Gastric Antral Vascular Ectasia: Resolution of Bleeding and Stabilization of Hematocrit Following Orthotopic Liver Transplantation.

Gastric Antral Vascular Ectasia (GAVE) is an uncommon cause of chronic gastrointestinal bleeding and iron deficiency anemia in the geriatric population. It is often associated with cirrhosis of the liver and is hypothesized to result from synthetic liver dysfunction. Treatment options include argon plasma coagulation, endoscopic band ligation, and radiofrequency ablation.

A Call To Action: Cholangiocarcinoma in the Setting of Sustained Hepatitis C Virologic Response - Case Report and Review of Literature.

The incidence of cholangiocarcinoma, an aggressive malignancy with poor prognosis, is increasing. Hepatitis B and C have been well established as predisposing factors for this malignancy. The availability and efficacy of treatment for hepatitis C infection has led to a substantial reduction in viral hepatitis-related cholangiocarcinoma mortality.

IPSILATERAL BULLOUS EXUDATIVE RETINAL DETACHMENT ASSOCIATED WITH EXTRACORPOREAL MEMBRANE OXYGENATION.

Purpose: To describe the first known case of an extracorporeal membrane oxygenation (ECMO)-related complication in an adult.

Methods: Case report.

Results: A 34-year-old man awaiting a lung transplant for interstitial lung disease was connected to an ECMO circuit as a bridge to lung transplant, with a drainage catheter attached to his right internal jugular vein.

Increasing Opportunity for Lung Transplant in Interstitial Lung Disease With Pulmonary Hypertension.

Background: Extracorporeal membrane oxygenation (ECMO) as a bridge to lung transplantation for end-stage interstitial lung disease (ILD) and pulmonary hypertension (PH) has varying results based on ECMO configuration. We compare our experience using venovenous (VV) and venoarterial (VA) ECMO bridge to transplantation for ILD with PH on survival to successful transplantation.

Methods: A single-center retrospective review was done of patients with ILD and secondary PH who were placed on either VV or VA ECMO as bridge to transplantation from 2010 to 2016.

Decreasing Catheter-Associated Urinary Tract Infections in the Neurological Intensive Care Unit: One Unit's Success.

Background: Catheter-associated urinary tract infections are preventable adverse outcomes that increase hospital morbidity, mortality, and costs. These infections are particularly prevalent in intensive care units.

Objectives: To describe the success of an 18-bed neurological intensive care unit in using several nurse-implemented strategies that reduced the number of catheter-associated urinary tract infections.

Long-term consequences of not closing the mesenteric defect after laparoscopic right colectomy.

Purpose: The controversy regarding closing the mesenteric defect after laparoscopic right colectomy remains a subject of debate. This study describes the consequences of not closing the mesenteric defect.

Methods: A 7-year prospective database revealed 530 consecutive patients who underwent laparoscopic right colectomy for neoplasia.

Minimally invasive colon resection for malignant colonic conditions is associated with a transient early increase in plasma sVEGFR1 and a decrease in sVEGFR2 levels after surgery.

Introduction: Plasma VEGF levels increase after minimally invasive colorectal resection (MICR) and remain elevated for 2-4 weeks. VEGF induces physiologic and pathologic angiogenesis by binding to endothelial cell (EC) bound VEGF-Receptor-1 (VEGFR1) and VEGFR2. Soluble forms of these receptors sequester plasma VEGF, decreasing the amount available to bind to EC-bound receptors.

Minimally invasive colon resection is associated with a transient increase in plasma sVEGFR1 levels and a decrease in sVEGFR2 levels during the early postoperative period.

Introduction: Plasma vascular endothelial growth factor (VEGF) levels are elevated for 2-4 weeks after minimally invasive colorectal resection (MICR). VEGF induces wound and tumor angiogenesis by binding to endothelial cell (EC)-bound VEGF-receptor 1 (VEGFR1) and VEGFR2. Soluble receptors (sVEGFR1, sVEGFR2) sequester VEGF in the blood and decrease VEGF's proangiogenic effect.

Asymptomatic intussusception of the appendix secondary to endometriosis.

This is a report of a 47-year-old woman with an asymptomatic clinical presentation of appendiceal intussusception secondary to endometriosis. Initially discovered during routine colonoscopy as a submucosal mass, it was ultimately diagnosed after surgical resection by pathology findings. The theories regarding the pathogenesis of appendiceal intussusception are reviewed and discussed here.

A preliminary prospective study of the usefulness of a magnetic endoscope locating device during colonoscopy.

Background: Although magnetic endoscope imaging of the colonoscope via the Endoscope Positioning Detecting Unit (EPDU) has been studied to some extent in Europe, its application in the United States has been limited. The purposes of this study were to determine whether the technique enabled for accurate localization of the lesion and to determine if and how the device facilitated scope insertion and completion of the colonoscopic exam.

Methods: Outpatient colonoscopies using the EPDU were performed by three experienced surgical endoscopists over a 5-month period.

Surgical management of acute colitis and toxic megacolon.

Toxic colitis, also known as fulminant colitis, or toxic megacolon when associated with bowel dilation, remains a significant emergent problem in patients with ulcerative colitis. The surgical options differ when compared with the patient undergoing elective resection for this disease and are influenced by the patients' overall medical status. Generally the options are total abdominal colectomy with ileostomy, and proctocolectomy with ileostomy or pouch reconstruction.

A survey of US medical education in otolaryngology.

Background: With the increasing amount and complexity of medical information, medical schools are challenged with incorporating surgical subspecialty education, such as otolaryngology (OTO), into a time-limited curriculum.

Objectives: To understand the state of OTO education in US medical schools and to generate a discussion of the role of surgical subspecialty education in the medical school curriculum.

Design: Mail survey and follow-up letter and telephone survey conducted in 2000 to 2001.

Combined fludarabine and rituximab for low grade lymphoma and chronic lymphocytic leukemia.

As both fludarabine and rituximab are active against indolent lymphoproliferative disorders, we have studied the combination of fludarabine and rituximab in patients with low-grade lymphoma and chronic lymphocytic leukemia (CLL) in phase I/II fashion. Of 33 patients enrolled, 21(63.6%) had low-grade lymphoma and 12 (36.

"Balanced" orbital decompression for severe Graves' orbitopathy: technique with treatment algorithm.

Background: Graves' orbitopathy can produce proptosis, compressive optic neuropathy, and extraocular motility abnormalities; symptoms result from an increase in orbital volume due to expansion of intraorbital fat, with or without extraocular muscle involvement.

Study Design: We conducted a chart review of patients who underwent orbital decompression to treat Graves' orbitopathy. Twenty-two orbits (13 patients) underwent orbital bone decompression, of which 17 orbits (9 patients) underwent the combined medial and lateral "balanced" decompression.