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Useful Procedure (useful + procedure)
Selected AbstractsNail Biopsy: Assessment of Indications and OutcomeDERMATOLOGIC SURGERY, Issue 2 2005Chander Grover MD, MNAMS Background For years, nail biopsy has been shunned as a difficult and scarring procedure, which is seldom required in day-to-day practice. Only a few studies with a limited number of patients have been carried out to assess its utility in dermatology. Methods We studied 270 patients with nail disorders (both infectious and noninfectious). In 205 cases, the clinical diagnosis could be confirmed with the help of routine diagnostic aids, in the form of potassium hydroxide preparation, fungal culture, and biopsy of associated skin lesions. In the remaining 65 cases, various types of nail biopsies were carried out after ruling out contraindications to nail surgery. Results Overall, the histopathologic changes were found to be diagnostic in 63% of cases. Findings were more characteristic in infectious disorders of the nail unit. The diagnostic yield varied with the type of biopsy procedure. Side effects in the form of scarring and nail dystrophy were seen in 29.2% of the patients. Discussion Nail biopsy is useful, especially in cases with isolated nail involvement, an absence of skin lesions, and disorders such as twenty-nail dystrophy. It should be advocated in cases in which the routine diagnostic procedures fail to yield results. Proper selection of cases, choice of biopsy technique, and attention to the surgical procedure help in minimizing the side effects associated with the procedure. Conclusion Nail biopsy was found to be a simple, safe, and useful procedure, especially in cases in which the clinical diagnosis is otherwise obscure. CHANDER GROVER, MD, DNB, MNAMS, SONI NANDA, MD, B. S. N. REDDY, MD, MNAMS, AND KRISHNAMOORTHY UMA CHATURVEDI, MD, HAVE INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPPORTERS. [source] ROLE OF ENDOSCOPY IN SCREENING OF EARLY PANCREATIC CANCER AND BILE DUCT CANCERDIGESTIVE ENDOSCOPY, Issue 2009Kiyohito Tanaka In the screening of early pancreatic cancer and bile duct cancer, the first issue was ,what are the types of abnormality in laboratory data and symptoms in case of early pancreatic cancer and bile duct cancer?' Early cancer in the pancreaticobiliary region has almost no symptoms, however epigastralgia without abnormality in the gastrointestinal (GI) tract is a sign of early stage pancreaticobiliary cancer. Sudden onset and aggravation of diabetes mellitus is an important change in the case of pancreatic cancer. Extracorporeal ultrasonography is a very useful procedure of checking up changes of pancreatic and biliary lesions. As the role of endoscopy in screening, endoscopic ultrasonography (EUS) is the most effective means of cancer detection of the pancreas, and endoscopic retrograde cholangiopancreatography (ERCP) is most useful of diagnosis tool for abnormalities of the common bile duct. Endoscopic retrograde cholangiopancreatography is an important modality as the procedure of sampling of diagnostic materials. Endoscopic ultrasonography-fine needle aspiration (EUS-FNA) has the role of histological diagnosis of pancreatic mass lesion also. Especially, in the case of pancreas cancer without evidence of cancer by pancreatic juice cytology and brushing cytology, EUS-FNA is essential. Intra ductal ultrasonography (IUDS) and perotral cholangioscopy (POCS) are useful for determination of mucosal extent in extrahepatic bile duct cancer. Further improvements of endoscopical technology, endoscopic procedures are expected to be more useful modalities in detection and diagnosis of early pancreatic and bile duct cancers. [source] Mechanisms Associated with the Negative Inotropic Effect of Deuterium Oxide in Single Rat Ventricular MyocytesEXPERIMENTAL PHYSIOLOGY, Issue 2 2000K. Hongo Deuterium oxide (D2O) is known to cause a negative inotropic effect in muscle although the mechanisms associated with this response in cardiac muscle are not well understood. We studied the effects of D2O in single rat ventricular myocytes in order to characterise the mechanisms associated with its negative inotropic effect and to assess its possible use as an acute modulator of microtubules. D2O rapidly reduced the magnitude of contraction in rat ventricular myocytes, and there was some recovery of contraction in the presence of D2O. Colchicine, an agent known to depolymerise microtubules, did not modify the effect of D2O. D2O decreased the L-type Ca2+ current (ICa), measured under whole cell and perforated patch clamp