Iatrogenic bile duct injury associated with anomalies of the right hepatic sectoral ducts: a misunderstood and underappreciated problem.

Although laparoscopic cholecystectomy (LC) has been widely accepted as the standard of care, it continues to have a higher complication rate than open cholecystectomy. Bile duct injury with LC has often been attributed to surgical inexperience, but it is also clear that aberrant bile ducts are present in a significant number of patients who sustain biliary injuries during these procedures. We present three cases of right sectoral hepatic duct injuries which occurred during LC and provide a discussion of the conditions which are likely to lead to these injuries, as part of a strategy to prevent them.

Daptomycin for the treatment of surgical site infections.

Background: The increasing frequency of methicillin-resistant Staphylococcus aureus (MRSA) as a cause of surgical site infections, and decreased susceptibility to vancomycin, highlight the need for alternative therapies.

Methods: All patients with a surgical site infection enrolled in the Cubicin Outcomes Registry and Experience (CORE 2007 retrospective multicenter registry were studied. Outcome was assessed at the end of daptomycin therapy using protocol-defined criteria.

Medullary thyroid carcinoma metastatic to skin.

Cutaneous metastases are a rarity, even more so when they arise from a medullary thyroid carcinoma (MTC) which accounts for only 8% of all thyroid cancers. MTC arises from C-cells that produce calcitonin, and it most commonly metastasizes to lymph nodes in the neck. Distant metastases of MTC may involve bone, lung and liver.

Mucobilia: current aspects in the management of a rare cause of malignant biliary obstruction.

Mucobilia is a rare pathologic condition characterized by the abnormal secretion and accumulation of abundant mucus within the biliary tree. It is usually seen in association with mucin-producing hepatobiliary and pancreatic tumors. Neoplastic transformation of these tumors can range from low-grade dysplasia to invasive adenocarcinoma.

Surgical management of hepatolithiasis.

Background: Globalization and intercontinental migration have not just changed the socioeconomic status of regions, but have also altered disease dynamics across the globe. Hepatolithiasis, although still rare, is becoming increasingly evident in the West because of immigration from the Asia-Pacific region, where the disease prevails in endemic proportions. Such rare but emerging diseases pose a therapeutic challenge to doctors.

A comprehensive review of evidence-based strategies to prevent and treat postoperative ileus.

Background: Postoperative ileus (POI) is a common complication of abdominal and several other surgeries leading to increased hospital stay and healthcare costs. POI also contributes towards numerous postsurgical comorbidities including deep vein thrombosis and pneumonia. POI is characterized by bowel distention and lack of bowel sounds, flatus and bowel movements.

The Page kidney phenomenon secondary to a traumatic fall.

Page kidney is a rare phenomenon of hyperreninemic hypertension caused by compression of the renal parenchyma. It has been reported in healthy individuals after blunt abdominal or flank trauma, and in patients after invasive nephrological interventions. We present a case of acute on chronic renal failure and Page kidney phenomenon in an elderly male after a traumatic fall, who underwent effective medical management until spontaneous recovery to baseline was observed.

Mercury BLASTP: Accelerating Protein Sequence Alignment.

Large-scale protein sequence comparison is an important but compute-intensive task in molecular biology. BLASTP is the most popular tool for comparative analysis of protein sequences. In recent years, an exponential increase in the size of protein sequence databases has required either exponentially more running time or a cluster of machines to keep pace.

Krukenberg tumor: metastasis of Meckel's diverticular adenocarcinoma to ovaries.

A 56-year-old female presented with abdominal pain, weight loss and fatigue. Computed tomography revealed an abdominopelvic mass and ascites. At surgery she had carcinomatosis and bilateral ovarian metastases arising from a cancer in a Meckel's diverticulum.

A comprehensive review of single-incision laparoscopic surgery (SILS) and natural orifice transluminal endoscopic surgery (NOTES) techniques for cholecystectomy.

Introduction: Surgery of the gallbladder has evolved tremendously over the last century. Laparoscopic cholecystectomy is the gold standard for gallbladder removal and the most common laparoscopic procedure worldwide. In recent times, innovative techniques of natural orifice transluminal endoscopic surgery (NOTES) and single-incision laparoscopic surgery (SILS) have been applied in gallbladder removal as a step towards even more less-invasive procedures.

