Surgery Commons^™

Hur/Elavl1 Drives Malignant Peripheral Nerve Sheath Tumor Growth And Metastasis, Marta Palomo-Irigoyen, Encarni Pérez-Andrés, Marta Iruarrizaga-Lejarreta, Adrián Barreira-Manrique, Miguel Tamayo-Caro, Laura Vila-Vecilla, Leire Moreno-Cugnon, Nagore Beitia, Daniela Medrano, David Fernández-Ramos, Juan José Lozano, Satoshi Okawa, José L Lavín, Natalia Martín-Martín, James D Sutherland, Virginia Guitiérez De Juan, Monika Gonzalez-Lopez, Nuria Macías-Cámara, David Mosén-Ansorena, Liyam Laraba, C Oliver Hanemann, Emanuela Ercolano, David B Parkinson, Christopher W. Schultz, Bs, Marcos J Araúzo-Bravo, Alex M Ascensión, Daniela Gerovska, Haizea Iribar, Ander Izeta, Peter Pytel, Philipp Krastel, Alessandro Provenzani, Pierfausto Seneci, Ruben D Carrasco, Antonio Del Sol, María Luz Martinez-Chantar, Rosa Barrio, Eduard Serra, Conxi Lazaro, Adrienne M Flanagan, Myriam Gorospe, Nancy Ratner, Ana M Aransay, Arkaitz Carracedo, Marta Varela-Rey, Ashwin Woodhoo

Department of Surgery Faculty Papers

Cancer cells can develop a strong addiction to discrete molecular regulators, which control the aberrant gene expression programs that drive and maintain the cancer phenotype. Here, we report the identification of the RNA-binding protein HuR/ELAVL1 as a central oncogenic driver for malignant peripheral nerve sheath tumors (MPNSTs), which are highly aggressive sarcomas that originate from cells of the Schwann cell lineage. HuR was found to be highly elevated and bound to a multitude of cancer-associated transcripts in human MPNST samples. Accordingly, genetic and pharmacological inhibition of HuR had potent cytostatic and cytotoxic effects on tumor growth, and strongly suppressed metastatic …

A Rare Case Of Three Years Disease Free Survival In A Locally Advanced Parathyroid Carcinoma Successfully Excised By Complete Surgical Resection, Abdul Ahad Sohail, Bushra Ayub, Syed Akbar Abbas, Shafqat Ali Sheikh, Talha Ahmed Qureshi, Muhammad Usman Tariq, Asad Diwan

Department of Surgery Docs

Parathyroid carcinoma (PC) is one of the rarest malignancies making approximately 0.005% of all cancers. It may arise sporadically or less commonly, in conjunction with genetic endocrine syndromes. Due to the rarity of the disease, no general consensus or definitive guidelines exist for its pre-operative diagnosis, management, or follow up. Surgical tumor removal is the gold standard treatment to prevent its recurrence. Parathyroid carcinoma has a high recurrence rate ranging from 40 to 60% in recent literature. We report a case of a seventy-year-old elderly female with locally advanced parathyroid carcinoma successfully surgically excised completely with a 3 year disease …

Risk Factors For Nonaccidental Burns In Children, Seyed A Arshad, Rebecca G Girardet, Mary T Austin

Faculty, Staff and Student Publications

BACKGROUND: The relative influences of baseline risk factors for pediatric nonaccidental burns have not been well described. We evaluated baseline characteristics of pediatric nonaccidental burn patients and their primary caretakers.

METHODS: A single-center retrospective cohort study was conducted of pediatric (age < 17) burn patients from July 1, 2013, to June 30, 2018. The primary outcome was nonaccidental burn, defined as burn secondary to abuse or neglect as determined by the inpatient child protection team or Child Protective Services. Univariate and multivariate analyses were performed.

RESULTS: Of 489 burn patients, 47 (9.6%) suffered nonaccidental burns. Nonaccidental burn patients more frequently had a history of Child Protective Services involvement (48.9% vs 9.7%, P < .001), as did their primary caretakers (59.6% vs 10.9%, P < .001). Non-Hispanic black children had higher rates of Child Protective Services referral (50.7% vs 26.7%, P < .001) and nonaccidental burn diagnosis (18.9% vs 5.6%, P < .001) than children of other races/ethnicities. On multivariate analysis, caretaker involvement with CPS (odds ratio 7.53, 95% confidence interval 3.38-16.77) and non-Hispanic black race/ethnicity (odds ratio 3.28, 95% confidence interval 1.29-8.36) were associated with nonaccidental burn.

