Surgery Commons^™

Anemia In A Middle Aged Female With Aortitis: A Case Report., Shabneez Hussain, Salman Naseem Adil, Shahid Ahmed Sami

Department of Surgery Docs

Abstract

BACKGROUND:

Idiopathic aortitis is among the most common causes of non-infectious aortitis, which rarely presents with anemia.

CASE PRESENTATION:

Here we report a case of a 49-year-old muhajir female who presented with shortness of breath and easy fatigability for the past 6 months. Physical examination revealed pallor and a diastolic murmur in the aortic region. Echocardiography showed thickened and calcified aortic and mitral valves, severe aortic regurgitation and dilatation of ascending aorta. She was advised aortic valve replacement and was referred to a haematologist due to concomitant anemia. Complete blood counts revealed haemoglobin: 7.7 gm/dl, mean corpuscular volume (MCV): …

Laparoscopic-Assisted Percutaneous Endoscopic Gastrostomy Tube Insertion In The Immediate Post-Partum Period For Head And Neck Cancer, Adil Aijaz Shah, Shabbir Akhtar, Nadeem Zuberi, Kamran Ali, Dania Aijaz Shah, Amir Hafeez Shariff

Department of Surgery Docs

Abstract

Percutaneous endoscopic gastrostomy (PEG) tube placement serves as a well-tolerated and efficacious technique for long-term enteral access in patients with medical conditions precluding oral food intake. The nutritional optimisation of patients with oral cancer is mostly achieved via PEG tube placement. However, certain special situations, such as pregnancy and the immediatepost-partum period, may render the placement of PEG tubes to be a challenge. A 28-year-old pregnant female patient presented to us with the diagnosis of squamous cell carcinoma of the tongue during her third trimester. Definitive surgical resection was planned post-delivery along with simultaneous PEG tube placement. Immediately following …

Short Term Outcome And Predictors Of Response To Neoadjuvant Treatment In Rectal Cancer, Rizwan Sultan, Tabish Chawla, Mirza Mirza Aman Beg

Department of Surgery Docs

Abstract

OBJECTIVE:

To evaluate response to neoadjuvant chemoradiation in the treatment of rectal cancer and to see if it can be predicted whether a particular patient will benefit from such treatment.

METHODS:

The retrospective case series was done at the Aga Khan University Hospital, Karachi, and comprised data related to period from January 2005 to December 2014 of patients with rectal cancer who had received neoadjuvant treatment. They were divided into responders and non-responders on the basis of imaging. Pre-treatment factors were compared to identify differences in the two groups. SPSS 19 was used for statistical analysis.

RESULTS:

The median …

Iv And Ip Administration Of Rhodamine In Visualization Of Wbc-Bbb Interactions In Cerebral Vessels., Zachary Wilmer Reichenbach, Hongbo Li, John P. Gaughan, Melanie B. Elliott, Ronald Tuma

Department of Neurosurgery Faculty Papers

Epi-illuminescence intravital fluorescence microscopy has been employed to study leukocyte-endothelial interactions in a number of brain pathologies. Historically, dyes such as Rhodamine 6G have been injected intravenously. However, intravenous injections can predispose experimental animals to a multitude of complications and requires a high degree of technical skill. Here, we study the efficacy of injecting Rhodamine 6G into the peritoneum (IP) for the purpose of analyzing leukocyte-endothelial interactions through a cranial window during real time intravital microscopy. After examining the number of rolling and adherent leukocytes through a cranial window, we found no advantage to the intravenous injection (IV). Additionally, we …

Is There Any Benefit Of Drain Placement On Postoperative Complications In Patients Undergoing The Sistrunk Procedure?, Talha Ahmed Qureshi, Anwar Suhail, Syed Sajjad Ali Zaidi, Wasif Siddiqui

Department of Surgery Docs

Abstract

Introduction Same-day, outpatient Sistrunk procedure is commonly performed to manage thyroglossal duct cyst anomalies and may lead to postoperative complications. Surgical drains are placed to prevent complications, but recent observations show no advantage and rather increased health care costs and patient discomfort. Objective The study evaluated if drain placement in the Sistrunk procedure offers any benefit on postoperative complications. Methods A retrospective analysis of patient records having undergone same-day, outpatient Sistrunk procedure from 2004 to 2014 was done. Of 58 (38 male and 20 female) patients included, 38 did not have drains placed and the remaining 20 had drains …

