Surgical Removal Of Tumor Research Articles

Candidate urine biomarker discovery from only five pairs of samples before and after tumor resection in glioma patients

Without control of the homeostatic mechanisms, urine accumulates systemic changes in the body to be an excellent biomarker source. But urine is affected by many factors other than the disease. Even though many candidate biomarkers are discovered in animal models, it may still require large number of clinical samples for successful candidate biomarkers discovery. Self‐control study may effectively reduce individual differences among patients. Gliomas are the most common primary malignant brain tumors with a very poor prognosis. Early diagnosis of gliomas and monitoring of tumor recurrence is crucial to improve the outcome of glioma patients. However, whether it is possible to find several promising biomarkers in relatively small samples of glioma patients remained unknown. In this study, urine samples of five glioma patients were collected at the time of tumor diagnosis and after total surgical removal of the brain tumor. A comparative proteomic analysis of urine samples before and after tumor resection were performed using liquid chromatography coupled with tandem mass spectrometry (LC‐MS/MS). Using label‐free proteome quantification, a total of 1422 urinary proteins were identified. It was found that 30 urine proteins changed significantly after tumor resection and 12 differential proteins had been reported to be associated with gliomas in previous studies, such as CEACAM1, ANXA7, CRYAB, pIgR, cathepsin D, beta‐glucuronidase, acid ceramidase and CD276 antigen. After functional annotation of these differential proteins, it was found that regulation of tissue remodeling, autophagy, negative regulation of gene expression, positive regulation of natural killer cell mediated cytotoxicity and angiogenesis were significantly enriched. In this study, candidate urinary biomarkers were identified in glioma patients that have the potential to detect the disease and monitor tumor recurrence after treatment. Our results suggested that self‐control before and after tumor resection is an effective way for finding differential proteins related to the tumor even in small number of urine samples. Our findings will provide clues for future biomarker studies involving brain cancers.Support or Funding InformationThis work was supported by the National Key Research and Development Program of China (2016YFC1306300), Beijing Natural Science Foundation (7173264, 7172076), and funds from Beijing Normal University (11100704, 10300‐310421102).This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Fatty Acid Synthase and Acetyl-CoA Carboxylase Are Expressed in Nodal Metastatic Melanoma But Not in Benign Intracapsular Nodal Nevi.

Melanoma is a potentially lethal form of skin cancer for which the current standard therapy is complete surgical removal of the primary tumor followed by sentinel lymph node biopsy when indicated. Histologic identification of metastatic melanoma in a sentinel node has significant prognostic and therapeutic implications, routinely guiding further surgical management with regional lymphadenectomy. While melanocytes in a lymph node can be identified by routine histopathologic and immunohistochemical examination, the distinction between nodal nevus cells and melanoma can be morphologically problematic. Previous studies have shown that malignant melanoma can over-express metabolic genes such as fatty acid synthase (FASN) and acetyl-CoA carboxylase (ACC). This immunohistochemical study aims to compare the utility of FASN and ACC in differentiating sentinel lymph nodes with metastatic melanomas from those with benign nodal nevi in patients with cutaneous melanoma. Using antibodies against FASN and ACC, 13 sentinel lymph nodes from 13 patients with metastatic melanoma and 14 lymph nodes harboring benign intracapsular nevi from 14 patients with cutaneous malignant melanoma were examined. A diagnosis of nodal melanoma was based on cytologic atypia and histologic comparison with the primary melanoma. All nodal nevi were intracapsular and not trabecular. Immunohistochemistry for Melan-A, S100, human melanoma black 45 (HMB45), FASN, and ACC were performed. The percentage of melanocytes staining with HMB45, FASN, and ACC was determined and graded in 25% increments; staining intensity was graded as weak, moderate, or strong. All metastatic melanomas tested had at least 25% tumor cell staining for both FASN and ACC. Greater than 75% of the tumor cells stained with FAS in 7/13 cases and for ACC in 5/12 cases. Intensity of staining was variable; strong staining for FASN and ACC was observed in 69% and 50% of metastatic melanoma, respectively. HMB45 was negative in 40% of nodal melanoma cases all of which stained with FASN and ACC. Capsular nevi were uniformly negative for FASN, ACC, and HMB45 immunoreactivity. All metastatic melanoma cases involving sentinel lymph nodes were positive for FASN and ACC while no staining was observed in intracapsular nevi. These findings suggest that FASN and ACC could be used as valuable ancillary stains in the distinction between nodal nevi and metastatic melanoma.

