Eradication of proliferative verrucous leukoplakia with toll-like receptor 7 agonist (topical imiquimod): a case report.

Proliferative verrucous leukoplakia (PVL) is an aggressive and distinct type of oral precancerous lesion characterized by warty surfaced white plaque diffusely involving oral mucosa. Surgical excision is the treatment of choice. However, PVL has persistent and recurrent growth patterns, requiring multiple surgical procedures.

Feasibility and Safety of Endovascular Interventions via Percutaneous Access to the Axillary Artery.

Background: Endovascular treatment of peripheral arterial disease requires safe and reliable arterial access. This study evaluates the feasibility and safety of percutaneous axillary artery access for endovascular therapy. A variety of anatomic and logistic obstacles can be overcome with upper extremity access.

An organized approach to imaging of benign cecal pathologies.

Unique problems in cecal embryogenesis and cecal pathology can result in characteristic imaging findings. Familiarity with these findings and utilization of an organized approach help to define the cecum's role in acute abdominal symptoms. Clinical symptoms associated with cecal diseases can be diverse and misleading.

Endometrial Axin2 Cells Drive Epithelial Homeostasis, Regeneration, and Cancer following Oncogenic Transformation.

The remarkable regenerative capacity of the endometrium (the inner lining of the uterus) is essential for the sustenance of mammalian life. Over the years, the role of stem cells in endometrial functions and their pathologies has been suggested; however, the identity and location of such stem cells remain unclear. Here, we used in vivo lineage tracing to show that endometrial epithelium self-renews during development, growth, and regeneration and identified Axin2, a classical Wnt reporter gene, as a marker of long-lived bipotent epithelial progenitors that reside in endometrial glands.

Tumor lysis without syndrome in adenocarcinoma of the lung: Case report.

Tumor lysis syndrome TLS is commonly seen during the treatment of rapidly proliferating. However TLS is rarely reported in Non-small cell Lung Cancer. This may because of low proliferative rate and chemo-resistant nature of NSCLC.

Contemporary outcomes of vertebral artery injury.

Objective: Vertebral artery injury (VAI) associated with cervical trauma is being increasingly recognized with more aggressive screening. Disparate results from previous literature have led to uncertainty of the significance, natural history, and optimal therapy for VAI.

Methods: To understand the natural history and treatment outcomes from our experience, we performed a retrospective, single-center review from a level I trauma center for the previous 10 years of all VAI.

The predictive value of general surgery application data for future resident performance.

Objective: The predictive value of application data for future general surgery resident performance and attrition are poorly understood. We sought to determine what variables obtained in the application process might predict future resident success.

Methods: We performed an 18-year review (1990-2008) of all matched residents (n = 101) to a university program.

International volunteerism during general surgical residency: a resident's experience.

Objective: The purpose of this article is to discuss a surgical resident's experience in Kenya as a component of a custom-designed dedicated year. The academic value, clinical experience, and lessons learned will be described. Hopefully, these insights will be useful to those planning to take a similar course or for those seeking to offer such an experience at their training programs.

The excluder aortic endograft.

Since its introduction, more than 59000 patients have been treated with Gore Excluder endoprosthesis (GORE) for abdominal aortic aneurysm (AAA) in the past 11 years. It has become clearer that differences in device delivery and design provide certain advantages that may favor one anatomical milieu over another. Behavior of the aneurysm sac also seems to be graft dependent as more long-term data become available.

Efficacy of laparoscopic cholecystectomy in the pediatric population.

Purpose: Gallbladder disease is increasingly affecting the pediatric population. The advent of new technology in the 1980s, specifically, hepatobiliary scintigraphy and laparoscopic cholecystectomy, gave a dramatic rise in both the diagnosis and treatment of biliary disease in the pediatric population. The purpose of this study was to determine (a) whether laparoscopic cholecystectomy for biliary dyskinesia is efficacious in the treatment of children with biliary colic and (b) the ability of cholescintigraphy to predict which patients may benefit from an operative intervention.

Thoracic manifestations of immune restoration syndromes in AIDS.

Immune restoration syndromes (IRS) in AIDS constitute a group of illness characterized by a pathologic inflammatory response in patients with late-stage AIDS who start highly active antiretroviral therapy. Although there is no standardized definition or therapy, IRS have partial immune restoration associated with an increase in their CD-4 cell count and a decrease in their viral load. Patients with IRS show a paradoxical reaction that is, clinical worsening rather than improvement on therapy, associated with a recognized or occult infection.

Evaluation of vertebral fractures on lateral chest radiographs of inner-city postmenopausal women.

We assessed the prevalence of vertebral fractures as a marker for osteoporosis on lateral chest radiographs in inner-city, minority, postmenopausal women. We reviewed outpatient lateral chest radiographs on all women 55 years and older at an inner-city hospital during two randomly selected months, August 2000 and April 2002. There were 106 women with a mean age of 65 (range 55-89) years, 45 were Hispanic, 42 Black, 9 White, 10 of other ethnicity.

