Surgery Commons^™

Surgical Management Of Pheochromocytoma In A 13-Week Pregnant Woman, Mazhar Ali Memon, Wajahat Aziz, Farhat Abbas

Section of Urology

A 34-year-old 13-week pregnant woman presented with hypertension refractory to medical therapy and on workup was found to have a right adrenal mass. Due to her persistent increased blood pressure she was advised urinary vanillylmandelic acid (VMA) and its level was raised. MRI of the abdomen showed a well-circumcised lesion in the right adrenal of 3.0×2.5 cm suggestive of pheochromocytoma. The patient was started on antihypertensives including α-blockers and β-blockers and planned for right open adrenalectomy. Intraoperatively, blood pressure was raised up to 180/110 mm Hg on slight manipulation of adrenal gland which was controlled with glyceryl-trinitrate and volatile agents. …

Rct Evaluating Safety & Efficacy Of Sodium Hyaluronate/Carboxymethylcellulose At Cesarean Delivery, Daniel G. Kiefer Md, Jolene C. Muscat Md, Jarrett Santorelli Bs, Martin R. Chavez Md, Cande V. Ananth Phd, Mph, John C. Smulian Md, Mph, Anthony M. Vintzileos Md

Department of Obstetrics & Gynecology

No abstract provided.

Culture-Independent Evaluation Of The Appendix And Rectum Microbiomes In Children With And Without Appendicitis, Hope T. Jackson, Emmanuel F. Mongodin, Katherine P. Davenport, Claire M. Fraser, Anthony D. Sandler, Steven L. Zeichner

Surgery Faculty Publications

Purpose

The function of the appendix is largely unknown, but its microbiota likely contributes to function. Alterations in microbiota may contribute to appendicitis, but conventional culture studies have not yielded conclusive information. We conducted a pilot, culture-independent 16S rRNA-based microbiota study of paired appendix and rectal samples.

Methods

We collected appendix and rectal swabs from 21 children undergoing appendectomy, six with normal appendices and fifteen with appendicitis (nine perforated). After DNA extraction, we amplified and sequenced 16S rRNA genes and analyzed sequences using CLoVR. We identified organisms differing in relative abundance using ANOVA (p

Results

We identified 290 taxa in …

Thoracic And Lumbar Spinal Surgery Under Local Anesthesia For Patients With Multiple Comorbidities: A Consecutive Case Series, Muhammad Babar Khan, Rajesh Kumar, Ather Enam

Section of Neurosurgery

Background: Although some patients with symptomatic spinal disease may benefit greatly from surgery, their multiple attendant comorbidities may make general anesthesia risky or contraindicated. However, there is scarce literature describing the efficacy and safety of local anesthesia to perform these operations. Here we report seven patients who successfully underwent spinal surgery utilizing local anesthesia to limit the risks and complications of general anesthesia.
Methods: Seven patients for whom general anesthesia was contraindicated were prospectively followed for a minimum of 3 months following spinal surgery performed under local anesthesia. Pain and functional improvement were assessed utilizing the Visual Analog Scores (VAS) …

Critical Role Of Tnf-Α In Cerebral Aneurysm Formation And Progression To Rupture., Robert M Starke, Nohra Chalouhi, Md, Pascal Jabbour Md, Stavropoula Tjoumakaris, L. Fernando Gonzalez, Robert H. Rosenwasswer Md, Kosuke Wada, Kenji Shimada, David M Hasan, Nigel H Greig, Gary K Owens, Aaron Dumont

Department of Neurosurgery Faculty Papers

BACKGROUND: Alterations in TNF-α expression have been associated with cerebral aneurysms, but a direct role in formation, progression, and rupture has not been established.

METHODS: Cerebral aneurysms were induced through hypertension and a single stereotactic injection of elastase into the basal cistern in mice. To test the role of TNF-α in aneurysm formation, aneurysms were induced in TNF-α knockout mice and mice pretreated with the synthesized TNF-α inhibitor 3,6'dithiothalidomide (DTH). To assess the role of TNF-α in aneurysm progression and rupture, DTH was started 6 days after aneurysm induction. TNF-α expression was assessed through real-time PCR and immunofluorescence staining.