CONCLUSION: Caretaker history of Child Protective Services involvement and non-Hispanic black race/ethnicity were associated with increased odds of pediatric nonaccidental burn. Prospective research is necessary to determine whether these represent true risk …

Crack Cocaine Induced Upper Airway Injury., N D Vandjelovic, A K Larson, E M Sugihara, N A Stern

Articles, Abstracts, and Reports

The paper describes the presentation and management of patients presenting with crack cocaine induced upper airway injury. The study involved a retrospective clinical series of six patients with crack cocaine induced upper airway injury. Demographics, symptoms, physical exam, flexible laryngoscopy findings, treatment and intervention were recorded. All patients with crack cocaine induced thermal injury presented with mouth or throat pain plus at least one other laryngeal symptom, such as globus sensation, dysphagia or throat tightness. On physical exam, the supraglottis was the most common subsite of endolaryngeal injury. The only statistically significant finding was the number of subsites on initial …

Outcome Of Cranial Firearm Injuries In Civilian Population Based On A Novel Classification System, Farrukh Javeed, Asad Abbas, Lal Rehman, Syed Raza Khairat Rizvi, Ali Afzal, Hafiza Fatima Aziz

Section of Neurosurgery

Background: Cranial firearm injuries (CFAIs) are expected to be frequent during warfare; however, it is becoming increasingly common among civilian population in our part of the world. These injuries are associated with significant morbidity and mortality in addition to financial loss. The objective of our study is to evaluate the pattern of gunshot injuries to cranium and their outcome.
Methods: The study was conducted on 114 patients presenting with CFAIs to Jinnah Postgraduate Medical Centre, Karachi, Pakistan, between June 2015 and January 2019. Patients were evaluated with respect to age, gender, pattern of injury, Glasgow coma scale on arrival, radiological …

Spermine Synthase And Myc Cooperate To Maintain Colorectal Cancer Cell Survival By Repressing Bim Expression, Yubin Guo, Qing Ye, Pan Deng, Yanan Cao, Daheng He, Zhaohe Zhou, Chi Wang, Yekaterina Y. Zaytseva, Charles E. Schwartz, Eun Young Lee, B. Mark Evers, Andrew J. Morris, Side Liu, Qing-Bai She

Markey Cancer Center Faculty Publications

Dysregulation of polyamine metabolism has been linked to the development of colorectal cancer (CRC), but the underlying mechanism is incompletely characterized. Here, we report that spermine synthase (SMS), a polyamine biosynthetic enzyme, is overexpressed in CRC. Targeted disruption of SMS in CRC cells results in spermidine accumulation, which inhibits FOXO3a acetylation and allows subsequent translocation to the nucleus to transcriptionally induce expression of the proapoptotic protein Bim. However, this induction is blunted by MYC-driven expression of miR-19a and miR-19b that repress Bim production. Pharmacological or genetic inhibition of MYC activity in SMS-depleted CRC cells dramatically induces Bim expression and apoptosis …

Effects Of Coronavirus (Covid-19) Pandemic On Orthopedic Residency Program In The Seventh Largest City Of The World: Recommendations From A Resource-Constrained Setting, Marij Zahid, Syed Arif Ali, Naveed Baloch, Shahryar Noordin

Section of Orthopaedic Surgery

The coronavirus (COVID-19) pandemic has hit the entire world hard. Since its inception from Wuhan China the whole world is affected now. Health care facilities and workers are overwhelmed and the situation is changing on daily basis. With the changes in the dynamics of the hospitals, residency and fellowships training programs have also suffered undoubtedly. Due to decreased elective cases and outpatient clinics surgical training gets compromised, however on the other side this physical distancing and isolation have proven to be effective measures in controlling the disease. In this article we share our experience of effect of COVID-19 pandemic on …

Acute Opioid Withdrawal Mimicking Postoperative Joint Infection Following Anterior Cruciate Ligament (Acl) Reconstruction: A Case Report., Qingwu Kong, Martin Griffis, Brandon J Shallop, Amrit S Khalsa, Kyle Brougham, Paul A Marchetto

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND A short course of opioid narcotics is often prescribed for postoperative anterior cruciate ligament (ACL) reconstruction pain management. Unfortunately, there is a well-documented incidence of opioid withdrawal syndrome (OWS) following short-term use of these medications. OWS can present with symptoms such as influenza-like illness. It is important to differentiate OWS from infectious illnesses, especially after surgery. CASE REPORT We present a case of OWS in a patient who underwent ACL reconstruction 7 days prior. The patient's OWS symptoms were similar to symptoms of a postoperative infection. The knee was aspirated, and the analysis of the aspirate was not concerning …