Dosimetrische Verifikation von MammoSite-Bestrahlungsplänen mit Monte-Carlo-Simulationen sowie Messungen mit einem 2D-Ionisationskammer-Array

The surgical removal of a breast tumour is often followed by postoperative irradiation of the surrounding tissue with a radioactive source (brachytherapy). When performing the MammoSite procedure, a spherical silicone balloon is inserted and filled with a NaCl solution. In a period of about five days in several sessions an iridium-192 source with high activity travels through a catheter into the balloon (afterloading) to irradiate the tumour cells remaining in the cavity. In this study, dose distributions of a MammoSite applicator are investigated based on measurements with a 2D detector array, Monte Carlo simulations and calculations with BrachyVision. The focus is set on the 2D detector array and its possible application in the verification process in 3D brachytherapy treatment planning. The measured dose distributions conform well to the doses of BrachyVision with deviations of less than 5% within the clinically relevant field range. The deviations of the measured and calculated distributions from the simulation results are below 3%. The 2D detector array allows a new verification method for MammoSite treatment plans with sufficient accuracy. Future verifications can be performed without additional Monte Carlo simulations.

MP48-20 CONTEMPORARY SURGICAL MANAGEMENT OF RENAL ONCOCYTOMA: A NATION’S OUTCOME

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy V1 Apr 2018MP48-20 CONTEMPORARY SURGICAL MANAGEMENT OF RENAL ONCOCYTOMA: A NATION’S OUTCOME Joana B Neves, John Withington, Sarah Fowler, Axel Bex, Prasad Patki, Ravi Barod, Faiz Mumtaz, Tim O'Brien, Michael Aitchison, and Maxine GB Tran Joana B NevesJoana B Neves More articles by this author , John WithingtonJohn Withington More articles by this author , Sarah FowlerSarah Fowler More articles by this author , Axel BexAxel Bex More articles by this author , Prasad PatkiPrasad Patki More articles by this author , Ravi BarodRavi Barod More articles by this author , Faiz MumtazFaiz Mumtaz More articles by this author , Tim O'BrienTim O'Brien More articles by this author , Michael AitchisonMichael Aitchison More articles by this author , and Maxine GB TranMaxine GB Tran More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1519AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To report on the contemporary UK experience of surgical management of renal oncocytomas. METHODS Descriptive analysis of practice and postoperative outcomes of cases with a final histological diagnosis of oncocytoma included in The British Association of Urological Surgeons (BAUS) national nephrectomy registry from 01/01/2013 to 31/12/2016. Short term outcomes were assessed over a follow-up of 60 days. RESULTS Over 4 years, 32130 renal surgical cases were recorded in the UK, of which 1202 were oncocytomas (3.7%). Most patients were male (n=756; 63.3%), the median age was 66.8 years (interquartile range (IQR) 13). Median lesion size was 4.1cm (IQR 3; range 1-25cm), 43.5% were ≤4cm and 34.2% were 4 to 7cm lesions. Thirty-five patients (2.9%) had preoperative biopsy. The majority of patients had minimally invasive surgery, most frequently radical (n=683; 56.8%) or partial (n=483; 40.1%) nephrectomy. One in five (n=253; 20.2%) patients had in-hospital complications: 48 were Clavien-Dindo classification grade III or above (4% of total cohort), including three deaths. Two additional deaths occurred within 60 days of surgery. The analysis is limited by the study’s observational nature, not capturing lesions on surveillance or those treated with ablation, possible underreporting, and short follow-up. CONCLUSIONS We report on the largest surgical series of renal oncocytomas. In the UK, the complication burden associated with surgical removal of a benign tumour was not negligible. Increased utilisation of biopsy may inform management, allow avoidance of overtreatment, and change patient outcomes for this benign tumour. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e633 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Joana B Neves More articles by this author John Withington More articles by this author Sarah Fowler More articles by this author Axel Bex More articles by this author Prasad Patki More articles by this author Ravi Barod More articles by this author Faiz Mumtaz More articles by this author Tim O'Brien More articles by this author Michael Aitchison More articles by this author Maxine GB Tran More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Natural Course of Local Bone Mineralization After Treatment of Benign or Borderline Bone Tumors and Cysts With a Composite Ceramic Bone Graft Substitute