Hepatic vascular response to elevated intraperitoneal pressure in the rat.

The rat is increasingly being used to study the physiological response to elevated intra-abdominal pressure (IAP) during laparoscopic surgery. Although decreased portal venous flow associated with the elevated IAP has been reported in large animals, little information is available in rats. Furthermore, the relative blood flow changes in the hepatic artery and portal vein have not been reported.

Complications related to osteopenia in the thoracic spine on admission chest radiographs of substance abuse detoxification patients.

Objective: To assess the prevalence of complications related to osteopenia in the thoracic spine (anterior wedging and fish vertebrae) of patients admitted for substance abuse detoxification.

Design And Patients: We retrospectively identified 150 sequential patients admitted to our drug and alcohol detoxification ward in whom posteroanterior and lateral admission chest radiographs and clinical charts were available for review. There were 116 men and 34 women with a mean age of 37 years (range 19-67 years).

Intrathoracic lymphadenopathy in patients with empyema.

Purpose: Our goal was to determine the prevalence of intrathoracic lymphadenopathy on chest CT in patients with empyema.

Method: We retrospectively identified 27 patients (14 men, 13 women, mean age 43 years) with nontuberculous empyema examined with chest CT. All scans were reviewed by two of three board-certified radiologists for the presence of intrathoracic lymphadenopathy (> or = 1 cm, short axis) in an American Thoracic Society (ATS) nodal station or the internal mammary region.

Effect of HIV status on chest radiographic and CT findings in patients with tuberculosis.

Aim: To compare the chest radiographic and chest CT findings of tuberculosis according to HIV status.

Patients And Methods: Ninety-eight HIV-tested patients with cultures positive for Mycobacterium tuberculosis (Mtb) between January 1991 and December 1993 whose clinical charts and radiographic records were available for review formed the study population. There were 67 HIV-positive patients (51 men, 16 women) and 31 HIV-negative patients (23 men, 8 women).

Transpyloric spread of gastric tumors: comparison of adenocarcinoma and lymphoma.

Objective: Our objective was to determine the relative frequency of transpyloric tumor spread in gastric antral carcinoma and lymphoma.

Materials And Methods: We reviewed the medical records of 127 cases of pathologically proven gastric malignant tumors, including 102 carcinomas and 25 lymphomas, over a 10-year period. The antrum had carcinoma in 64 cases and lymphoma in 15.

Sigmoid diverticulitis: diagnostic role of CT--comparison with barium enema studies.

The diagnostic value of computed tomography (CT) and barium enema (BE) studies was evaluated prospectively in hospitalized patients with the presumptive diagnosis of acute sigmoid diverticulitis based on the presence of left-lower-quadrant pain and tenderness, fever, and leukocytosis. Of 56 patients, 11 had sigmoid diverticulitis confirmed at surgery and 16 by clinical response to medical therapy. CT, performed in all diverticulitis patients, had positive results in 93% (25 of 27).

Closed-loop obstruction of the small bowel: CT and sonographic appearance.

Two patients with closed loop obstruction diagnosed by CT and sonography are reported. Abdominal radiograph was nonspecific. The characteristic CT and sonographic features included (a) isolated conglomerate of dilated, fluid-filled bowel loops; (b) fixation of these "U" shaped distended loops; (c) thickened bowel wall; and (d) extraluminal fluid.

CT of peritoneal lymphomatosis.

The CT and clinical findings are presented in seven patients with diffuse peritoneal malignancy caused by non-Hodgkin lymphoma. All seven patients had CT evidence of ascites, omental infiltration, and peritoneal implants mimicking carcinomatosis. Bulky retroperitoneal or mesenteric adenopathy was present in only one patient.

Histoplasmosis involving the omentum in an AIDS patient: CT demonstration.

The anatomy and pathology of the greater omentum as demonstrated by CT has been well described. Approximately 80% of cases of omental pathology are caused by malignancy and the remaining 20% are the result of inflammatory disease, mainly tuberculosis or pancreatitis. Histoplasmosis has not been previously reported to involve the greater omentum.

CT evaluation of extrahepatic disease in patients with metastatic colorectal carcinoma receiving hepatic arterial chemotherapy.

Computed tomography (CT) of the abdomen and pelvis in 88 patients with hepatic metastases from colorectal carcinoma undergoing hepatic arterial chemotherapy has been reviewed. Extrahepatic disease was present as determined by CT examination in 83 (94%). Tissue proof was available for 23 sites in 19 patients, with the most common sites being retroperitoneal lymph nodes (5), lung (3), abdominal wall (3), and peritoneum or mesentery (3).

Right ureteral obstruction associated with pancreatitis.

In a 5-year review of 207 patients with acute pancreatitis examined by computed tomography, 124 (60%) had findings consistent with active (acute or acute superimposed on chronic) pancreatitis. Six patients (3%), in addition to having evidence for pancreatitis, had associated mild to moderate right hydronephrosis and proximal hydroureter. These patients' findings are presented with a discussion of the renal manifestations of pancreatitis.