Simple New Risk Score Model For Adult Cardiac Extracorporeal Membrane Oxygenation: Simple Cardiac Ecmo Score., Graham Peigh, Nicholas Cavarocchi, Scott W. Keith, Hitoshi Hirose

Department of Surgery Faculty Papers

BACKGROUND: Although the use of cardiac extracorporeal membrane oxygenation (ECMO) is increasing in adult patients, the field lacks understanding of associated risk factors. While standard intensive care unit risk scores such as SAPS II (simplified acute physiology score II), SOFA (sequential organ failure assessment), and APACHE II (acute physiology and chronic health evaluation II), or disease-specific scores such as MELD (model for end-stage liver disease) and RIFLE (kidney risk, injury, failure, loss of function, ESRD) exist, they may not apply to adult cardiac ECMO patients as their risk factors differ from variables used in these scores.

METHODS: Between 2010 and …

Initial Validation Of A Novel Method Of Presurgical Language Localization Through Functional Connectivity (Fcmri), Stephanie M. Noble, Dustin Scheinost, Susan Y. Bookheimer, Patricia Walshaw, R Todd Constable, Christopher F. Benjamin

Yale Day of Data

OBJECTIVE: Neurosurgery is potentially curative in chronic epilepsy but can only be offered to patients if the surgical risk to language is known. Clinical functional magnetic resonance imaging (fMRI) is an ideal, noninvasive method for localizing language cortex yet remains to be validated for this purpose. We have recently presented a novel method for localizing language cortex. Here we present a preliminary evaluation of this method’s validity. We hypothesized language regions identified using this novel method would demonstrate stronger functional connectivity than randomly generated set of proximal networks. METHOD: fMRI data were collected from sixteen temporal lobe patients …

Disc In Flames: Roles Of Tnf-Α And Il-1Β In Intervertebral Disc Degeneration., Z I Johnson, Z R Schoepflin, H Choi, I M Shapiro, M V Risbud

Department of Orthopaedic Surgery Faculty Papers

The intervertebral disc is an important mechanical structure that allows range of motion of the spinal column. Degeneration of the intervertebral disc--incited by aging, traumatic insult, genetic predisposition, or other factors--is often defined by functional and structural changes in the tissue, including excessive breakdown of the extracellular matrix, increased disc cell senescence and death, as well as compromised biomechanical function of the tissue. Intervertebral disc degeneration is strongly correlated with low back pain, which is a highly prevalent and costly condition, significantly contributing to loss in productivity and health care costs. Disc degeneration is a chronic, progressive condition, and current …

A Case Of Three Patients With Severe Hypothermia Rewarmed With Ecmo, Matthew Niehaus Do, Rita Pechulis Md, Fccp, James K. Wu Md

Department of Emergency Medicine

No abstract provided.

Relationships Between Cancer Pattern, Country Income And Geographical Region In Asia., Chirk Jenn Ng, Chin Hai Teo, Nurdiana Abdullah, Wei Phin Tan, Hui Meng Tan

Department of Surgery Faculty Papers

BACKGROUND: Cancer incidence and mortality varies across region, sex and country's economic status. While most studies focused on global trends, this study aimed to describe and analyse cancer incidence and mortality in Asia, focusing on cancer site, sex, region and income status.

METHODS: Age-standardised incidence and mortality rates of cancer were extracted from the GLOBOCAN 2012 database. Cancer mortality to incidence ratios (MIRs) were calculated to represent cancer survival. The data were analysed based on the four regions in Asia and income.

RESULTS: Cancer incidence rate is lower in Asia compared to the West but for MIR, it is the …

Review Of Fluorescence Guided Surgery Visualization And Overlay Techniques, Jonathan T. Elliott, Alisha V. Dsouza, Scott C. Davis, Jonathan D. Olson, Keith Paulsen, David Roberts, Brian Pogue

Dartmouth Scholarship

In fluorescence guided surgery, data visualization represents a critical step between signal capture and display needed for clinical decisions informed by that signal. The diversity of methods for displaying surgical images are reviewed, and a particular focus is placed on electronically detected and visualized signals, as required for near-infrared or low concentration tracers. Factors driving the choices such as human perception, the need for rapid decision making in a surgical environment, and biases induced by display choices are outlined. Five practical suggestions are outlined for optimal display orientation, color map, transparency/alpha function, dynamic range compression, and color perception check.

