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Annals of the Royal College of Surgeons... Apr 2020A fibrovascular polyp is a rare benign pseudotumour of the oesophagus and hypopharynx. Although patients usually present with dysphagia, aspiration related mortality may...
A fibrovascular polyp is a rare benign pseudotumour of the oesophagus and hypopharynx. Although patients usually present with dysphagia, aspiration related mortality may occur. If the tumour is too large and/or located in the proximal oesophagus, it may protrude from the mouth. The general approach to treatment is complete reconstruction with cervicotomy. We present our experience of a giant oesophageal fibrovascular polyp that was protruding from the mouth and treated with endoscopic resection. A 55-year-old man was admitted to our outpatient clinic complaining of a mass protruding from his mouth when he coughed. Endoscopy and bronchoscopy both revealed a 15-18cm long polypoid mass originating from the proximal oesophagus (at the level of the hypopharynx). Complete resection was performed via endoscopy.
Topics: Esophageal Neoplasms; Esophagoscopy; Esophagus; Humans; Male; Middle Aged; Polyps; Treatment Outcome; Tumor Burden
PubMed: 31964152
DOI: 10.1308/rcsann.2020.0008 -
Seminars in Plastic Surgery Nov 2011The prominent ear can produce significant social and psychological effects on an individual. Through the last century, many procedures have been described to correct...
The prominent ear can produce significant social and psychological effects on an individual. Through the last century, many procedures have been described to correct this deformity. In this review, the authors navigate through the history of otoplasty for the protruded ear, and describe some of the breakthroughs in the procedure. Furthermore, they discuss key measurements that must be kept in mind in preoperative and intraoperative settings. They also describe in more detail some of the more common methods for correcting the protruded ear, as well as postoperative management and common complications faced after surgery.
PubMed: 23115535
DOI: 10.1055/s-0031-1288921 -
Medicine Jul 2018Rectal foreign bodies are not an uncommon finding in outpatient departments globally. Most such objects are inserted through the anus. Occasionally, a foreign body may... (Review)
Review
RATIONALE
Rectal foreign bodies are not an uncommon finding in outpatient departments globally. Most such objects are inserted through the anus. Occasionally, a foreign body may be ingested and may successfully pass through the entire gastrointestinal tract and be held up in the rectum. In extremely rare cases, foreign bodies in adjacent tissues or organs can penetrate the rectal wall and enter the rectal lumen. We report a rare case that the IUCD had migrated and was embedded in the rectal wall. A part of the IUCD was loosened and deformed into a metallic wire that protruded through the anus.
PATIENT CONCERNS
A 45-year-old woman presented with complaints of a metallic wire protruding through her anus when she used the washroom. The wire would become longer when she manually pulled it; however, this process was associated with pain in the lower abdomen, and she therefore stopped manipulating it.
DIAGNOSES
A rectal foreign body secondary to intrauterine contraceptive device (IUCD) migration and rectal perforation, as well as a pelvic cyst.
INTERVENTIONS
Under general anesthesia, she underwent laparoscopic removal of the rectal foreign body, pelvic adhesiolysis, pelvic cyst resection, and ileostomy combined with colonoscopy.
OUTCOMES
Her postoperative recovery was uneventful.
LESSONS
Foreign bodies in adjacent tissues or organs can penetrate the rectal wall and enter the rectal lumen. Regular follow-up after IUCD insertion is very important. We report this rare case that would increase awareness among clinicians regarding the differential diagnosis and treatment in such cases.
Topics: Anal Canal; Colonoscopy; Female; Foreign Bodies; Humans; Ileostomy; Intestinal Perforation; Intrauterine Device Migration; Intrauterine Devices; Laparoscopy; Middle Aged; Rectum; Tomography, X-Ray Computed
PubMed: 29995819
DOI: 10.1097/MD.0000000000011512 -
Medicina Oral, Patologia Oral Y Cirugia... Jul 2015The authors present a technique for selected cases of CBCL. The primary repair of the CBCL with a severely protruding premaxilla in one stage surgery is very difficult,...
