A Rare Case of Papillary Thyroid Carcinoma in Marine-Lehnhart Syndrome-Indication for Biopsy of Hot Thyroid Nodules?

An uncommon occurrence in which Graves disease (GD) coincides with autonomous functioning thyroid nodules (AFTNs) is termed Marine-Lehnhart syndrome (MLS). While hyperfunctioning nodules in MLS are commonly benign, there exists a rare potential for malignancy. A 41-year-old male patient was initially managed conservatively upon being diagnosed with MLS type 1.

Hyperthyroxinemia and Hypercortisolemia due to Familial Dysalbuminemia.

A 23-year-old man and his grandmother with hyperthyroxinemia and hypercortisolemia were heterozygous for an mutation (p. Arg218Pro), known to cause familial dysalbuminemic hyperthyroxinemia (FDH). However, serum-free cortisol levels in these individuals were normal and total cortisol concentrations fell markedly after depletion of albumin from their serum.

Non-cross-linked biological mesh in complex abdominal wall hernia: a cohort study.

Purpose: Complex abdominal wall hernia repair (CAWHR) is a challenging procedure. Mesh prosthesis is indicated, but the use of synthetic mesh in a contaminated area may add to overall morbidity. Biological meshes may provide a solution, but little is known about long-term results.

[Technological Innovations in Diabetes Therapy].

Technological Innovations in Diabetes Therapy Abstract. In the last few years a whole array of technical innovations has dramatically increased treatment options for patients with diabetes mellitus. Capillary blood glucose measurements are increasingly replaced by continuous glucose monitoring.

Impact of Diabetes Mellitus and Insulin on Nonalcoholic Fatty Liver Disease in the Morbidly Obese.

Introduction And Aim: The prevalence of obesity, type 2 diabetes mellitus and non-alcoholic fatty liver disease are increasing. Type 2 diabetes mellitus may aggravate non-alcoholic fatty liver disease, increasing the risk of developing cirrhosis and hepatocellular carcinoma. This study aims to determine the effect of type 2 diabetes mellitus and insulin therapy on non-alcoholic fatty liver disease in the patients with morbid obesity.

What is the evidence for the use of biologic or biosynthetic meshes in abdominal wall reconstruction?

Introduction: Although many surgeons have adopted the use of biologic and biosynthetic meshes in complex abdominal wall hernia repair, others have questioned the use of these products. Criticism is addressed in several review articles on the poor standard of studies reporting on the use of biologic meshes for different abdominal wall repairs. The aim of this consensus review is to conduct an evidence-based analysis of the efficacy of biologic and biosynthetic meshes in predefined clinical situations.

[Comparison of Open vs. Laparoscopic Techniques in Complete Mesocolic Excision (CME) During Right Hemicolectomy].

Aims: The technique of open complete mesocolic excision (CME) has improved the outcomes of patients with colon carcinoma. Meanwhile it has become an established international standard procedure. It remains unclear if laparoscopic procedures are able to match the high quality of open resections.

Triple-step laparoscopic incisional hernia repair: midline suture closure supported by dorsal component separation and intraperitoneal onlay mesh reinforcement.

Incisional hernias remain a surgical challenge when balancing surgical morbidity, functional restoration, and risk of recurrence. Laparoscopic intraperitoneal onlay mesh (IPOM) placement reduces postoperative wound infections and allows fast patient recovery. Yet, current IPOM techniques do not achieve closure of the midline hernia gap, thereby increasing the risk of persistent mesh bulging with poor abdominal wall function.

[Use of biological meshes in abdominal wall reconstruction. Results of a survey in Germany].

Background: Surgical treatment of incisional hernia includes implantation of a mesh. The use of synthetic grafts in contaminated fields results in an increased risk of infection. In these cases a potential advantage is described for biological repair material.

Appendicitis-the balance between cost effectiveness and safety remains challenging.

Purpose: The diagnosis of acute appendicitis remains a challenge in daily clinical practice. The aim of the present study was to determine clinical criteria for a careful and cost-effective integration of computed tomography (CT) scans in the clinical pathway for the diagnosis of acute appendicitis.

Methods: In this retrospective study, we analyzed all patients who were admitted to our hospital with suspected appendicitis (2008-2011).

The use of purse-string skin closure in loop ileostomy reversals leads to lower wound infection rates--a single high-volume centre experience.

Purpose: Wound infections affect not only the individual patient but lead to an increase in medical costs. After ileostomy reversal, surgical site infections are a common problem. The objective of the study was to compare the infection rates of purse-string and conventional skin closure techniques in a high volume setting.

A comprehensive study of clinical, biochemical, radiological, vascular, cardiac, and sleep parameters in an unselected cohort of patients with acromegaly undergoing presurgical somatostatin receptor ligand therapy.

Context: Attainment of safe GH and IGF-1 levels is a central goal of acromegaly management.