Department Of Surgery Update, September 2015, Wright State University Department Of Surgery

Department of Surgery Updates

A three page newsletter created by the Department of Surgery documenting changes to the department. This issue contains a message from the chair, a list of important dates, committee meetings, scholarly activity and more.

Laser Treatment Of Laryngeal Papillomatosis In A Young Child: Anaesthetic And Surgical Management, Faisal Shamim, Durriya Raza, Mubasher Ikram

Department of Surgery Docs

Abstract

The authors report the case of a 4-year boy who required anaesthetic and surgical care during LASER excision of laryngeal papillomatosis. He presented with hoarseness and stridor and underwent emergency tracheostomy after confirmation of laryngeal papillomas on CT scan. He required LASER treatment under general anaesthesia with a requirement of paediatric LASER-safe endotracheal tube but unfortunately, this was not available in the country. Balanced anaesthesia technique using inhalational anaesthetic, muscle relaxant and narcotic is used with modifications. After three successful surgical sessions, the airway became patent and tracheostomy was de-cannulated. The perioperative issues surrounding this process are discussed including …

Near Complete Aortic Transection And Its Successful Repair Using A Novel Cardiopulmonary Bypass Technique, Dania Aijaz Shah, Adil Aijaz Shah, Syed Jawad Shah, Muhammad Naseer Khan, Saulat H. Fatimi

Department of Surgery Docs

Abstract

The case of a 38-year old female, victim of a road traffic accident who presented with a near complete aortic transection is presented. An emergent repair employing cardiopulmonary bypass was attempted in the operating room. Anticipating a high-risk of compromise to cerebral perfusion from air micro-emboli, the bypass was attempted with an innovative approach involving the successful cannulation of the pulmonary artery and descending aorta. The patient survived and was found to be doing well on subsequent post-operative visits.

Systemic Candidiasis And Cytomegalovirus Infection In The Setting Of Artificial Cardiac Device Deployment., Manoj Thangam, Bindu Akkanti, Maan Malahafio, Sriram Nathan, Indranee Rajapreyar, Pranav Loyalka, Biswajit Kar, Igor Gregoric

The VAD Journal

Heart failure is a serious cause of morbidity and mortality worldwide. The advent of implantable cardiac assist devices has generated a new arsenal for treating severe heart failure. However, the potential ramifications of ventricular assist device (VAD) usage are not fully understood. Immune modulation resulting from VAD implantation is an area of growing research. Although we do not fully understand the mechanisms contributing to host immune alteration, changes in cytokine concentrations, deceased lymphocyte activity, and the local effects of device materials have been shown to down regulate immune function. ^7,8 Infection is a serious complication that affects prognosis in this …

A Tale Of Two Techniques: Demystifying The Myth, M. Fuad Jan

Journal of Patient-Centered Research and Reviews

N/A

Fasting Headache, A Cross-Sectional Study, Adnan Salim, Muhammad Ahmed Ilyas, Mehwish Rizvi, Arzlan Ullaha Baig, Syed Hassaan Ahmed, Zuha Pandit, Muhammad Saleem Ilyas

Section of Neurosurgery

Headache is a predominant disorder in general population and is classified into primary and secondary forms by the International Headache Society. Fasting headache is currently classified in Group 10 of ICHD-III as “Headache attributed to disorders of homeostasis”. In spite of continuing research, there is still indistinctness regarding the exact cause of fasting headache. Hypoglycaemia, previous history of headache, stress, caffeine withdrawal, lack of sleep and female gender have been speculated as causative factors. Our rationale for this study is to find out what percentage of the population experiences fasting headache and to find out any link between the occurrence …

Department Of Surgery Update, August 2015, Wright State University Department Of Surgery

Department of Surgery Updates

A three page newsletter created by the Department of Surgery documenting changes to the department. This issue contains a message from the chair, a list of important dates, committee meetings, scholarly activity and more.