conditions. Slowing of the time to peak and a delay in inactivation of ICa were observed. Intracellular calcium ([Ca2+]i) and sodium ([Na+]i) were measured using the fluorescent indicators fura-2 and SBFI, respectively. The fall in contraction upon exposure to D2O was not associated with a fall in the [Ca2+]i transient; this response is indicative of a reduction in myofilament Ca2+ sensitivity. Both the [Ca2+]i transient and [Na+]i increased during the partial recovery of contraction in the presence of D2O. We conclude that a decrease in the myofilament sensitivity for Ca2+ and a reduction in Ca2+ influx via ICa are principally responsible for the negative inotropic effect of D2O in cardiac muscle. We found no evidence to explain the negative inotropic effect of D2O in terms of microtubule proliferation. In addition we suggest that acute application of D2O is not a useful procedure for the investigation of the role of microtubules in excitation-contraction coupling in cardiac muscle. [source] Accuracy assessment of computer-assisted flapless implant placement in partial edentulismJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 4 2010N. Van Assche Van Assche N, van Steenberghe D, Quirynen M, Jacobs R. Accuracy assessment of computer-assisted flapless implant placement in partial edentulism. J Clin Periodontol 2010; 37: 398,403. doi: 10.1111/j.1600-051X.2010.01535.x Abstract Aim: To assess the accuracy of implants placed flapless by a stereolithographic template in partially edentulous patients. Material and Methods: Eight patients, requiring two to four implants (maxilla or mandible), were consecutively recruited. Radiographical data were obtained by means of a cone beam or a multi-slice CT scan and imported in a software program. Implants (n=21) were planned in a virtual environment, leading to the manufacture of one stereolithographic template per patient to guide the implant placement in a one-stage flapless procedure. A postoperative cone beam CT was performed to calculate the difference between virtual implant (n=21) positions in the preoperative planning and postoperative situation. Results: A mean angular deviation of 2.7° (range 0.4,8, SD 1.9), with a mean deviation at the apex of 1.0 mm (range 0.2,3.0, SD 0.7), was observed. If one patient, a dropout because of non-conformity with the protocol, was excluded, the angular deviation was reduced to 2.2° (range 0.6,3.9, SD 1.1), and the apical deviation to 0.9 mm (range 0.2,1.8). Conclusion: Based on this limited patient population, a flapless implant installation appears to be a useful procedure even when based on accurate and reliable 3D CT-based image data and a dedicated implant planning software. [source] Synthesis of azirines containing aldehyde functionality and their utilization as synthetic tools for five membered oxazoles and isoxazolesJOURNAL OF HETEROCYCLIC CHEMISTRY, Issue 2 2008Sulagna Brahma A simple and useful procedure for the synthesis of azirines containing aldehyde functionality from open chain bromo/chloro-aldehydes at room temperature is reported. The scope of the ring expansion reaction of a number of 3-substituted-2-formyl-azirines has been examined using different oraganometallic catalysts and a variety of Lewis acids. [source] Influence of the thickness of the resin palatal vault on the closest speaking space with complete denturesJOURNAL OF ORAL REHABILITATION, Issue 10 2001G. Schierano The closest speaking space (CSS) has been considered stable over time, and therefore useful to determine the vertical dimension of occlusion (VDO) in edentulous patients. Clemençon affirms that, in complete denture wearers, CSS is not constant but depends on the thickness of the resin palatal vault, and that is the air volume needed to pronounce words to remain constant. The aim of this study was to evaluate Clemençon hypothesis in a group of edentulous patients rehabilitated with traditional maxillary denture and mandibular implant anchored overdenture. The CSS was determined by means of a kinematics method using the Elite System® at 30, 60, 90, 180, 360 days from delivery. The CSS was assessed twice at each stage: with the unmodified denture and a second time after thickening the resin palatal vault by 2 mm with a calibrated wax layer. The CSS after thickening the resin palatal vault was wider. The wider CSS observed can be because of oro-sensory feedback excited by contact between tongue and palatal vault. As hypothesized by Clemençon thickening the resin palatal vault could be a useful procedure to increase the VDO, in cases in which it is too low from the aesthetic stand point. [source] Clinical