Objective: The aim of this study was to determine the extent to which reductions in GH and IGF-1 concentrations correlate with amelioration of radiological, metabolic, vascular, cardiac, and respiratory sequelae in a single unselected patient cohort.

Study Design: This was a prospective, within-subject comparison in 30 patients with newly diagnosed acromegaly (15 women and 15 men: mean age, 54.

Benefit of a clipping device in use in intestinal bleeding and intestinal leakage.

Background: The over-the-scope clip (OTSC) system was first used to close the access route in natural orifice transluminal endoscopic surgery and is increasingly used for other indications.

Objective: We analyzed the use of the OTSC in intestinal bleeding and in closure of GI tract leaks.

Design: Analysis of a consecutive series of patients.

Valproate inhibits colon cancer growth through cell cycle modification in vivo and in vitro.

Valproate (VPA) is a well-characterized histone deacetylase inhibitor with anti-neoplastic properties. We analyzed the growth blocking effects and the molecular mode of action of this compound in colorectal cancer cells in vitro and in vivo. Caco-2, SW-480, CX-1 or WIDR cell lines were exposed to VPA (0.

Early post-operative measurement of cytokine plasma levels combined with pre-operative bilirubin levels identify high-risk patients after liver resection.

Identification of patients at risk of a complicated course after liver resection is crucial for adapting post-operative care. In the present study, we investigated the diagnostic value of the plasma levels of various cytokines obtained immediately after surgery. IL-6, IL-10, IL-8, monokine induced by interferon-γ (MIG), monocyte chemotactic protein-1 (MCP-1) and interferon-inducible protein-10 (IP-10) concentrations were measured in 26 patients after liver resection using a cytometric bead assay and were correlated with liver function, resectate weight, surgery duration, ischemia/reperfusion, hospitalization time and occurrence of complications.

Hypoxia and reoxygenation of primary human hepatocytes induce proteome changes of glucose metabolism, oxidative protection and peroxisomal function.

Protective hepatocellular responses to a hypoxic challenge are crucial to preserve liver function. The knowledge of affected metabolic functions could help assess and enhance hepatic ischemic tolerance. Here we studied adaptive mechanisms in human hepatocytes after hypoxia and reoxygenation using a proteomic approach.

Complement and neutrophil function changes after liver resection in humans.

Background: Complement activation contributes to the regulation of liver regeneration after liver resection (LR) in mice.

Methods: We hypothesized that complement activation and changes in C5a-receptors (C5aR, C5L2) on polymorphonuclear cells (PMN) and monocytes are important in clinical LR. Anaphylatoxin and C5b9 plasma levels were measured (bead-array, ELISA) (25 patients) and receptor expression was assessed after LR (19 patients) (FACS).

The regulation of liver cell survival by complement.

Complement effectors are known to contribute to host cell injury in several inflammatory diseases. Contrary to this paradigm, in this study utilizing surgical liver resection (partial hepatectomy) in various complement-deficient mice as a model, we have demonstrated that complement anaphylatoxins C3a and C5a are required for the survival of liver cells during regeneration. The mechanisms of these cytoprotective functions of complement were related to the regulation of IL-6 and TNF production or release after liver resection.

[Inguinal hernia: laparoscopic or open surgery?].

Background: Today, mesh repair is the preferred technique in surgery of inguinal hernia. Whether the mesh should be placed laparoscopically or by open techniques is still controversial.

Methods: A comparison of open mesh and laparoscopic techniques was made with the help of meta-analyses and prospective trials.

Effect of atorvastatin on plasma levels of asymmetric dimethylarginine in patients with non-ischaemic heart failure.

Background: Elevated plasma levels of asymmetric dimethylarginine (ADMA), an endothelial nitric oxide synthase (eNOS) inhibitor, may contribute to endothelial dysfunction in chronic heart failure (CHF). Since statins upregulate eNOS and ameliorate endothelial dysfunction in non-ischaemic CHF, we hypothesized that this may be in part through modification of ADMA.

Aim: To evaluate the effect of atorvastatin on the relationship between ADMA and endothelial function in non-ischaemic CHF.

Autocrine stimulation of human hepatocytes triggers late DNA synthesis and stabilizes long-term differentiation in vitro.

Isolated human hepatocytes are of great value in investigating cell transplantation, liver physiology, pathology, and drug metabolism. Though hepatocytes possess a tremendous proliferative capacity in vivo, their ability to grow in culture is severely limited. We postulated that repeated medium change, common to most in vitro systems, may prevent long-term maintenance of hepato-specific functions and growth capacity.

[Hepatic angiomyolipoma--a rare liver tumor].

A 22-year-old woman was treated for a hepatic lesion with a high suspicion of a liver adenoma at another hospital. The patient presented with unspecific abdominal pain. Further physical examination was unremarkable.