En Bloc Resection Of A Giant Retroperitoneal Liposarcoma: A Surgical Challenge, Talal Almas, Muneeb Ullah, Maryam Ehtesham, Absam Akbar, Muhammad Kashif Khan

Medical College Documents

Liposarcomas are exceedingly rare entities that evoke malignant transformation of connective tissue and fat cells.These tumours occur throughout the soft tissues of the body, afflicting a myriad of regions. In the adult population, liposarcomas represent the most prevalent subtype of sarcomas, and often arise de novo. Retroperitoneal liposarcomas (RLS) are a ubiquitous subset of sarcomas that, due to their deep location in the hollow abdomen, can grow to astronomical proportions before manifesting any noticeable symptoms; a prompt diagnosis of RLS is therefore often rendered dilatory. We hereby delineate the case of a 43-year-old woman who presented with vague left hemiabdominal …

Seasonal Influence On Postoperative Hip Fracture Complications: Retrospective Cohort Of More Than 1000 Patients From A Tertiary-Care University Hospital, Obada Hasan, Mashal Amin, Fatima Mahmood, Amna Rabbani, Umar Rabbani, Shahryar Noordin

Department of Paediatrics and Child Health

Background: Hip fractures account for one of the most debilitating conditions affecting the general population amongst the developed and developing nations. Investigators aimed to study the influence of the ongoing season i.e. whether patients operated upon in summer or winter, on post-operative complications occurring within 30 days of surgical procedure for hip fractures at a tertiary care hospital and level 1 trauma center.
Materials and methods: Investigators conducted a non-funded, non-commercialized retrospective cohort of 1045 patients with hip fractures managed surgically. Primary exposure was surgical procedures undertaken during the summer months (April-September). Our primary outcome was determining post-operative complication rates …

Do New Trainees Pose A Threat To Postoperative Complications After Hip Fracture Surgeries? Retrospective Cohort Of 1045 Patients Over A Decade At A University Hospital, Obada Hasan, Mashal Amin, Umar Rabbani, Amna Rabbani, Fatima Mahmood, Shahryar Noordin

Department of Paediatrics and Child Health

Introduction: Induction of new residents and surgical trainees in most institutes occurs once a year. Fresh residents with no experience, may pose a threat to the surgical procedure outcome and there can be a potential increase in patients' morbidity and mortality as a result of this turnover. Literature is inconclusive about this effect. Our aim was to study the "new residents' induction effect" on postoperative complications after hip fracture surgeries.
Methodology: This is non funded non commercialized study from a university hospital. Investigators studied a retrospective cohort of 1045 adult hip fracture patients who were operated at our tertiary care …

Effectiveness Of Home-Based Rehabilitation Program In Minimizing Disability And Secondary Falls After A Hip Fracture: Protocol For A Randomized Controlled Trial, Anum Sadruddin Pidani, Saniya Sabzwari, Khabir Ahmad, Ata Khan, Shahryar Noordin

Department of Surgery Docs

Introduction: Hip fractures are a major health problem globally and are associated with increased morbidity, mortality, and substantial economic costs. Successful operative treatment of hip fracture patients is necessary for the optimization of post-op mobility and functional recovery of the patient. Rehabilitation after surgical stabilization of a hip fracture is crucial in order to restore pre-fracture function and to avoid long-term institutionalization. In particular ongoing exercise which targets balance can prevent up to 40% of falls. Therefore, we have designed a post-discharge home-based physical rehabilitation intervention program to minimize disability and falls in this high-risk elderly population.
Methods and analysis: …

Circulating Tumor Cell And Regulator T-Lymphocyte In Core Biopsy For Breast Cancer, Sonar Soni Panigoro, Diani Kartini, Dewi Wulandari, Arif Supono

The New Ropanasuri Journal of Surgery

Introduction: Breast cancer is the most common malignancy found in Indonesia. Core biopsy is one of the modalities used in breast cancer diagnosis with sensitivity of 91-99% and specificity of 96-100%. The procedure causes damage to tumor tissue thus causing tumor cells to enter circulation (CTC) and therefore acute inflammation and infiltration of inflammatory cells. In the final phase of infiltration, the number of Tregs cells will increase, as well as secretion of TGFβ and IL-10, creation of immunosuppresion microenvironment, COX2 stimulation by TGFβ then conversion of CD4+ T cells into FoxP3+ (Tregs), therefore the number of Tregs cells will …

Purse-String Suture For Skin Closure Following Large Thyroidectomy, Ahmad Kurnia, Bintang Abadi Siregar, Muchlis Ramli

The New Ropanasuri Journal of Surgery

Introduction. The total number of patients with thyroid nodules, especially large thyroid nodules (> 6 cm diameter), is increasing. However, the conventional suturing technique for closure of thyroidectomies is still only recommended as the standard for the tumor with a diameter up to 6 cm. Hence, this study aims to prove another surgical technique, purse-string stitching technique, for better esthetic outcomes on large thyroidectomy.