New And Contemporary Markers Of Prognosis In Nonmuscle Invasive Urothelial Cancer, Hammad Ather, Syed M Nazim

Department of Surgery Docs

Abstract

Nonmuscle invasive (NMI) urothelial cancer (UC) is associated with varied biological potential. It is characterized by frequent recurrence and progression, which thus worsens the oncological outcome. Nearly three-quarters of NMI UCs recur within 5 years, whereas half can progress during follow-up. Progression is particularly seen in T1 and carcinoma in situ (CIS). Undoubtedly, NMI UC is one of the most expensive cancers to manage. The European Organisation for Research and Treatment of Cancer (EORTC) risk calculator is a commonly used tool for assessing the recurrence and progression potential of a newly diagnosed cancer. The parameters used in the assessment …

A Sensorless Haptic Interface For Robotic Minimally Invasive Surgery, Baoliang Zhao

Department of Mechanical and Materials Engineering: Dissertations, Theses, and Student Research

Robotic minimally invasive surgery (R-MIS) has gained in popularity due to its advantages of improving the accuracy and dexterity of surgical interventions while minimizing trauma to the patient. However, because of the loss of direct contact with the surgical site, the surgeon cannot perceive tactile information, which may adversely affect surgical efficiency and/or efficacy. The lack of haptic feedback is regarded as a limiting factor in existing R-MIS technology.

To solve this problem, researchers have incorporated force sensors on the surgical tools to measure the tool-tissue interaction forces, and reproduce these forces at the surgeon console. However, the employment of …

Mobile Cloud Computing Based Non Rigid Registration For Image Guided Surgery, Arun Brahmavar Vishwanatha

Computer Science Theses & Dissertations

In this thesis we present the design and implementation of a Mobile Cloud computing platform for non-rigid registration required in Image Guided Surgery (MCIGS). MCIGS contributes in flexible, portable and accurate alignment of pre-operative brain data with intra-operative MRI, for image guided diagnosis and therapy and endoscopic skull base surgery. Improved precision of image guided therapy and specifically neurosurgery procedures is known to result in the improved prognosis for brain tumor patients. MCI GS system is tested with Physics Based Non-Rigid Registration method form ITK. Our preliminary results for brain images indicate that the proposed system over Wi-Fi can be …

Robot-Assisted Surgeries: Developing A Database For Future Research On Better Practice, Mack Trexler, Sarah K. Wenrich Pa-C, Kyle M. Langston Pa-C

Research Scholars Poster Presentation

Robot-Assisted Surgeries: Developing a Database for Future Research on Better Practice

Mack Trexler¹
Sarah Wenrich, PA-C^1,2 and Kyle Langston, PA-C^1,2

¹Department of Robotic Surgery, LVHN
²Summer Research Scholar Program Mentor

Abstract

Although the first FDA approved utilization of Intuitive Surgical’s da Vinci® Surgery System dates back to the year 2000, the Lehigh Valley Health Network (LVHN) only began using this emergent technology for minimally invasive surgery in 2007. Since the inception of the Robotic Surgery Department roughly 8 years ago, the LVHN has performed over 4,000 robotic cases—a number seemingly large enough to derive valuable …

Incidence Of Rejection In Renal Transplant Surgery In The Lvhn Population Leading To Graft Failure: 6 Year Review, Jessica Ludolph, Lynsey S. Biondi Md, Michael J. Moritz Md

Research Scholars Poster Presentation

Incidence of Rejection in Renal Transplant Surgery in the LVHN Population Leading to Graft Failure: 6 Year Review

Jessica Ludolph¹

Lynsey Biondi, MD^1,2 and Michael Moritz, MD^1,2

¹Department of Surgery, Lehigh Valley Health Network

²Research Scholar Program Mentor

Abstract

To obtain optimal outcomes, it is vital to continually investigate variables potentially effecting rejection and graft failures. 407 renal transplant recipients who were transplanted at The Transplant Center of the Lehigh Valley from January 2009 to December 2014 were analyzed using descriptive statistics. Variables potentially influencing graft survival, including delayed graft function, and cell mediated and …

The Effect Of Aspirin On Bleeding And Transfusion In Contemporary Cardiac Surgery., Jordan E Goldhammer, Gregary D. Marhefka, Constantine Daskalakis, Mark W Berguson, John E Bowen, James Diehl, Jianzhong Sun

Department of Medicine Faculty Papers

OBJECTIVE: Despite evidence that preoperative aspirin improves outcomes in cardiac surgery, recommendations for aspirin use are inconsistent due to aspirin's anti-platelet effect and concern for bleeding. The purpose of this study was to investigate preoperative aspirin use and its effect on bleeding and transfusion in cardiac surgery.