BACKGROUND
The authors present a technique for selected cases of CBCL. The primary repair of the CBCL with a severely protruding premaxilla in one stage surgery is very difficult, essentially because a good muscular apposition is difficult, forcing synchronously to do a premaxillary setback to facilitate subsequent bilateral lip repair and, thus, achieving satisfactory results. We achieve this by a reductive ostectomy on the vomero-premaxillary suture.
MATERIAL AND METHODS
4 patients with CBCL and severely protruding premaxilla underwent premaxillary setback by vomerine ostectomy at the same time of lip repair in the past 24 months. The extent of premaxillary setback varied between 9 and 16 mm. The required amount of bone was removed anterior to the vomero-premaxillary suture. The authors did an additional simultaneous gingivoperiosteoplasty in all patients, achieving an enough stability of the premaxilla in its new position, to be able to close the alveolar gap bilaterally. The authors have examined the position of premaxilla and dental arch between 6 and 24 months. We did not do the primary nose correction, because this increased the risk of impairment of the already compromised vascularity of the philtrum and premaxilla.
RESULTS
The follow-up period ranged between 6 and 24 months. None of the patients had any major complication. During follow-up, the premaxilla was minimally mobile. We achieved a good lip repair in all cases: adequate muscle repair, symmetry of the lip, prolabium and Cupid's bow, as well as good scars. Conclusions: To our knowledge, there are few reports of one stage surgery with vomerine ostectomy to repair CBCL with severely protruding premaxilla. Doing this vomerine ostectomy, we don't know how it will affect the subsequent growth of the premaxila and restrict the natural maxillary growth. Applying this alternative treatment for children with CBCL and protruded premaxilla without any preoperative orthopedic, we can successfully perform, in a single-stage surgery, a good primary lip repair at our center. Further confirmations of this surgery with follow up and anthropometric studies of these patients during childhood and adolescence are required.
Topics: Cleft Lip; Female; Humans; Infant; Male; Maxilla; Orthopedic Procedures; Severity of Illness Index; Vomer
PubMed: 26034932
DOI: 10.4317/medoral.20568 -
Radiographics : a Review Publication of... 2011Differentiation of direct inguinal hernias, indirect inguinal hernias, and femoral hernias is often difficult at clinical examination and presents challenges even at... (Review)
Review
Differentiation of direct inguinal hernias, indirect inguinal hernias, and femoral hernias is often difficult at clinical examination and presents challenges even at diagnostic imaging. With the advent of higher-resolution multidetector computed tomography (CT), the minute anatomic detail of the inguinal region can be better delineated. The authors examine the appearance of these hernias at axial CT, as the axial plane remains the diagnostic mainstay of evaluation of acute abdomen. They review and label key anatomic structures, present cases of direct and indirect inguinal hernias and femoral hernias, and demonstrate their anatomic differences on axial images. Direct inguinal hernias protrude anteromedial and inferior to the course of the inferior epigastric vessels, whereas indirect inguinal hernias protrude posterolateral and superior to the course of those vessels. The proposed lateral crescent sign may be useful in diagnosis of early direct inguinal hernias, as it represents lateral compression and stretching of the inguinal canal fat and contents by the hernia sac. Femoral hernias protrude inferior to the course of the inferior epigastric vessels and medial to the common femoral vein, often have a narrow funnel-shaped neck, and may compress the femoral vein, causing engorgement of distal collateral veins. Familiarity with these anatomic differences at axial CT, along with the lateral crescent sign of direct inguinal hernias, may help the radiologist better assist the clinician in accurate diagnosis of the major types of hernias of the inguinal region. Supplemental material available at http://radiographics.rsna.org/lookup/suppl/doi:10.1148/rg.312105129/-/DC1.