Methods. This study was a non-randomized control trial. The subjects included the patients of Cipto Mangunkusumo Hospital in 2013 to 2014 with a thyroid tumor > 6 cm in diameter without any history of anterior cervical …

A Solitary Bone Plasmacytoma In The Mandible: A Case Report, Erwin D. Yulian, Andre S. Suryadi

The New Ropanasuri Journal of Surgery

Abstract

Introduction: Solitary bone plasmacytoma (SBP) is a localized neoplasms in the bone consisting of abnormal plasma cells. We herein report an unusual case of SBP that presents in mandible bone.

Case Illustration: A 57-year-old woman, with chief complaint for the lump at right jaw, which gradually increasing in size since 13 years ago. Diagnosis was based on clinical, radiological, and histopathological findings. The patient was referred for radiotherapy before surgery using 50 Gy dose of radiation for 25 times with the result of partial response, followed by hemimandibulectomy and reconstruction with free fibular flap. Complete resection in a form …

Capsular Contracture, Prolonged Use Of Breast Implants With Pleural Effusion: A Case Report, Yefta Moenadjat

The New Ropanasuri Journal of Surgery

A case with prolonged implanted breast prosthesis experienced a prolonged capsular contracture complicated with pleural effusion. A complete capsular removal proceeded instead of removal of the prosthesis solely. The present case aimed to share experiences that may add to the scientific horizon regarding the rare complications of breast prosthesis and rarely reported.

Cardiac Tamponade And Laceration Of Right Ventricle In Blunt Thoracic Injury: A Case Report, Prabowo W. Simbolon, Muhammad A. Putra

The New Ropanasuri Journal of Surgery

Introduction. Cardiac tamponade caused by blunt thoracic injuries is a rare case with a high mortality rate. Generally, patients with blunt cardiac injury were not survived before they reach the hospital. We present the case of a 50-year-old man was admitted to our emergency department after a motorcycle hit the cart he was pushing on the street, and then the handle hit the chest. He presented with hemodynamically unstable and a bruised on precordial area, then he went into cardiac arrest. Standard CPR was done for 2 minutes, continued with intubation and ROSC. FAST showed fluid in the pericardial …

Minireview: Covid–19: Criticism Of The Pathogenesis Based On The Tropism, Yefta Moenadjat

The New Ropanasuri Journal of Surgery

No abstract provided.

Endovascular Management Of Post Traumatic Lower Extremity Pseudoaneurysm: An Evidence Based Case Report, Patrianef Darwis, Feyona H. Subrata

The New Ropanasuri Journal of Surgery

Introduction. Increasing incidence of trauma all over the world will increase the risk of vascular trauma, so will the prevalence of pseudoaneurysm. Post traumatic pseudoaneurysm occurs within days or months and commonly diagnosed as hematoma in its early presentation. An effective, less invasive, and low-cost treatment with high rate of survival is needed by patients with post traumatic pseudoaneurysm. Endovascular surgery is one of the less invasive techniques. This case report was made to find out the effectivity of endovascular surgery in the treatment of post traumatic pseudoaneurysm.

Method. Literature searching was performed in Cochrane Library, EBSCOhost, ClinicalKey, …

Hernia Through Winslow Foramen In Cipto Mangunkusumo General Hospital, Jakarta: A Case Report, Eko Ristiyanto, Taufik A. Wibowo, Ridho A. Syaiful, Benny Philippi, Toar J.M. Lalisang

The New Ropanasuri Journal of Surgery

Introduction. Hernias through Winslow foramen are extremely rare, occurred for 0.1% of all abdominal hernias and found during laparotomy due to strangulated bowel obstruction. This study aims to describe hernia of Winslow foramen and its management.

Method. Data were retrospectively collected based on medical records. Clinical manifestations, laboratory data, supporting radiographic examinations, treatment, postoperative care, and outcomes were collected.

Case summary. We report the first case of Winslow foramen hernia at Cipto Mangunkusumo General Hospital, Jakarta. A man 54 years in 2019. Ileus was the main clinical symptoms and presented epigastric pain, nausea and vomiting. Plain abdominal x-ray …