidectomy hemorrhage requiring hemostatic control under endotracheal anesthesia. A two-year prospective study of patients undergoing inpatient adenoidectomy, with (n = 462) or without ...

OBJECTIVE:: To investigate late objective outcomes 14 years after laparoscopic anterior 180-degree partial versus Nissen fundoplication. BACKGROUND:: Clinical outcomes from randomized clinical trials suggest good outcomes for anterior 180-degree partial fundoplication, with similar control of reflux symptoms and less side effects, compared with Nissen fundoplication. However, objective outcomes at late ...

Purpose- We present our experience with the use of metallic stents (wallstents) in the management of malignant ureteral obstruction in order to maintain renal function thereby permitting the use of chemotherapeutic agents treating the underlying malignancy. Materials and Methods- We retrospectively reviewed the records of 24 patients with ureteral obstruction ...

BACKGROUND: Decannulation is the ultimate therapeutic goal for patients who undergo stenting because of inoperable benign tracheal stenosis. In this study, our objectives were to evaluate whether long-term airway stenting allows decannulation in patients with benign tracheal stenosis who were deemed inoperable and to identify possible predictive factors for successful ...

Idiopathic thrombocytopenic purpura (ITP) is an autoimmune disorder leading to low platelet count and an increased risk of bleeding. Major joint replacement surgery in a patient with ITP can be associated with severe postoperative bleeding. We present our experience of perioperative management in a patient with severe refractory chronic idiopathic ...

BACKGROUND: This study aims to evaluate the early and long-term outcome of aortomitral fibrous body reconstruction with bovine pericardium in double-valve replacement. METHODS: Between January 1997 and December 2010, 30 consecutive patients (20 male patients) underwent aortomitral fibrous body reconstruction with double-valve replacement. Mean age was 52 ± 15 years ...

Aims: The present study aimed to compare the long-term (five-year) safety and efficacy between the one-stent, two-stent and double-kissing (DK) crush strategies, utilising drug-eluting stents, for unprotected left main coronary artery (ULMCA) bifurcation lesions. Methods and results: Between March 2004 and April 2007, 633 consecutive patients with ULMCA bifurcation lesions ...

OBJECTIVES/HYPOTHESIS: Nasal backflow is the regurgitation of material into nasopharynx during swallowing and it can be easily observed by videofluoroscopy. We aimed to evaluate the association between nasal backflow and the prevalence of aspiration, as well as the relationship between nasal backflow and the opening of the upper esophageal sphincter. ...

Octreotide is generally administered based on the surgeon's interpretation of perceived risk for pancreatic fistula at the time of pancreaticoduodenectomy (PD). A single-institution, prospective randomized trial was conducted between April 2009 and December 2011 involving 62 PD patients who were randomized to receive octreotide (100 μg subcutaneously every 8 h; n = ...

PURPOSE: We evaluated the retrieval rates and reproductive outcomes of percutaneous sperm retrieval according to the cause of obstructive azoospermia. MATERIALS AND METHODS: We retrospectively studied the records of 146 men with obstructive azoospermia who underwent sperm retrieval for intracytoplasmic sperm injection. Patients were grouped by the cause of obstruction, ...

Objective: To investigate the feasibility and safety of endoscopic submucosal dissection (ESD) of esophageal or gastric carcinomas under general anesthesia. Subjects and Methods: ESD removal of esophageal or gastric carcinomas was performed in 59 patients under midazolam sedation (control group), and in 46 patients under general anesthesia (GA group). The ...

We evaluated the outcomes of 64 consecutive revision total hip arthroplasties with an alumina-on-alumina bearing surface in 61 patients with osteolysis. No implants had been rerevised nor was osteolysis detected at a mean of 9.8 years (range, 7.0-13.1 years) postoperatively. There was 1 case of stem loosening but no cup ...

BACKGROUND: Zirconium total knee arthroplasties theoretically have a low incidence of failure as they are low friction, hard wearing and hypoallergenic. We report the five year survival of 213 Profix zirconium total knee arthroplasties with a conforming all polyethylene tibial component. METHODS: Data was collected prospectively and multiple strict end ...

BACKGROUND: Endovenous Laser Ablation (EVLA) is one of the most accepted treatment options for varicose veins. The aim of this study was to investigate the efficacy and safety of the new radial fiber slim (ELVeS-radial-slim kit(TM)) for the 1470 nm diode laser in perforator veins with a 1 month follow-up. ...

The aim of this study was to investigate peritoneal dialysis catheter malposition following low-position modified peritoneal dialysis catheterization and its clinical application value. A total of 48 patients receiving traditional peritoneal dialysis catheterization (the traditional group) and 95 patients receiving right low-position modified peritoneal dialysis catheterization (the modified group) from ...

To analyze the postoperative strabismic angle for five years or more and to investigate when the angle stabilized in intermittent exotropia. We retrospectively reviewed the clinical records of 89 patients who had undergone surgery for intermittent exotropia. The postoperative strabismic angles measured were analyzed at one-year intervals up to five ...

BACKGROUND: Acoustic radiation force impulse (ARFI) elastography is an ultrasound technique that is capable of measuring tissue stiffness noninvasively. It is difficult to differentiate idiopathic portal hypertension (IPH) from liver cirrhosis (LC) or chronic hepatitis (CH), and liver biopsy is essential. We investigated whether it would be possible to noninvasively ...

OBJECTIVESThe study aimed to assess the long-term follow-up of patients with an autologous pericardial aortic valve (APAV) replacement and to analyse in vivo histopathological changes in implanted APAVs.METHODSFrom 1996 to 1997, 15 patients (mean age, 34 years) underwent aortic valve replacement with the glutaraldehyde-treated autologous pericardium. All patients were followed ...

This study compares the incidence of venous thromboembolic event (VTE) in 55 patients (110 knees) undergoing simultaneous bilateral TKA with 287 patients (287 knees) undergoing unilateral TKA using a mobile compression device as monotherapy prophylaxis in both groups. All patients were clinically evaluated 3months after surgery with symptomatic confirmed VTE ...

OBJECTIVES: To investigate the feasibility of small intestinal submucosa graft for the repair of selected anterior urethral strictures. METHODS: From June 2009 to May 2011, 28 men (mean age 39 years) with anterior urethral strictures underwent urethroplasty using a four-layer small intestinal submucosa patch graft in an onlay or inlay ...

To evaluate the efficacy of human thrombin in the treatment of bleeding gastric and ectopic varices. Retrospective observational study in a Tertiary Referral Centre. Between January 1999-October 2005, we identified 37 patients who were endoscopically treated with human thrombin injection therapy for bleeding gastric and ectopic varices. Patient details including ...

Malignant gastric outlet obstruction (MGOO), a late complication of advanced carcinoma of the stomach, duodenum, periampulla or pancreas, causes significant malnutrition and morbidity. The current treatment for MGOO is palliative in nature, with the goal of maintaining the best quality of life possible during the terminal phase of the illness. ...

The course of autosomal dominant polycystic kidney disease (ADPKD) is often associated with pain, hypertension, and kidney failure. Preclinical studies indicated that vasopressin V(2)-receptor antagonists inhibit cyst growth and slow the decline of kidney function. In this phase 3, multicenter, double-blind, placebo-controlled, 3-year trial, we randomly assigned 1445 patients, 18 ...

Introduction: The embryogenesis of gastroschisis is not completely understood. The aim of our study was to evaluate the impact of a simple abdominal wall defect versus a defect including eviscerated intestine or omentum for the development of gastroschisis in a fetal lamb model. Material and Methods: At mid-gestation (day 77) ...