After surgical bone tumor removal, filling of the bone defect is frequently performed using a bone graft or bone graft substitute. During follow-up, precise quantification of changes in bone mineral density, within the treated bone defect, is very difficult using conventional X-ray examinations. The objectives of this study were to characterize the pattern of resorption/biodegradation of a composite calcium sulfate/hydroxyapatite bone graft substitute and to quantify the bone defect healing with repeated dual-energy X-ray absorptiometry (DXA) measurements. Seventeen patients treated for 18 benign bone lesions, with subsequent defect filling using 2 variants of a composite ceramic bone graft substitute (CERAMENT™|BONE VOID FILLER or CERMAMENT™|G, BONESUPPORT AB, Lund, Sweden), were scanned postoperatively and after 2, 6, 12, 26, and 52 wk using DXA. After an initial increase in bone mineral density after implantation of the bone graft substitute, bone mineral density decreased in the bone defect region throughout the 52 wk: rapidly in the first 12 wk and slower in the remaining weeks. Despite this continuous decrease, bone mineral density remained, on average, 25% higher in the operated extremity, compared with the nonoperated extremity, after 52 wk. The observed pattern of reduction in bone mineral density is consistent with the anticipated resorption of calcium sulfate within the bone graft substitute during the first 12 wk after surgery. We believe the DXA technique provides a precise method for quantification of bone graft resorption, but for evaluation of new bone formation, 3-dimensional imaging is needed.

Postoperative Tinnitus After Vestibular Schwannoma Surgery Depends on Preoperative Tinnitus and Both Pre- and Postoperative Hearing Function.

Tinnitus is one of the most common symptoms before and/or after the surgical removal of a vestibular schwannoma (VS) affecting almost half of the patients. Although there is increasing evidence for the association of hearing impairment and VS-associated tinnitus, the effect of hearing deterioration due to surgery and its relation to the postoperative tinnitus (postTN) is poorly investigated. This knowledge, however, might (i) enlighten the pathophysiology of VS-associated tinnitus (i.e., peripheral or central origin) and (ii) improve preoperative patient counseling. The aim of this study was to understand the predisposition factors for a postTN in relation to hearing outcome after surgery. This retrospective study analyzed the presence of tinnitus in 208 patients with unilateral VS before and after surgical removal. A binomial logistic regression was performed to ascertain the effect of pre- and postoperative hearing as well as age, gender, tumor side, and size, and intraoperative cochlear nerve resection (CNR) on the likelihood of postoperative VS-associated tinnitus. Preoperative tinnitus was the strongest predictor of postTN. In addition, deterioration of functional hearing was increasing, while functional deafferentation (i.e., postoperative hearing loss) of non-functional hearing was reducing the risk of postTN. At the same time, patients with no preoperative tinnitus but complete hearing loss had the lowest risk to suffer from postTN. Patient age, gender, tumor side, and size as well as CNR played a subordinate role. While the presence of preoperative tinnitus was the strongest predictor of postTN, there is a distinct relationship between hearing outcome and postTN depending on the preoperative situation. Functional or anatomical deafferentation due to surgical tumor removal does not prevent postTN per se.

Tumores da base do crânio em pacientes idosos

Objetivo: Avaliar o resultado do tratamento cirúrgico de tumores da base do crânio em pacientes idosos através da aplicação da escala de resultado de Glasgow. Pacientes e Métodos: 40 pacientes com diagnóstico de tumor de base do crânio com idade igual ou superior a 60 anos foram selecionados e acompanhados durante e após o procedimento operatório. A maioria das lesões foi benigna (75%) e os tumores mais freqüentes foram o schwannoma e meningeoma. Resultados: Complicações cirúrgicas e clínicas ocorrem emcerca de um terço dos casos, geralmente de caráter transitório. 87% dos indivíduos encontravam-se independentes funcionalmente por ocasião do diagnóstico. Após o procedimento, 80% mantiveram-se independentes. Houve um óbito (2,5%) relacionado ao procedimento operatório. Conclusão: A abordagem cirúrgica é a melhor opção terapêutica para a maioria dos pacientes. Ela pode permitir a remoção completa ou subtotal da lesão, descompressão de estruturas neurais e o diagnóstico anatomopatológico, combaixo risco de mortalidade e elevado índice de independência funcional.