RESULTS: …

A Novel Parp Inhibitor Resistance Mechanism Mediated By The Rna-Binding Protein Hur, Saswati N. Chand, Nicole Meisner-Kober, Shruti Lal, Charles J. Yeo, Md, Jordan M. Winter, Md, Jonathan R. Brody, Md

Department of Surgery Faculty Papers

Abstract

Pancreatic ductal adenocarcinoma (PDA) is the 4th leading cause of cancer-related deaths in the United States, and ranks as the third most common cancer associated with BRCA mutations, not including Fanconi Anemia gene mutations such as PALB2. Current combinations of chemotherapeutics have significant toxicities and only minimally extend overall patient survival. Poly-ADP ribose polymerase (PARP) inhibitors (PARPi), which target the DNA damage repair (DDR) pathway, have delivered promising preclinical and clinical results. Although synthetic lethality conferred by PARPi is a promising approach, still “selected” patients with DNA repair-deficient tumors (e.g., BRCA2 mutated) that initially respond to such molecular-targeted therapies …

Promoter Hypermethylation Of Tumor Suppressor Genes Correlates With Tumor Grade And Invasiveness In Patients With Urothelial Bladder Cancer, Shumaila M. Bilgrami, Sohail A. Qureshi, Shahid Pervez, Farhat Abbas

Section of Urology

Purpose: To investigate the promoter methylation status at selected loci which encode for key proteins involved in apoptosis, DNA repair, cell cycle control and progression in urothelial cell carcinoma of bladder and compare the findings from tissue samples with that of plasma.
Methods: Total genomic DNA was isolated from 43 non-muscle invasive (low grade) and 33 muscle invasive (high grade) urothelial bladder cancer samples along with 10 control cases of normal bladder mucosa. Promoter methylation status was investigated for RASSF1A, APC, MGMT, CDKN2A and CDKN2B genes using real-time methylation-specific PCR with SYBR® green. Plasma samples from 16 patients with muscle …

Outcomes Of Recurrent Rectal Cancer After Transanal Excision, Sachin Vaid, Christopher Buzas, John S. Park Md, Robert J. Sinnott Md

Department of Surgery

No abstract provided.

Improving Anatomical Knowledge Retention In Medical Students Entering The Surgery And Obstetrics And Gynecology Clinical Rotations By Nesting Interactive Modules, Samantha Ahle, Jill Krapf, Kirsten Marie Brown, Juliet Lee, Gisela Butera, Ellen Goldman, Myriam Ferzli, Rosalyn A. Jurjus

GW Research Days 2014

Background: It is well documented in the medical education literature that students retain minimal anatomy knowledge when transitioning from pre-clinical didactics to clinical application on the wards. In a previous study at our own institution we were able to quantify this knowledge deficit in students on surgical clerkships, specifically surgery and obstetrics and gynecology (OB/GYN). Using our previous data, we designed an integrated, nested clinical teaching model utilizing e-modules to review clinically relevant surgical anatomy during their clinical rotations.

Objective: The goal of this study is to evaluate the impact of a newly designed method of teaching clinically relevant anatomy …

Instructional Posters And Prevention Education: Do They Really Work?, William D. Mcquilken Ba, Deanna Shisslak, Judith M. Schultz Ba, Cstr

Department of Surgery

No abstract provided.

Department Of Surgery Update, April 2014, 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, students' results from National Match day and more.

Bilateral Laparoscopic Partial Adrenalectomy: A Case Presentation And Review Of The Literature, Sean Satey, Nathan Richards, Frederick J. Brody

Surgery Faculty Publications

Laparoscopic adrenalectomy is the standard of care for benign adrenal diseases. Partial adrenalectomy has been performed for various tumors to preserve adrenal function while avoiding steroid supplements postoperatively. This article discusses a patient that underwent bilateral laparoscopic partial adrenalectomies for bilateral pheochromocytomas and reviews the literature on partial adrenalectomy. A 40-year-old woman with a recent diagnosis of hypertension and an emergent Caesarian section for pre-eclampsia presented to an outside clinic with labile blood pressure, diaphoresis, palpitations, and headache. Physical examination was unremarkable with no bruits appreciated in the neck or abdomen. Medical management of her hypertension was initiated with minimal …

Childhood Achalasia: A Comprehensive Review Of Disease, Diagnosis And Therapeutic Management, Ashanti L. Franklin, Mikael Petrosyan, Timothy D. Kane