Practice Guidelines for the Use of Axillary Sentinel Lymph Node Biopsy in Carcinoma of the Breast: Current UpdateTHE BREAST JOURNAL, Issue 2 2004Gordon F. Schwartz MD, MBAArticle first published online: 10 MAR 200 Abstract: Axillary sentinel lymph node biopsy (SLNB) has been adopted as a suitable alternative to traditional level I and II axillary dissection in the management of clinically node-negative (N0) breast cancers. There are two current techniques used to identify the sentinel node(s): radiopharmaceutical, technetium sulfur colloid, and isosulfan blue dye (used in the United States) and technetium-labeled albumin and patent blue dye (used in Europe). (The labeled albumin is not U.S. Food and Drug Administration [FDA] approved in the United States.) SLNB to replace axillary dissection should only be performed by surgeons and patient management teams with appropriate training and experience. Although both radiocolloid and blue dye are used together by most surgeons, and training should be in both techniques, some experienced surgeons use one or the other almost exclusively. In addition, surgical pathologists must recognize the need to examine these small specimens with great care, using a generally adopted protocol. Imprint cytology or frozen sections may be used, followed by additional sections for light microscopy. Immunochemical staining with cytokeratin or other techniques to identify "submicroscopic" metastasis is often used, but the results should not be used to influence clinical decisions with respect to adjuvant therapy. "Failed" SLNB implies the surgeon's failure to identify the sentinel nodes, in which case a complete dissection is performed. A "false-negative" SLNB implies the finding of metastasis in the excised sentinel nodes by light microscopy after a negative frozen section examination. Whether a false-negative SLNB mandates completion axillary dissection is controversial, with clinical trials currently under way to answer this question. Although SLNB was initiated to accompany breast-conserving treatment, it is equally useful in patients undergoing mastectomy. It is more difficult to perform with mastectomy. When using blue dye only, SLNB may require a separate incision because of time constraints between injection and identification of the blue-stained nodes; radiocolloid usually does not. Completion axillary dissection after false-negative SLNB is more difficult after mastectomy. SLNB is a useful procedure that may save 70% of women with clinically negative (N0) axillae and all of those with pathologically negative axillae from the morbidity of complete axillary dissection. Ideally the sentinel nodes should be able to identified in more than 95% of patients, with a false-negative rate of less than 5%. Until these rates can be achieved consistently, however, surgeons should not abandon traditional axillary dissection., [source] An anonymous survey of registrar training in the use of Kjelland's forceps in AustraliaAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 5 2009Marian CHINNOCK Large series suggest that, when used with appropriate care and skill, rotational deliveries with Kjelland's forceps are a safe and useful procedure. We surveyed obstetric trainees in Australia to assess their experience with, and intentions to use, Kjelland's forceps. The response rate was 65%, and it was uncommon for even senior trainees to have performed more than ten Kjelland's forceps rotations during their training. Ninety-four per cent of final-year trainees stated they did not intend to use Kjelland's forceps in their consultant practice. [source] Conditional and Unconditional Simulation of Healthy Patients' Visual FieldsBIOMETRICAL JOURNAL, Issue 4 2004M. V. Ibáñez Abstract This paper describes a simulation problem, motivated by the study of glaucoma, a very serious and widespread ocular illness. To ascertain whether a patient suffers from glaucoma, a perimetric test is done, but the evolution of the disease is very slow, and large longitudinal sets of tests taken on the same patient are needed to study its evolution, to analyze the efficiency of existing methods to detect the progression of glaucoma and to develop new ones. Simulation can be a very useful procedure to get appropriate data sets to work with. Our aim in this work is to simulate several VFs in a healthy patient to reflect his evolution in time. We use a spatio-temporal model to simulate from, taking into account the correlation existing between the observed (or simulated) values in space and time. Two different simulation procedures (unconditional and conditional) are