Cochlear Implantation After Partial or Subtotal Cochleoectomy for Intracochlear Schwannoma Removal-A Technical Report.

Objective:To describe the technique for surgical tumor removal, cochlear implant (CI) electrode placement and reconstruction of the surgical defect in patients with intracochlear schwannomas.Study Design:Retrospective case review.Setting:Tertiary referral center.Patients:Ten patients (five men, five women, mean age 48 ± 12 yr) with profound or severe to profound hearing loss due to intralabyrinthine schwannomas with intracochlear location.Interventions:Surgical tumor removal through extended round window approach, partial or subtotal cochleoectomy with or without labyrinthectomy and reconstruction of the surgical defect with cartilage, perichondrium or temporal muscle fascia, and bone pâté. Eight patients received a cochlear implant in the same procedure.Main Outcome Measures:Retrospective evaluation of clinical outcome including safety aspects (adverse events) and audiological performance at early follow up in cases of cochlear implantation.Results:The tumor was successfully removed in all cases without macroscopic (operation microscope and endoscope) tumor remnants in the bony labyrinth apart from one case with initial transmodiolar growth. One patient needed revision surgery for labyrinthine fistula. At short-term follow up (3-month post-surgery), good hearing results with the cochlear implant were obtained in all but one patient with a word recognition score of 100% for numbers, and 64 ± 14% for monosyllables (at 65 dB SPL in quiet).Conclusions:Surgical tumor removal and cochlear implantation is a promising treatment strategy in the management of intralabyrinthine schwannoma with intracochlear location, further extending the indication range for cochlear implantation. It is, however, of importance to observe the long-term outcome in these patients and to address challenges like follow up with magnetic resonance imaging.

COMBINED TREATMENT OF PATIENTS WITH PANCREATIC NEUROENDOCRINE CARCINOMAS

Aim. To analyze the results of treatment of patients with pancreatic malignant neuroendocrine tumors. Materials and Methods . Since 2005 to 2014 period 49 patients with malignant neuroendocrine tumors were examined and treated. 76.6% patients (n = 38) were treated within 2010–2014 years. In 59.2% of cases liver metastatic lesion occured. Comprehensive specific treatment with surgical resection of primary tumor site was used in 73.5% of cases (n = 36). Some patients received perioperative intraarterial chemoembolization and surgical tumor removal was supplemented by radiofrequency or microvave ablation of metastatic liver sites, anatomical liver resections. Results. Postoperative mortality was observed only after extended surgical resection (8.3%, (n = 3)). All patients with low differentiated tumors had histological signs of perineural invasion, abcence of therapeutical effect of specific treatment even after surgical resection of primary tumor site. In view of this long-term survival was low. At present time most of surgically treated patients (85.2%, (n = 32)) with low and moderately differentiated neuroendocrine tumors live without signs of progression. Follow-up varies within 5–119 months. Conclusion. Combined treatment including aggressive surgical approach and perioperative intraarterial chemoembolization is associated with good remote results in case of highly and moderately differentiated neuroendocrine tumors.

Effect of endostatin on preventing postoperative progression of distant metastasis in a murine lung cancer model.

The relapse and metastasis of cancer remain a predominant cause of death after surgical removal of the primary tumor. There is a positive linkage between the postoperative upregulation of systemic angiogenic activity and distant tumor metastasis. In the present study, we established a spontaneous metastasis model and investigated whether antiangiogenic therapy using endostatin could prevent the progression of distant metastasis after removal of the primary tumor. Female C57BL/6 mice were implanted subcutaneously with 1 × 106 Lewis lung cancer cells. Twenty days after implantation of the cancer cells, the primary tumor was removed and the mice were randomly divided into three groups. The NS group received normal saline, the L-ES group received 3 mg/kg endostatin, and the H-ES group received 20 mg/kg endostatin intravenously daily for 10 days. The effect of endostatin on lung metastases and the survival time of the mice were observed. Flow cytometry and immunohistochemistry were carried out to assess the angiogenic activity. The serum endostatin levels in peripheral blood were measured using an enzyme-linked immunosorbent assay. The mean number of metastatic pulmonary nodules and the mean net lung weight in the NS, L-ES and H-ES groups was 10.2, 2.8 and 4.0, and 0.55 g, 0.31 g and 0.36 g, respectively. The difference between the NS group and the endostatin-treated groups was statistically significant (P <0.05). The endostatin-treated mice showed prolonged overall survival (P <0.05). Compared with the NS group, the endostatin-treated groups had lower levels of circulating endothelial cells in peripheral blood and showed a decrease in microvessel density in the metastatic tumors, with a more marked reduction in the L-ES group (P <0.05). The systemic presence of endostatin was gradually increased with the continued administration of endostatin to the mice. Antiangiogenic therapy with endostatin is effective in inhibiting the postoperative progression of distant metastasis.