Surgery Faculty Publications

Achalasia is an esophageal motility disorder characterized by failure of lower esophageal sphincter (LES) relaxation and is rare in children. The most common symptoms are vomiting, dysphagia, regurgitation, and weight loss. Definitive diagnosis is made with barium swallow study and esophageal manometry. In adults, endoscopic biopsy is recommended to exclude malignancy however; it is not as often indicated in children. Medical management often fails resulting in recurrent symptoms and the ultimate definitive treatment is surgical. Laparoscopic Heller myotomy with or without an anti-reflux procedure is the treatment of choice and has become standard of care for children with achalasia. Peroral …

Transoral Incisionless Fundoplication Effective In Eliminating Gerd Symptoms In Partial Responders To Proton Pump Inhibitor Therapy At 6 Months: The Tempo Randomized Clinical Trial, Karim S. Trad, William E. Barnes, Gilbert Simoni, Ahmad B. Shughoury, Peter G. Mavrelis, Mamoon Raza, Jeffrey Heise, Daniel G. Turgeon, Mark A. Fox

Surgery Faculty Publications

Background. Incomplete control of troublesome regurgitation and extraesophageal manifestations of chronic gastroesophageal reflux disease (GERD) is a known limitation of proton pump inhibitor (PPI) therapy. This multicenter randomized study compared the efficacy of transoral incisionless fundoplication (TIF) against PPIs in controlling these symptoms in patients with small hiatal hernias.

Methods. Between June and August 2012, 63 patients were randomized at 7 US community hospitals. Patients in the PPI group were placed on maximum standard dose (MSD). Patients in the TIF group underwent esophagogastric fundoplication using the EsophyX₂ device. Primary outcome was elimination of daily troublesome regurgitation or …

Processing And Characterization Of Innovative Magnesium Alloys For Biodegradable Orthopaedic Implants, Christopher E. Smith

Dissertations

There is a need for innovation in medical implant devices through novel biomaterials that will improve the quality of life. The first step in the creation of a foundation of knowledge and technology to improve these implant devices is through the creation of new alloys with the capabilities of biodegradation and bioabsorption without a toxic effect that will pass through FDA regulatory procedures. In this study, unique heat treatment processing techniques coupled with innovation in elemental alloying produced distinctive magnesium (Mg) based alloy systems. The MgZnCa system was used as the underpinning system where four groups of novel alloys were …

The Cutting Edge Spring 2014, 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 features a dedication to former faculty Robert Peter Turk, faculty news, a listing of special lectures, clinical news, and more.

Pharmaceuticals And Personal Care Products: Emerging Contaminants In Aquatic Ecosystems, Jenny E. Zenobio

Open Access Theses

In recent years, the presence of pharmaceuticals and personal care products (PPCPs) in aquatic systems has led to research on their fate and effects. PPCPs have been found in mixture in wastewater effluents, surface, ground, and drinking water at low concentrations from areas of intense urbanization. Although adverse effects to human health from the current environmental concentrations are unlikely, the impacts to ecological receptors are not clear. We performed field and laboratory studies to quantify and evaluate effects of PPCPs on fish. First, a field study was conducted at the Baca National Wildlife Refuge, Colorado (2010-2012) because a portion of …

Current Trends In Undergraduate Medical And Dental Research: A Picture From Pakistan, Waqar Jeelani, Sanaa Masood Aslam, Asrar Elahi

Department of Surgery Docs

Abstract

BACKGROUND:

Initiatives taken over the last few years have led us to the day when most of the medical and dental institutions in the developed countries have established a strong research culture at undergraduate level but the situation is quite the contrary in Pakistan. This study was carried out to investigate the current trends in undergraduate medical and dental research and to highlight the research barriers.

METHODS:

A cross-sectional study was conducted at six medical and dental colleges of Rawalpindi and Islamabad. A structured questionnaire was used to collect data from 300 students. Results were recorded as percentages. Findings …

Novel Anticancer Agents In Clinical And Preclinical Trials, Adnan Salim

Section of Neurosurgery

No abstract provided.

Changing The Road To Recovery: A Lesson In Pediatric Surgery Efficiency, Hope L. Johnson Msn, Rn, Cnor

Patient Care Services / Nursing

No abstract provided.