Pancreaticoduodenectomy after Roux-en-Y gastric bypass and novel endoscopic ultrasound-directed transgastric ERCP procedure.

Performing a pancreaticoduodenectomy (PD) in patients having undergone a Roux-en-Y gastric bypass (RNYGB) poses a significant surgical challenge. We present a patient with a history of RNYGB and endoscopic ultrasound-directed transgastric ERCP (EDGE) procedure who underwent a successful PD. This 77-year-old female with history of open RNYBG presented with resectable pancreatic adenocarcinoma.

Modern Radiation Treatment Planning Parameters and Outcomes in Pediatric Tectal Gliomas.

Purpose: Pediatric low-grade tectal gliomas are rare, indolent tumors of the brain stem. We reviewed outcomes of pediatric patients who received a diagnosis of low-grade tectal gliomas and report dosimetric parameters for those receiving radiation therapy (RT).

Methods And Materials: We retrospectively reviewed all pediatric patients (age <18 years) at our institution diagnosed with a low-grade glioma between 1993 and 2020 (n = 288).

Comparison activity of pure and chromium-doped nickel oxide nanoparticles for the selective removal of dyes from water.

The current study involves a synthesis of a composite of nickel oxide nanoparticles (NiONPs) with a chromium dopant to yield (Cr/NiONPs). Synthesis of nickel oxide was performed by the co-precipitation method. The synthesis of the composite was conducted by the impregnation method.

A Comparative Investigation Applying Testicular Fine Needle Aspiration Cytology and Open Testicular Biopsy Histology for the Diagnosis of Azoospermia and Severe Oligospermia.

Open testicular biopsy histology and fine needle aspiration cytology (FNAC) are the most popular tests used to diagnose male infertility. This study aimed to assess the cytological characteristics of 186 infertile males aged 24-63 with testicular FNAC. Furthermore, the existing relationship between males with severe oligospermia (sperm count: 5 million/ml) and azoospermia was investigated via both cytological and histological diagnosis methods.

A Rare Case of Postoperative Encephalopathy in Twin.

The clinical picture of encephalopathy invites a broad differential with multiple etiologies. It is with judicious history, hospital course, lab testing, and imaging that the ultimate cause is identified. We present a unique case of identical twins who share a similar clinical presentation of postoperative encephalopathy.

Genetic Parameters for Functional Longevity, Type Traits, and Production in the Serbian Holstein.

In this study, the authors focused on the evaluation of the genetic parameters of longevity, milk yield traits, and type traits in dairy cattle populations in the Republic of Serbia. The total dataset used consisted of production records and pedigree data for 32,512 Holstein cows that calved from 1981 to 2015. The animal model was applied to determine the variance and covariance components and genetic parameters of the analyzed traits by applying the restricted maximum likelihood (REML) approach and using the programs VCE6 and PEST.

Immunogenicity of the hepatitis B vaccine adjuvanted with AS04C in patients with biological therapies.

Background: Hepatitis B vaccination is necessary for patients with biologic therapies because of the immunomodulatory effect of these drugs. Due to the elevated use of these therapies in the latest years, the research for new vaccination regimens and the improvement of the current ones is essential. New adjuvants like AS04C might be a potential strategy to improve immune response.

Ruptured gastro-intestinal stromal tumor as a surgical emergency: A case report and literature review.

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. GISTs of the small bowel are rare, and often present with an abdominal mass and/or bleeding. Chemotherapy and surgery are the mainstay of therapy.

Low-Grade Appendiceal Mucinous Neoplasm: A Case Series.

Low-grade appendiceal mucinous neoplasm (LAMN) is a lesion of the appendix with potentially fatal consequences if untreated. Though LAMN can be asymptomatic and stable, it can rupture and seed mucin and neoplastic epithelium into the peritoneum, leading to pseudomyxoma peritonei (PMP), a serious complication characterized by intraperitoneal accumulation of mucinous tumors and ascites with a high morbidity and mortality rate. Therefore, timely identification and treatment of LAMN are crucial for reducing PMP risk and improving prognosis and outcome.

Effect of nanovesicular surface-functionalization via chitosan and/or PEGylation on cytotoxicity of tamoxifen in induced-breast cancer model.

Aims: The effect of surface-modification of Tamoxifen (Tam)-loaded-niosomes on drug cytotoxicity and bio-distribution, via functionalization with chitosan and/or PEGylation, was investigated.

Materials And Methods: Tam-loaded hybrid-nanocarriers (Tam-loaded niosomes, chitosomes, PEGylated niosomes, and PEGylated chitosomes) were formulated and characterized.