Endothelial Tie1-mediated angiogenesis and vascular abnormalization promote tumor progression and metastasis.

The endothelial tyrosine kinase receptor Tie1 remains poorly characterized, largely owing to its orphan receptor status. Global Tie1 inactivation causes late embryonic lethality, thereby reflecting its importance during development. Tie1 also plays pivotal roles during pathologies such as atherosclerosis and tumorigenesis. In order to study the contribution of Tie1 to tumor progression and metastasis, we conditionally deleted Tie1 in endothelial cells at different stages of tumor growth and metastatic dissemination. Tie1 deletion during primary tumor growth in mice led to a decrease in microvessel density and an increase in mural cell coverage with improved vessel perfusion. Reduced angiogenesis and enhanced vascular normalization resulted in a progressive increase of intratumoral necrosis that caused a growth delay only at later stages of tumor progression. Concomitantly, surgical removal of the primary tumor decreased the number of circulating tumor cells, reduced metastasis, and prolonged overall survival. Additionally, Tie1 deletion in experimental murine metastasis models prevented extravasation of tumor cells into the lungs and reduced metastatic foci. Taken together, the data support Tie1 as a therapeutic target by defining its regulatory functions during angiogenesis and vascular abnormalization and identifying its role during metastasis.

Serological markers “CEA test &amp; sAPRIL test” in Iraqi patients with colon cancer

Background: Colonic cancer is a very common disease world-wide being fourth most common cancer characterized by abnormal proliferation of the inner wall of colon then taking full colon wall thickness then spreading to surrounding lymph nodes and tissues and finally distant metastasis. It is one of most complicated diseases with debilitating symptoms which becomes more sever , prominent and specific with advancing stage with high percent of fatality and relatively short survival if diagnosed late or if left untreated.Objective: To evaluate the efficacy of serum CEA &amp; sAPRIL levels in the diagnosis and screening of colon cancer and their validity for this.Patients and methods: This study was applied on 35 patients with colonic cancer, 35 patients with benign polyps and 15 negative controls. All individuals were subjected to blood sampling for measuring their serum CEA &amp; sAPRIL using ELISA technique.Results: In this study, majority of patients with colon cancer were presented at ages between 53-82 years of age (mean 68.5±6.4 years). Serum levels of sAPRIL &amp; CEA were significantly elevated in those patients with advancing stages (C &amp; D) compared with stages (A &amp; B) and lower levels were found in patients who had surgical removal of tumor or received chemotherapy. Also a positive relation was found between sAPRIL &amp; CEA with alcohol intake and smokingConclusion: according to this study sample it was found that sAPRIL and CEA together are strong indicators for colon cancer screening &amp; diagnosis, and by this will reduce the need for more invasive screening &amp; diagnostic tools.&#x0D;

Factors Affecting Psychosocial Adjustment in Patients with Surgical Removal of Benign Breast Tumor.

To identify factors influencing psychosocial adjustment in patients with surgical removal of benign breast tumor. With a survey design, data were collected using the Psychosocial Adjustment to Illness Scale-Self Report (PAIS-SR), Body Image Scale, Physical Discomfort Scale, and Family Support Scale with patients who had had surgical removal of a benign breast tumor from September to November 2017. Data were analysed with descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, and stepwise multiple regression. The mean scores for physical discomfort, body image, family support, and psychosocial adjustment were 1.57±0.51, 0.37±0.64, 3.62±0.67, and 4.00±0.45, respectively. Family support, body image, physical discomfort, number of surgical removal of benign breast tumor (twice), and cancer insurance status (yes) were verified as factors influencing psychosocial adjustment. These factors accounted for 57.4% of psychosocial adjustment. In this study, family support, body image, and physical discomfort were identified as significant predictors of psychosocial adjustment. Therefore, this study can be used as fundamental data to develop nursing intervention strategies in order to increase psychosocial adjustment in patients with surgical removal of a benign breast tumor.