Topics: Hernia, Inguinal; Humans; Radiographic Image Enhancement; Radiography, Abdominal; Tomography, X-Ray Computed
PubMed: 21415178
DOI: 10.1148/rg.312105129 -
Surgical Case Reports Feb 2024Intraductal oncocytic papillary neoplasm (IOPN), previously classified as a subtype of intraductal papillary mucinous neoplasm (IPMN), has been described as an...
BACKGROUND
Intraductal oncocytic papillary neoplasm (IOPN), previously classified as a subtype of intraductal papillary mucinous neoplasm (IPMN), has been described as an independent disease by the WHO since 2019. IOPN is a rare tumor, with few reported cases. Herein, we report a case of resected non-invasive IOPN that formed a lesion protruding toward the duodenum from the accessory papilla.
CASE PRESENTATION
An 80-year-old woman was referred to our hospital because of a giant mass in the pancreatic head detected on abdominal contrast-enhanced computed tomography (CT) performed for a close examination of a mass in the right breast. CT revealed a 90-mm-sized tumor with a mixture of solid and cystic components, with contrast enhancement in the pancreatic head, and a dilated main pancreatic duct. Esophagogastroduodenoscopy revealed a semi-circumferential papillary tumor protruding toward the duodenal lumen, which did not protrude from the papilla of Vater. Transpapillary biopsy led to a preoperative diagnosis of IPMN with an associated invasive carcinoma. As there were no distant metastasis, open subtotal stomach-preserving pancreaticoduodenectomy was performed. Analysis of the surgical specimen and histopathological examination revealed that the tumor was an IOPN that protruded toward the duodenal mucosa from the accessory papilla while replacing the duodenal mucosa with no obvious stromal invasion.
CONCLUSION
IOPN is a rare and poorly recognized tumor with few reported cases. There have been no reports describing IOPN forming a protruding lesion toward the duodenum from the accessory papilla. Therefore, further accumulation of cases such as this one is important to advance the study of IOPN.
PubMed: 38358457
DOI: 10.1186/s40792-024-01841-w -
Journal of Medical Cases Aug 2022Adenosarcomas are biphasic neoplasms that usually originate in the uterine corpus and comprise a benign epithelial component and a malignant stromal component. Uterine...
Adenosarcomas are biphasic neoplasms that usually originate in the uterine corpus and comprise a benign epithelial component and a malignant stromal component. Uterine adenosarcomas typically present with abnormal genital bleeding, an enlarged uterus, and a tumor that protrudes into the endometrial cavity. These tumors rarely protrude through the cervical os and are often misdiagnosed as cervical polyps. We present the case of a patient with cervical adenosarcoma with characteristics different from those reported in previous cases. This tumor showed endophytic growth, which is rare in cervical adenosarcomas. No watery discharge or obvious genital bleeding was noted. Although the tumor measured 4 cm, vaginal bleeding was noted only once at 6 months before diagnosis and was in the form of faint brown discharge.
PubMed: 36128067
DOI: 10.14740/jmc3952 -
ACS Applied Materials & Interfaces Sep 2023Hexagonal boron nitride (h-BN) is a well-known layered van der Waals (vdW) material that exhibits no spontaneous electric polarization due to its centrosymmetric...
Hexagonal boron nitride (h-BN) is a well-known layered van der Waals (vdW) material that exhibits no spontaneous electric polarization due to its centrosymmetric structure. Extensive density functional theory (DFT) calculations are used to demonstrate that doping through the substitution of B by isovalent Al and Ga breaks the inversion symmetry and induces local dipole moments along the -axis, which promotes a ferroelectric (FE) alignment over antiferroelectric. For doping concentrations below 25%, a "protruded layered" structure in which the dopant atoms protrude out of the planar h-BN layers is energetically more stable than the flat layered structure of pristine h-BN or a wurtzite structure similar to w-AlN. The computed polarization, between 7.227 and 21.117 μC/cm, depending on dopant concentration and the switching barrier (16.684 and 45.838 meV/atom) for the FE polarization reversal are comparable to that of other well-known FEs. Interestingly, doping of h-BN also induces a large negative piezoelectric response in otherwise nonpiezoelectric h-BN. For example, we compute of -24.214 pC/N for GaBN, which is about 5 times larger than that of pure w-AlN (5 pC/N), although the computed (-1.164 C/m) is about 1.6 times lower than that of pure w-AlN (1.462 C/m). Because of the layered structure, the rather small elastic constant provides the origin of the large . Moreover, doping makes h-BN an electric auxetic piezoelectric. We also show that ferroelectricity in doped h-BN may persist down to its trilayer, which indicates high potential for applications in FE nonvolatile memories.