studied, and applied to obtain the simulations we are interested in. (© 2004 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source] Convergent/Divergent Synthesis and Photophysical Studies of Alternating Benzene,Furan Oligoaryls from Substituted Propargylic DithioacetalsCHEMISTRY - AN ASIAN JOURNAL, Issue 1-2 2006Chih-Ming Chou Abstract A range of oligoaryls that contain alternating benzene,furan rings is synthesized by a rapid convergent/divergent method from the annulation of a propargylic dithioacetal and an aldehyde with a propargylic dithioacetal moiety as a substituent. These oligomers are fairly soluble in a range of organic solvents and can be easily purified by reprecipitation. The substituents on the furan rings can be varied according to the substituents in the starting propargylic dithioacetals. This route provides a useful procedure for the synthesis of alternating benzene,furan oligomers without repeated units. These furan-containing oligoaryls are highly fluorescent in the visible region and are electrochemically active. The band gaps of these oligomers appear to be less sensitive towards changes in conjugation length than those of oligofurans. [source] Multimodality Approach to Management of the Paralyzed FaceTHE LARYNGOSCOPE, Issue 8 2006Tessa A. Hadlock MD Abstract Objectives: Despite the ability of facial reanimation techniques to introduce meaningful movement to the paralyzed face, dynamic methods do not address all zones of the face. Our objective was to retrospectively review outcomes after multimodality management of the patient with facial paralysis, to describe several novel surgical methods that introduce subtle improvements in static facial balance, and to present an algorithm for comprehensive management of the paralyzed face. Methods/Results: Three hundred thirty-seven patients with facial paralysis were seen and treated in a busy facial nerve center setting over a 3-year period using a range of standard muscle transfers, physical therapy, chemodenervation with botulinum toxin, and static surgical techniques. Three adjunct techniques emerged as novel and useful procedures that more fully addressed facial balance issues than existing techniques. Of patients proceeding with physical therapy, greater than 80% of patients experienced a benefit, and 97% of those who proceeded with botulinum toxin therapy experienced a benefit. Conclusions: Facial paralysis is best managed using a multimodality approach that includes surgical interventions, physical therapy, and chemodeneveration. We describe three adjunctive surgical techniques for management of the paralyzed face and present a comprehensive algorithm for management of the paralyzed face. That may provide improved function and cosmesis in all zones of the paralyzed face. [source] Endoscopic ultrasound of pancreatic cystic lesionsANZ JOURNAL OF SURGERY, Issue 9 2010Shyam Prasad Abstract Background:, The impact of endoscopic ultrasonography (EUS) on the management of pancreatic cystic lesions remains unclear, and there are no published studies of the Australian experience in this area. The aim of this study was to review the experience of EUS for such lesions within our institution. Methods:, A retrospective review was undertaken of data collected prospectively over a two-year period within the EUS database of St. Vincent's Hospital. Patients who underwent EUS for suspected pancreatic cystic lesions were identified. Data were collected on demographic variables, EUS findings, the results of EUS-guided fine-needle aspiration (FNA) and the findings on clinical and radiological follow-up. Results:, Fifty-nine patients were identified. Two thirds were female. Most lesions were located at the pancreatic head. Median diameter was 25 mm. FNA was performed in 36 cases (61%). On cytology, six (17%) showed features of mucinous tumours and five (14%) showed adenocarcinoma. The remainder contained either non-specific benign cells or insufficient epithelial tissue. Follow-up data on 48 cases (83%), after a median duration of 15 months, revealed that 15 lesions (31%) had been resected, including six serous and six mucinous tumours. The level of carcinoembryonic antigen in FNA specimens appeared to be higher in mucinous than in serous neoplasms. Twenty-four lesions had undergone repeat radiological imaging: only three had grown in size. Conclusions:, EUS and FNA are useful procedures for assessing pancreatic cystic lesions. Malignant features are demonstrated in only a small minority. The majority of the remainder show no signs of progression during follow-up. [source] | |||||||||||||