Metastatic glioblastoma multiforme: A rare case of long-term survival

Glioblastoma Multiforme (GBM) is the most common primary malignant brain tumor. Median survival is usually less than 1 year from the time of diagnosis, and even in the most favorable situations, a majority of patients die within 2 years. Standard therapy consists of surgical resection, radiotherapy and chemotherapy. In this case report, we described a 38 y old woman with GBM survived 7 years after a series of treatments. For the patient, the tumor was found extensively infiltrate the sagittal sinus, the surgery unable completely remove of tumor, radiotherapy, chemotherapy and individualized anti-cancer herbs therapy were further applied. After all therapy, the patient was awake, with moderate bone window tension, palpable mass, right partial hemianopia, good right limb muscle strength. In summary, comprehensive treatment schedule including thorough surgical removal of tumor, systematic radiation, standard chemotherapy and individualized anti-cancer herbs therapy can help to prolong the survival of patients with GBM and gliosarcoma.

Abstract A017: Optimization of a cachexia animal model for efficacy evaluation of candidates

Abstract Cachexia-anorexia syndrome, which is called cancer cachexia, is a common and important indicator of cancer and occurs in 30% to 80% of cancer patients. Cancer cachexia is characterized by a severe progressive body wasting, accompanied by loss of adipose tissue and skeletal muscle mass. The presence of cachexia is associated with a worsened prognosis and contributes to up to 20% of cancer deaths. In most cases, cancer cachexia patients clinically show anorexia caused through a complex system of hormones and neuropeptides. To investigate efficacy in development of new medicine, an optimized animal model is essentially required. Although several cancer cachexia animal models have been established, we focused on developing a better animal model particularly for efficacy evaluation with advanced bioimaging evaluation methods. First of all, we confirmed that an appropriate mouse strain is CDF1 in comparison with DBA1 and Balb/c after xenografting of Colon26. As the second step, we checked cell numbers with pattern of tumor growth. In human clinics, cure of cancer cachexia is usually performed with surgical removal of tumor. To make the animal model similar to clinical circumstances, we tested recovery time and pattern after removal of tumor. With optimized mouse model we tested efficacy of anticancer drug Megace 200 mg/kg as a positive control. In addition, we applied advanced bioimaging equipment such as MRI and CT to visualize actual tumor and fat with body composition. We expect that optimized animal model of cancer cachexia will prepare the way for more accurate efficacy test in preclinical state to go to a clinical trial. Citation Format: Jiyeong Bae, Ig Jun Cho, Jung Hyu Shin, Hyung Soo Yuh, Hyung Ho Moon, Hye Lim Lee, Yeong Nang Jo, Yeon Ju Park, Woo Sung Choi, Byung Hwa Hyun. Optimization of a cachexia animal model for efficacy evaluation of candidates [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2017 Oct 26-30; Philadelphia, PA. Philadelphia (PA): AACR; Mol Cancer Ther 2018;17(1 Suppl):Abstract nr A017.

Post-operative oropharyngeal dysphagia after surgical removal of metastatic tumors in the cerebellum: Report of a case

Post-operative oropharyngeal dysphagia after surgical removal of metastatic tumors in the cerebellum: Report of a case

The Rubbish Rib Tickler - Successful Complete Surgical Removal of Large Symptomatic Rib Tumour

The Rubbish Rib Tickler - Successful Complete Surgical Removal of Large Symptomatic Rib Tumour