METHODS: This retrospective study involved consecutive patients (n=1571) who underwent CABG, valve, or combined CABG and valve surgery at a single center between March 2007 and July 2012. Of all patients, 728 met the inclusion criteria and were divided into two groups: those using (n=603) or not using (n=125) aspirin within 5 days …

Implementation Of Resident-Driven, Quality-Based Improvement Projects At A Single Academic Institution: Resident Value And Institutional Outcomes, Kathleen M. Lamb, Md, Randi E. Altmark, Rn, Bsn, Cnor, Adam P. Johnson, Md, Mph, Richard A. Burkhart, Md, Karen A. Chojnacki, Md, Facs, Scott W. Cowan, Md, Facs

Department of Surgery Faculty Papers

Significance

Finding a viable and sustainable methodology for resident involvement in surgical quality improvement is not only a GME requirement, but also imperative to patient care.

The Cutting Edge Summer 2015, Wright State University Department Of Surgery

The Cutting Edge Newsletter

A twelve page newsletter created by the Department of Surgery documenting current affairs of the department. This issue contains features such as faculty news, information on general surgery residencies, a list of scholarly activity, special lectures, and more.

Department Of Surgery Update, July 2015, Wright State University Department Of Surgery

Department of Surgery Updates

A three page newsletter created by the Department of Surgery documenting changes to the department. This issue contains a message from the chair, a list of important dates, committee meetings, scholarly activity and more.

Multiple Cerebral Hydatid Cysts In 8-Year-Old Boy: A Case Report And Literature Review Of A Rare Presentation, Muhammad Baba Khan, Muhammad Riaz, Muhammad Ehsan Bari

Section of Neurosurgery

Background: Multiple cerebral hydatid cysts are very rare with only a few reports in the literature detailing diagnostic workup, medical management, surgical techniques, possible complications, and outcomes.
Case description: We present the case of an 8-year-old boy who presented with progressively worsening headaches, vomiting, and intermittent fever since 20 days. Diagnostic workup was performed, and magnetic resonance imaging revealed multiple intracranial cysts predominantly in the right frontal region with significant mass effect. A total of 19 intracranial cysts were removed surgically, and the child recovered uneventfully.
Conclusions: Neurosurgeons should keep hydatidosis in the list of differentials when evaluating patients with …

Venous Thromboembolism-Incidence Of Deep Venous Thrombosis And Pulmonary Embolism In Patients With Head And Neck Cancer: A Tertiary Care Experience In Pakistan, Naeem Sultan Ali, Ahmad Nawaz, Montasir Junaid, Maliha Kazi, Shabbir Akhtar

Department of Surgery Docs

Abstract

Introduction Although venous thromboembolism (VTE) is seen with morbidity and mortality in various surgical specialties, scarce data are available in the head and neck surgery domain. Objective We aim to determine the incidence of VTE in patients receiving surgery for head and neck cancer. Methods Four hundred thirteen patients who underwent head and neck surgery procedures between 2005 and 2013 were reviewed retrospectively. All patients with head and neck surgery had received thromboprophylaxis (i.e., compression stockings and subcutaneous heparin). Patient demographics, operating time, and length of hospital stay were analyzed. The incidence of symptomatic deep venous thrombosis (DVT) and …

Resection Of Posterior Mediastinal Tumors By Video Assisted Thoracic Surgery, Taimur Asif Ali, Saulat Hasnain Fatimi, Syed Saad Naeem

Department of Surgery Docs

Abstract

This case report illustrates successful Video Assisted Thoracic Surgery (VATS) performed on a 45-year-old woman and 52-year-old man presenting with a mass in left and right paravertebral space on the CT scan respectively. VATS has many benefits over traditional open operation (thoracotomy), resulting in less pain and shorten recovery time. However, VATS has higher equipment cost but when an experienced surgeon performs the surgery, better outcomes are achieved. VATS is not common in Pakistan's surgical setup as it is an expensive method of eradicating mediastinal pathologies and not every patient undergoes VATS. The primary objective of presenting these cases …