Ganglioneuroma of the adrenal gland and retroperitoneum: A case report.

Context: Ganglioneuromas are benign tumors of the sympathetic nervous system that rarely arise in the adrenal gland. Majority of cases are detected incidentally since they are usually asymptomatic. Up to the current era of laparoscopic adrenal mass excision, this unusual entity has not been adequately reported in the surgical literature.

Novel method of stump closure for distal pancreatectomy with a 75% reduction in pancreatic fistula rate.

Background: Pancreatic fistula is a significant problem for patients undergoing distal pancreatectomy with fistula rates up to 61%. Fistulas lead to substantial morbidity. The study objective was to compare radiofrequency dissector closure with traditional stump closure for distal pancreatectomy.

Laparoscopic assisted central pancreatectomy with pancreaticogastrostomy reconstruction - An alternative surgical technique for central pancreatic mass resection.

Context: Central pancreatectomy has gained popularity in the past decade as treatment of choice for low malignant potential tumor in the midpancreas due to its ability to achieve optimal preservation of pancreatic parenchyma. Simultaneously, advancement in minimally invasive approach has contributed to numerous novel surgical techniques with significantly lower morbidity and mortality. With the purpose of improving patient outcomes, we describe a laparoscopic assisted central pancreatectomy with pancreaticogastrostomy as an alternative method to the previously described open central pancreatectomy with roux-en-y pancreaticojejunostomy reconstruction.

A noncommercial polymerase chain reaction-based method to approach one hundred percent recombinant clone selection efficiency.

Molecular cloning is an important procedure in molecular biology, but this is often a rate-limiting step and can be very time-consuming, possibly due to low ligation efficiency. Here, we describe a simple polymerase chain reaction (PCR)-based strategy to approach 100% selection efficiency. The post-ligation mixture containing the recombinant was subjected to insert-specific primer-mediated PCR amplification using a high-fidelity DNA Pfu polymerase generating a plasmid containing staggered nicks.

Treatment of spontaneous lumbar artery pseudoaneurysm by computed tomography--guided thrombin injection.

A case of spontaneous pseudoaneurysm of a lumbar artery that was treated with computed tomography- guided thrombin injection is reported in this study. To the authors' knowledge, pseudoaneurysm of lumbar artery without any predisposing factors has been reported only twice in the literature previously. The aims of this case report are to discuss the differential diagnosis and management of this difficult problem.

Beyond lymph node staging: molecular predictors of outcome in breast cancer.

This article briefly reviews the exciting, yet unproven, reports of alternate methods of predicting outcomes in breast cancer and highlights new molecular methods of diagnosing, classifying, and treating this disease. The author starts by reviewing well-known factors in breast cancer with which all alternate methods of staging and predicting outcomes must be compared prospectively.

Risk factors associated with earlier age of onset in familial pancreatic carcinoma.

Background: An estimated 5-10% of all pancreatic adenocarcinomas have a hereditary association. The objective of the current study was to characterize the clinical and pathologic features of familial pancreatic carcinoma and to determine potential differences in demographics, risk factors, and outcomes between familial and sporadic pancreatic carcinoma populations.

Methods: A retrospective review was performed to identify patients diagnosed with pancreatic carcinoma who had an associated familial disposition.

Palliative surgery of soft tissue sarcoma.

Despite an increasing trend towards early diagnosis of breast cancer,patients still present with locally advanced disease. Also, in some patients chemotherapy will fail, and local and regional recurrence will occur. This article outlines options for palliative care for such patients.

The role of epidural anesthesia and analgesia in surgical practice.

Objective: To review the potential and proven benefits and complications of epidural anesthesia/analgesia.

Summary Background Data: Advances in analgesia/anesthesia have improved patient satisfaction and perioperative outcomes. Epidural anesthesia/analgesia is one of these advances that is gaining rapid acceptance due to a perceived reduction in morbidity and overall patient satisfaction.

Counterpoint: sentinel lymph node biopsy is not indicated for ductal carcinoma in situ.

The purpose of axillary surgery in breast cancer is to provide prognostic information to guide the choice of adjuvant systemic therapy. Axillary surgery for ductal carcinoma in situ (DCIS) was abandoned in the 1980s because of the extremely low risk of lymph node metastases and high survival rates. Most women with metastases probably harbored an unrecognized focus of invasion or had metastases subsequent to an invasive local recurrence.

Surgical treatment of hyperparathyroidism improves health-related quality of life.

Hypothesis: The surgical treatment of primary hyperparathyroidism results in an improved health-related quality of life.

Design: Prospective cohort analysis of consecutive patients with primary hyperparathyroidism analyzed preoperatively and 1 year postoperatively.

Setting: Academic multispecialty referral clinic.