Key Findings: Chitosanization with/without PEGylation proved to selectively enhance Tam-release at the cancerous-acidic micromilieu.

Successful use of endovascular aneurysm repair in the treatment of acute aortoduodenal syndrome.

Aortoduodenal syndrome is a rare phenomenon, described as a duodenal obstruction secondary to direct compression from an abdominal aortic aneurysm. Although traditionally managed with gastrointestinal bypass and subsequent open aortic aneurysm repair, such procedures hold high mortality. Therefore, there is great value in treating this syndrome with an endovascular, minimally invasive technique that is both consistent and successful.

Large uterine leiomyoma presenting as pseudo-Meigs' syndrome with an elevated ca125: a case report and literature review.

Ascites, pelvic mass and elevated CA-125 in females carry a grim prognosis, likely an ovarian carcinoma. However, more benign etiologies such as Meigs' and pseudo-Meigs' syndrome must be considered. Pseudo-Meigs' syndrome presenting with an elevated CA-125 is rare and presents a diagnostic challenge.

Extensive lymphadenopathy leading to cancerous pericardial effusion and tamponade in a T1 pancreatic head adenocarcinoma: a case report.

In 2019, Pancreatic cancer became the third leading cause of cancer related mortality in the United States of America. Pancreatic cancer is a fatal malignancy that is predominantly seen in men with advanced age with aggressive course. Ninety percent of cases are adenocarcinoma.

Traumatic rupture of a hemorrhagic hepatic cyst: a case presentation and literature review.

Hemorrhagic hepatic cyst with or without rupture is rare cause of acute abdomen with less than 20 cases reported in the literature. A standardardized management algorithm is currently not present, but literature suggests surgical management is ideal for definitive treatment and successful patient outcome. We report a case of a 39-year-old female with a chief complaint of sudden onset abdominal pain, nausea and vomiting.

Gallbladder adenosquamous carcinoma: a case report and literature review.

Representing 90-95% of all malignant gallbladder neoplasms, adenocarcinoma is by far the most common subtype. Adenosquamous carcinoma is a rare subtype, accounting for only 1-5% of all gallbladder carcinomas. These tumors have been shown to have aggressive biologic behavior, commonly extending to adjacent structures.

Giant sliding inguinal hernia requiring intraoperative aspiration of fluid: a case report and literature review.

Giant inguinal hernias are defined as inguinal hernias that extend below the midpoint of the inner thigh when the patient is in the standing position or an anteroposterior diameter of at least 30 cm or a laterolateral diameter of ~50 cm with non-reducibility for >10 years. This article presents a 39-year-old male with a five-year history of a giant left inguinal hernia that was treated with left inguinal hernia repair with mesh, orchiectomy, complicated scrotoplasty, intraoperative ultrasound and aspiration of 3.9 L of fluid from the hernia sac.

Abdominal wall endometrioma presenting as a cystic abdominal wall mass: a case report and literature review.

Endometriosis is classically defined as 'the presence of endometrial glands and stroma outside of the uterine cavity and musculature'. Although it most commonly occurs in the pelvis, various extrapelvic locations have been reported in the literature. There seems to be a strong association between abdominal wall endometriomas and previous surgical scars.

A genetic analysis of a Spanish population with early onset Parkinson's disease.

Introduction: Both recessive and dominant genetic forms of Parkinson's disease have been described. The aim of this study was to assess the contribution of several genes to the pathophysiology of early onset Parkinson's disease in a cohort from central Spain.

Methods/patients: We analyzed a cohort of 117 unrelated patients with early onset Parkinson's disease using a pipeline, based on a combination of a next-generation sequencing panel of 17 genes previously related with Parkinson's disease and other Parkinsonisms and CNV screening.

Formulation and optimization of drug-loaded mesoporous silica nanoparticle-based tablets to improve the dissolution rate of the poorly water-soluble drug silymarin.

Porous carriers have been put forward as a promising alternative for stabilizing the amorphous state of loaded drugs, and thus significantly improving the dissolution rate of poorly soluble compounds. The purpose of this study was to enhance the saturation solubility, dissolution rate and drug loading of the poorly water-soluble drug silymarin via incorporation into mesoporous silica nanospheres within a lyophilized tablet to obtain a unique formulation. 3 full factorial design was applied to study the effect of both independent variables, polyvinyl alcohol (PVA) as stabilizer and binder and sucrose as cryoprotectant and disintegrant; and on the dependent variables that included the mean particle size (Y), disintegration time (Y), tablet strength (Y) and % of drug release after 2 min, R,Y.