Technique of Granulation Tissue Genesis from Diploe

Introduction: Many techniques are used in surgery for importing scalp losses. Microsurgery reinsertion dominates these techniques. When reinsertion is not possible, other alternatives are available. Among these is the production of the granulation tissue by diploic perforation. Many authors have reported this technic without explaining the physiological mechanisms that contribute to the genesis of this granulation tissue from the diploe. We intend to recall them. Patients and Methods: This was a series of 3 cases supported for significant loss of the scalp. The technic consisted in making trepan drill holes and carrying the outer table to the diploe by using a Doyen drill. Then fat dressings were applied every other day until the formation of granulation tissue over the entire loss of tissue surface. Observations: Three patients benefited from this technique, 2 traumatic and the other one iatrogenic after a scalp tumor excision. The missing area of traumatic wounds was estimated at 18 and 25 cm2 respectively. The third patient had a loss of scalp after surgical removal of an ulcerous-budding tumor of the scalp without any impacting the skull. Granulation tissue was obtained in all cases after an average of 30 days. There was no infection. Two patients were grafted with favorable progress and one patient went under indirect wound healing. Conclusion: The ability of the diploe to generate granulation tissue is due to its intrinsic anatomical and functional potentialities. This is a technic of last resort when conventional reconstructive surgery is contraindicated for several reasons.

Adjuvant Therapy for Stage IB Germ Cell Tumors: One versus Two Cycles of BEP.

Testicular germ cell tumours are the commonest tumours of young men and are broadly managed either as pure seminomas or as ‘nonseminomas'. The management of Stage 1 nonseminomatous germ cell tumours (NSGCTs), beyond surgical removal of the primary tumour at orchidectomy, is somewhat controversial. Cancer-specific survival rates in these patients are in the order of 99% regardless of whether surveillance, retroperitoneal lymph node dissection, or adjuvant chemotherapy is employed. However, the toxicities of these treatment modalities differ. Undertreating those destined to relapse exposes them to the potentially significant toxicities of 3-4 cycles of bleomycin, etoposide, and cisplatin (BEP) chemotherapy. Conversely, giving adjuvant chemotherapy to all patients following orchidectomy results in overtreatment of a significant proportion. Therefore, the challenge lies in delineating the patient population who require adjuvant chemotherapy and in determining how much chemotherapy to give to adequately reduce relapse risk. This chapter reviews the factors to be considered when adopting a risk-adapted strategy for giving adjuvant chemotherapy in Stage 1B NSGCT sand discusses the data regarding the number of BEP cycles to administer.

ВПЛИВ ПІСЛЯОПЕРАЦІЙНОЇ АНАЛГЕЗІЇ БУПІВАКАЇНОМ НА ІНТЕНСИВНІСТЬ БОЛЬОВОЇ РЕАКЦІЇ У СОБАК ЗА МАСТЕКТОМІЇ

Influence of analgesia on the animals is relevant in clinical practice, since changes of the cardiovascular, respiratory systems, body temperature, metabolism, may have therapeutic effect. Nowadays in veterinary anaesthesiology pain scales, which are verbal evaluation, simple descriptive and visual analogues are used. The aim of this study is the determine the effectiveness of postoperative analgesia with bupivacaine in dogs in case of mastectomy. Two groups of dogs (experimental and control) with tumors of mammary gland, which was carried out by a mastectomy were made. After surgery in the experimental group, an epidural bupivacaine for analgesia was taken, and the analgesia in the control group was not performed. In both groups pain level response in animals was determined, comparison of the results between the groups was made. The object of the study was 24 dogs (bitches) in which the intensity of pain in the postoperative period in case of mastectomia was determined. Operative technic&nbsp; was performed by xylazine premedication 1,5 ml per 10 kg body weight, lumbosacral epidural puncture, catheterization and anesthesia with 2% lidocaine solution. In animals of the experimental group, postoperative analgesia was performed with 0,2 %&nbsp; bupivacaine solution&nbsp; 4 times a day for 3 days; In the control group, there was no post-operative analgesia. In animals of both groups, the intensity of pain before surgery and during the first three days after every 6 hours was studied ‒ by the Visual analog scale (VAS) in mm (from 0 to 100 mm) and the Melbourne University (MPS) scale in points (from 0 to 27 points). The tumors of the mammary gland in the dogs were larger than 3 cm, and had one-sided localization with the involvement of regional lymph nodes. Radical surgical removal of tumors using the regional mastectomy in the area of ​​3‒4‒5 mammary gland was performed. When tumors were removed, a broad local excision was used which involved removing it together with the skin and capturing 2‒3 cm of healthy tissue from all sides around. During the research it was found that postoperative bupivacaine analgesia in animals in the experimental group significantly reduces the pain response, which was manifested by a decrease in the intensity of pain on the parameters of VAS and the MPS scale, in contrast to similar indices in the control group, where in the first 48 hours after the operative intervention probable increase in the intensity of pain were observed.