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Evaluation Of The Use Of Patient-Focused Simulation For Student Assessment In A Surgery Clerkship., Gerald A Isenberg, Katherine W Berg, Judith A Veloski, Dale D Berg, J J. Veloski, Charles Yeo

Department of Surgery Faculty Papers

BACKGROUND: The purpose of this study was to evaluate the use of simulated patients in conjunction with anatomic and tissue task-training models to assess skills.

METHODS: Faculty reviewed the objectives of the clerkship to identify skills to be acquired. Three cases were developed related to rectal examination, suturing, and inserting intravenous lines and nasogastric tubes. Student scores were based on their ability to gather data from simulated patients and perform procedures on simulation models.

RESULTS: A total of 670 students were assessed between 2006 and 2009. Alpha reliability coefficients were .97 for Communication/Interpersonal Skills, .71 for Procedures, and .58 for …

Ercc1 And Rrm1 As Predictors Of Survival And Response In Pancreatic Ductal Adenocarcinoma Treated With Gemcitabine-Based Chemotherapy, Thomas Holdbrook, Kathleen D. Danenberg, Suneeta Satti, Jessica Kline, Charles J. Yeo, Jonathan R. Brody, Peter Mccue, Agnieszka K. Witkiewicz

Department of Surgery Faculty Papers

Conclusion:

In this study, we used RT-PCR and IHC to analyze RRM1 and ERCC1 mRNA and protein expression in PDA specimens. PDA patients with low expression of RRM1 by IHC derived benefit from gemcitabine-based chemotherapy. Assessment of RRM1 mRNA expression was limited by the small sample size. Low ERCC1 expression by RT-PCR was associated with a 2.5 times higher risk of mortality than high expression (p=0.031). There was no association between ERCC1 expression by IHC and survival; however, agreement between mRNA and protein expression was poor for ERCC1. This study demonstrates the ERCC1 and RRM1 expression have an impact on …

Ventral Hernia Repairs: 10 Year Single Institution Review At Thomas Jefferson University Hospital, Frederick C. Sailes, Md, Jason Walls, Md, Daria Guelig, Md, Mike Mirzabeigi, Ma, William D. Long, Ms, Albert Crawford, Phd, John H. Moore Jr, Md, Facs, Steven E. Copit, Md, Gary A. Tuma, M.D, James Fox, Md

Department of Surgery Faculty Papers

Abstract

Background Definitive repair of recurrent ventral hernias using abdominal wall reconstruction techniques is an essential tool in the armentarium for general and plastic surgeons. Ramirez 1 et al describes the “component separation” technique to mobilize the rectus-abdominus internal oblique and external oblique flap to correct the defect. The recurrence rate of incisional hernias increases to 20% after gastric bypass or extensive weight loss.2 The incidence of ventral hernias after failed recurrent hernia repair increases to 40%.3 It has been reported that utilizing the sliding myofascial flap repair technique, the recurrence rate was reduced to 8.5%.4

Materials and Methods This …

Metastatic Disease To The Pancreas And Spleen, Shayna L. Showalter, Eric Hager, Charles J. Yeo

Department of Surgery Faculty Papers

Isolated metastases to the pancreas and spleen are a rare occurrence. When they are diagnosed, pancreatic metastases are most often from renal cell carcinoma, lung cancer, and breast cancer. The most common source of splenic metastases is gynecological in origin; the overwhelming majority is ovarian. If extensive staging studies reveal these metastases to be isolated, then curative resection may be warranted. This review will demonstrate that long-term survival may be achieved in patients with isolated metastases and a prolonged disease-free interval.

Resected Serous Cystic Neoplasms Of The Pancreas: Locally Aggressive Behavior As A Predictor Of Malignant Disease? A Review Of 158 Patients With Recommendations For Treatment., Charles Galanis, Amir Zamani, John L. Cameron, Kurtis A. Campbell, Keith D. Lillemoe, David Caparrelli, David Chang, Ralph H. Hruban, Charles Yeo

Department of Surgery Faculty Papers

Background: Serous cystic neoplasms of the pancreas are regarded as a benign entity with rare malignant potential. Surgical resection is generally considered curative. Objective: To perform the largest single institution review of patients who underwent surgical resection for serous cystic neoplasms of the pancreas in the hopes of guiding future management. Methods: Between June 1988 and January 2005, 158 patients with serous cystic neoplasms of the pancreas underwent surgical resection. A retrospective analysis was performed. Univariate and multivariate models were used to determine factors influencing perioperative morbidity and mortality. Major complications were defined as pancreatic fistula or anastomotic leak, postoperative …