Abstract: In recent years the study of the diseases has advanced in complexity focused in molecular and laboratory studies, perhaps this valuable advances the medical exercise are guided in more of the cases by an accurate clinical examination. For the correct identification of the patterns given for each disease the clinician need a deep background in general pathology and in the identification of a correct diagnosis.
Abstract: A 24 year old woman delivered a normal newborn and a papyraceous fetus (PF), along with a monochorial-biamniotic placenta, at 37 weeks’ gestation. Pliny the Elder first mentioned the PF in 70 AD; the dead fetus is remarkably flattened because of loss of fluid, and most of the soft tissue looks like papyrus, the paper used in ancient civilizations.
Abstract: New therapies for chronic lymphocytic leukemia (CLL) are needed, particularly those that can eradicate residual disease and elicit anti-CLL immune responses. CD40 ligation on CLL cells, which can be achieved using adenovirus encoding chimeric CD154 (Ad-ISF35), enhances their ability to function as antigen presenting cells and increases their sensitivity to clearance by immune-effector mechanisms. In this study, we report the results of a first-in-man Phase I trial of intranodal direct injection (IDI) of Ad-ISF35 in patients with CLL to evaluate toxicity, safety, and tolerability. Fifteen patients received a single IDI of 1-33 x 1010 Ad-ISF35 viral particles (vp), with a defined maximum tolerated dose as 1x1011 vp. Although the most common adverse events were transient grade 1-2 pain at the injection site and flu-like symptoms following IDI, some patients receiving the highest dose had transient, asymptomatic grade 3-4 hypophosphatemia, neutropenia, or transaminitis. Increased expression of death receptor, immune co-stimulatory molecules, and Ad-ISF35 vector DNA was detected in circulating CLL-cells. Notably, we also observed preliminary clinical responses, including reductions in leukemia cell counts, lymphadenopathy, and splenomegaly. Six patients did not require additional therapy for more than 6 months, and 3 achieved a partial remission. In conclusion, Ad-ISF35 IDI was safely delivered in patients with CLL and induced systemic biological and clinical responses. These results provide the rationale for phase II studies in CLL, lymphomas, and CD40-expressing solid tumors.
Abstract: The vein of Galen aneurysmal malformation (VGAM) is an extremely rare arterio-venous malformation. The
VGAM clinical manifestations vary depending on the magnitude of vascular compromise and the age at initial
presentation. Neonates typically present with severe congestive heart failure. Here we present a case in which
a systolic heart murmur was the first manifestation of high output heart failure due to a VGAM.
Abstract: Abstract
BACKGROUND:
"Pure" NOTES and "hybrid" NOTES procedures have gained popularity during the past few years. However, most of these published series have been documented outside the United States.
METHODS:
This is a prospective, nonrandomized series of patients. Female subjects who presented to the University of California at San Diego surgery clinic for elective cholecystectomy were offered participation in this study. Patients met the following criteria: aged 18-75 years; diagnosis of gallbladder disease that required cholecystectomy and American Society of Anesthesiology (ASA) class 1. Hybrid NOTES transvaginal technique was used for cholecystectomy.
RESULTS:
A total of 27 women underwent hybrid transvaginal NOTES cholecystectomy during a 43-month period. The median age was 40.1 (range 23-63) years. The mean body mass index was 25.2 (range 16.4-34.1). All patients had an ASA I-II classification. The mean operative time was 92 (range 38-165) min. There was no conversion to an open operation. The mean hospital stay was 1.07 (range 1-2) days. Patients were followed for a mean of 3.32 (range 0.06-12.2) months. There were no postoperative complications. No scars were visible on the abdominal wall.
CONCLUSIONS:
This study is the largest series of hybrid transvaginal cholecystectomy published in the United States. With our experience, we demonstrate that this technique is safe and clinically viable.
Abstract: Rare congenital tumors can be localized in the peribulbar area. Here we report an unusual case presented in a 3-year-old child with a history of a congenital tumor in the lacrimal caruncle of the right eye, associated with epiphora and constant discomfort. A surgical resection was performed, and the final histopathological diagnosis was lacrimal caruncle complex choristoma. Choristomas are growths of apparently normal tissue in an abnormal location, which can be situated anywhere in the body, including ocular and peribulbar structures. These almost unknown congenital tumors constitute the most common conjunctival tumors in children and can be interpreted clinically as different lesions, which are only differentiated through precise histopathological analysis.
Abstract: During the last years, laparoscopic surgery has shown safety and efficacy in the treatment of different pediatric urologic problems. With the rapid development of new surgical options in the minimally invasive field, robotic surgery has emerged as a solid alternative, with good outcomes. The principal objective of this article is to review the current literature on the current status of robotic surgery in pediatric urology and future perspectives.
Abstract:
INTRODUCTION:
Solitary neurofibromas are benign tumors, often the manifestation of neurofibromatosis, and reflect a hereditary pathology with several variants. The clinical manifestations of solitary neurofibromas change according to their location and can generate a variety of symptoms. Usually, solitary neurofibromas are located in the skin and rarely in other places. Surgical removal is the only treatment; malignant transformation and recurrence are unusual.
OBJECTIVE:
A case is reported of solitary neurofibroma in the abdominal wall of a 19-year-old patient without neurofibromatosis.
MATERIALS AND METHODS:
Articles included are from Proquest, Pubmed and Ovid databases. Key words used were neurofibroma, tumors of the neural sheath, and case report. The search is current as of May 24, 2007.
CONCLUSIONS:
This case appears to be the first one with these characteristics reported in the English and Spanish medical literature.
