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   Table of Contents - Current issue
October-December 2017
Volume 2 | Issue 4
Page Nos. 81-112

Online since Thursday, December 28, 2017

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Large decompressive craniectomy combined with vascular reconstruction in patients with severe craniocerebral injury p. 81
Xipeng Wang, Feng Ruan, Ping Liu
Aim: This study aims to compare the effect of large decompressive craniectomy combined with vascular reconstruction and traditional decompressive craniectomy in the treatment of severe craniocerebral injury. Methods: Forty-eight cases of severe craniocerebral injury were collected from March 2012 to March 2015 in Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology. Patients undergoing large decompressive craniectomy combined with vascular reconstruction or traditional decompressive craniectomy were randomly divided into two groups: the experimental group and the control group. The hemodynamic changes were observed by computed tomography perfusion, and the postoperative Glasgow Outcome Score (GOS) was analyzed. Results: The cerebral blood flow (CBF) and cerebral blood volume (CBV) scores in experimental group were higher than that in the control group at 1 week and 1 month after the operation (P < 0.05). The mean transit time (MTT) and time to peak (TTP) scores in experimental group were lower than that in the control group at 1 week and 1 month after the operation (P < 0.05). The relative CBF and relative CBV values of the control group in 1 week were higher than that in 1 month, while the relative MTT and relative TTP values in 1 week were lower than that in 1 month. The rate of good recovery (including good and residual cases) in experimental group was higher than that in the control group whereas the rate of poor recovery (including severe disability, vegetative state, and death) in experimental group was lower than that in the control group (P < 0.05). Conclusion: The large decompressive craniectomy combined with vascular reconstruction can not only decrease intracranial pressure but also recover the blood supply of the brain. It deserves the clinical promotion.
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Biomaterials and surgical applications: The translational perspective p. 85
Brenda Vega-Ruiz, Rodrigo Ramos-Zúñiga, Ivan Segura Duran, Yara Ursiel-Ortega
Basic research provides the results necessary to pursue translational work, where basic and translational approaches used in conjunction can allow for an increased impact in solving public health problems. Biomaterials draws from both approaches and are used today in many surgical specialty areas, such as tissue regeneration and regenerative medicine. These materials can be used as replacements for tissue, as scaffolds for regeneration, as substrates for cell growth, as drug-releasing or bioactive molecule-releasing vehicles, and as several other medical devices. Biopolymers used in regenerative medicine provide a good example of such materials and demonstrate the methodology of a translational approach, where the product begins at the laboratory bench, is applied in preclinical stages, and is finally delivered as a new medical solution back to the patient. The biocompatible, biodegradable, and bioactive properties of some of these polymers have opened different possibilities for their use in the repair and/or regeneration of different tissues, including skin, bone, cartilage, nerves, liver, and muscle. This article serves as a review of the properties of these biopolymers, their use in tissue engineering, and promising alternatives in regenerative medicine.
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Case of hemangioblastoma and central neurocytoma presenting as synchronous primary brain tumors in a young man p. 103
Veronica De Los Santos, Federico Salle, Ramiro Lima, Edgardo Spagnuolo
This study presents a very infrequent case of a young man with two different brain tumors. The peculiarity of this case is that both tumors appeared at the same time. The patient was admitted with headaches and confusion. Computed tomography scan and magnetic resonance imaging confirmed two tumors, one in the posterior fossa and another in the intraventricular supratentorial space. These findings were initially interpreted as the same tumor with two different localizations, a very infrequent situation. A first surgery was performed to remove the posterior fossa tumor. The pathology confirmed an hemangioblastoma. Six months later, a second surgery was performed for the supratentorial tumor. The surgical aspect was totally different compared to the tumor of the posterior fossa, and the pathology confirmed a central neurocytoma. The authors made a bibliographic review and did not find references of this association.
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Valentino's syndrome: An unusual presentation of a perforated peptic ulcer p. 106
Alessandro Sgro, Mahir Petkar, Angelo Benevento, Francesco Pata
Valentino's syndrome occurs when digestive fluids tend to settle in the right iliac fossa through a perforated gastric or duodenal ulcer, causing peritonitis and clinically mimicking acute appendicitis. Herein, we present the case of a 32-year-old male who was admitted to the emergency department with signs and symptoms suggestive of acute appendicitis. During laparoscopic appendectomy, inspection of the peritoneal cavity revealed an anterior, perforated duodenal ulcer, which was treated with a patch repair. The patient's recovery was uneventful, and a gastrointestinal endoscopy at his 6-week follow-up showed complete healing of the ulcer. This case highlights that Valentino's syndrome should be considered in the differential diagnosis of any patient who has an abdominal examination consistent with acute appendicitis.
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Hemorrhagic duodenal ulcer and subsequent acute appendicitis following lobectomy for lung cancer p. 109
Tyson A Moore, Steven T.F Chan
A 62-year-old Vietnamese male presented for an elective video-assisted thoracoscopic surgery lobectomy for treatment of a suspicious lung mass. Postoperatively, he developed a hemorrhagic duodenal ulcer requiring endoscopic hemostasis. Interestingly, he subsequently became septic secondary to perforated acute appendicitis necessitating laparoscopic appendectomy. Surgery can evoke a physiological stress response and may be a causative factor in the pathogenesis of stress ulcers in surgical patients. A recent article has found an association between the development of acute appendicitis in patients with a history of peptic ulcer disease. The pathological mechanism responsible for this association may be the result of an imbalance of the autonomic nervous system and neuromusculature spasms at the ceco-appendiceal junction.
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