Near lethal endometriosis and a massive (64 kg) endometrioma: case report and review of the literature.

A 51-year-old morbidly obese, hypertensive, anemic, and amenorrheic female presented with anuria and respiratory symptoms. The patient had a distinctly massive abdomen with necrotic anterior abdominal wall, and laboratory findings revealed a leukocytosis, profound anemia, coagulopathy and renal failure. An abdominal sonogram showed a large, complex intra-abdominopelvic mass and ascites.

Agenesis of the dorsal pancreas and its association with pancreatic tumors.

Morphogenesis of the pancreas is a complex process; nevertheless, congenital anomalies are rare. At embryogenesis, the pancreas develops from the endoderm-lined dorsal and ventral buds of the duodenum. The ventral bud gives rise to the lower head and uncinate process of the pancreas; whereas, the dorsal bud gives rise to the upper head, isthmus, body, and tail of the pancreas.

Sociodemographic characteristics, health beliefs, and the accuracy of cancer knowledge.

Background: Recent studies have found that knowledge about cancer prevention and treatment differs across ethnic and socioeconomic status (SES) backgrounds, which could directly impact our decisions to engage in protective health behaviors. In this study, we examined sociodemographic-based differences in cancer knowledge and health beliefs and examined differences in the accuracy of the cancer knowledge based on health beliefs.

Methods: Cross-sectional surveys were conducted between July 1995 and March 2004 on adult, healthy, cancer-free control participants (N = 2074; 50% male) enrolled into a molecular epidemiological case-control study.

Comparison of amyloid plaque contrast generated by T2-weighted, T2*-weighted, and susceptibility-weighted imaging methods in transgenic mouse models of Alzheimer's disease.

One of the hallmark pathologies of Alzheimer's disease (AD) is amyloid plaque deposition. Plaques appear hypointense on T(2)-weighted and T(2)*-weighted MR images probably due to the presence of endogenous iron, but no quantitative comparison of various imaging techniques has been reported. We estimated the T(1), T(2), T(2)*, and proton density values of cortical plaques and normal cortical tissue and analyzed the plaque contrast generated by a collection of T(2)-weighted, T(2)*-weighted, and susceptibility-weighted imaging (SWI) methods in ex vivo transgenic mouse specimens.

Acute progression of multiple visceral artery aneurysms.

A 62-year-old male with multiple medical problems including a long-standing history of muscular dystrophy presented with recurrent abdominal and back pain of 2-month duration. Two consecutive mesenteric arteriograms were performed 3 weeks apart as part of the work-up and treatment. The latest study revealed a significant progression in the size and number of visceral artery aneurysms.

Peripheral artery leiomyosarcoma.

Vascular leiomyosarcomas are extremely rare tumors and represent only 0.001% of all malignancies. Venous leiomyosarcomas occur five times more often than arterial ones, with 50% of them originating in the inferior vena cava (IVC).

Management of Enteropathy-Associated T-Cell Lymphoma: An Algorithmic Approach.

Perforation of the small intestine is the most lethal complication following induction chemotherapy for enteropathy-associated T-cell lymphoma (EATL). We report a case of EATL with a near perforated jejunal ulcer, and suggest a novel approach towards its management. Surgical resection followed by aggressive chemotherapy should limit chemotherapy-associated gastrointestinal toxicity, thus allowing patients to receive adequate dose and duration of chemotherapy.

Reliable real-time clinical monitoring using sensor network technology.

We propose wireless sensor networks composed of nodes using low-power 802.15.4 radios as an enabling technology for patient monitoring in general hospital wards.

Biosequence Similarity Search on the Mercury System.

Biosequence similarity search is an important application in modern molecular biology. Search algorithms aim to identify sets of sequences whose extensional similarity suggests a common evolutionary origin or function. The most widely used similarity search tool for biosequences is BLAST, a program designed to compare query sequences to a database.

Works-in-progress: guiding junior scientists through career development applications.

Background: Career development awards are important to the professional careers of many junior scientists. Designed to launch researchers as independent scientists earlier in their careers, such grants release them from full schedules of teaching and clinical service, protecting their time for research and publishing. Yet few know how best to embark on this crucial endeavor.