PubMed: 37650582
DOI: 10.1021/acsami.3c07744 -
Journal of Cranio-maxillo-facial... Aug 2017The aim of the study was to evaluate the possibility of supracortical peri-implant bone formation after periosteal elevation.
PURPOSE
The aim of the study was to evaluate the possibility of supracortical peri-implant bone formation after periosteal elevation.
MATERIALS AND METHODS
Periosteal elevation with an elevation height of 5 or 10 mm was performed in an animal experiment with 24 female domestic pigs. For this purpose, four implants were inserted in the frontal bone of each animal. The implants protruded from the local bone by 5 or 10 mm. In the test groups, the periosteum was attached to the protruding implants. In the control groups, the implants were covered with biocompatible degradable periosteal-shielding devices. Each 8 animals were sacrificed after 20, 40 and 60 days. De novo bone formation was evaluated radiographically and histologically.
RESULTS
Bone formation rate was higher in the test groups compared to the control groups after 20, 40 and 60 days. After 40 and 60 days, a statistically significant higher (P < 0.01) bone formation rate was found for both elevation heights. The maximum height of the generated bone was statistically significantly higher (P < 0.01) in the test groups for both elevation heights, compared to the control groups for all time points investigated.
CONCLUSION
Periosteal elevation by dental implants is a treatment option for supracortical peri-implant bone formation.
Topics: Animals; Cortical Bone; Dental Implants; Female; Osteogenesis; Periosteum; Swine
PubMed: 28606438
DOI: 10.1016/j.jcms.2017.05.009 -
Sleep & Breathing = Schlaf & Atmung Jun 2002The objectives were to evaluate the impact of body posture on cephalometric measures and the level and the extent to which treatment with a mandibular protruding device...
The objectives were to evaluate the impact of body posture on cephalometric measures and the level and the extent to which treatment with a mandibular protruding device (MPD) affects pharyngeal width. The study was composed of 77 patients: 50 were diagnosed with obstructive sleep apnea (OSA) and 27 snored. After each patient underwent a baseline medical (including a somnographic registration), dental and stomatognathic examination, an MPD that would protrude the mandible 75% of the maximal protrusion range was fabricated. In a radiographic examination, four cephalograms were taken: two in the upright position with and without the MPD and two in the supine position with and without the MPD. The cephalometric measures focused on the pharyngeal structures. MPD treatment significantly increased the relative pharyngeal area (at the level of the oropharynx and the hypopharynx) by a mean of +89.6 mm2 (P < 0.01) in the upright posture. The relative pharyngeal area, however, was reduced by more than 50% in the supine position compared with the upright position, independent of MPD treatment. In the supine position, compared with upright, most pharyngeal measures decreased significantly; the hyoid was significantly lower and displaced posteriorly, and the area of the velum increased by a mean of +201.2 mm2 (P < 0.001). We conclude that the MPD significantly increased most pharyngeal measures except the linear distance between the hyoid bone and the third vertebra and decreased the area of the velum.
Topics: Adult; Aged; Cephalometry; Female; Humans; Male; Mandibular Advancement; Middle Aged; Pharynx; Posture; Radiography; Reproducibility of Results; Sleep Apnea, Obstructive
PubMed: 12075480
DOI: 10.1007/s11325-002-0055-7