American Journal of Surgery and Clinical Case Reports最新文献

{"title":"Retroperitoneal Mesothelial Cyst: An Incidental Finding","authors":"Serrano-Méndez P, Perez-Chrzanowska H","doi":"10.47829/ajsccr.2023.61002","DOIUrl":"https://doi.org/10.47829/ajsccr.2023.61002","url":null,"abstract":"","PeriodicalId":7649,"journal":{"name":"American Journal of Surgery and Clinical Case Reports","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82408575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoughts and Suggestions for Lower Alveolar Nerve Injury Caused by Tooth Extraction on the Lower Left 8th Tooth: A Case Report","authors":"C. J, Florenly, L. C","doi":"10.47829/ajsccr.2023.6602","DOIUrl":"https://doi.org/10.47829/ajsccr.2023.6602","url":null,"abstract":"","PeriodicalId":7649,"journal":{"name":"American Journal of Surgery and Clinical Case Reports","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80252613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mixed Poorly-Differentiated Neuroendocrine Carcinoma and Well-Differentiated Neuroendocrine Tumor in the Extrahepatic Common Bile Duct: A Unique Rare Case","authors":"Young Ar, Amin A, Ram B, Sham S, Monika SA, Paterson J","doi":"10.47829/ajsccr.2023.61218","DOIUrl":"https://doi.org/10.47829/ajsccr.2023.61218","url":null,"abstract":"The World Health Organization classified neuroendocrine neoplasms of the digestive system into well-differentiated neuroendocrine tumor (NET) and poorly-differentiated neuroendocrine carcinoma (NEC) based on their unique morphological, clinical, epidemiological, histological, and prognostic differences. We pres-ent a case of an 80-year old female found to have a 31x22x21 mm mass in the perihilar common bile duct on CT scan. A tan-yellow mass within the common bile duct wall, extending into the surrounding fibroconnective tissue was noted on gross examination. Histologic examination revealed a well-circumscribed tumor with a biphasic appearance consisting of predominantly well-differentiated NET (approximately 80%) arranged in a trabecular architecture with round nuclei, finely granular chromatin, moderate cytoplasm, rare mitosis (6/2mm 2 ), and minor poorly differentiated NEC (approximately 20%) with markedly pleomorphic cells, necrosis, and abundant mitosis (40/2mm 2 ). Tumor cells in both morphologies showed immunoreactivity for AE1/AE3, CD56, synaptophysin and chromogranin. The Ki-67 proliferation index in the well-differentiated component was low (approximately 3-20%) and unequivocally high in the poorly-differentiated component (focally >50%). In the well-differentiated component, p53 staining was patchy and weak (wild-type), whereas it was negative (null-type) in the poorly-differentiated component. RB1 immunostaining showed weak staining in the well-differentiated component and diffusely strong staining in the poorly-differentiated component. The final diagnosis of mixed well-differentiated NET and poorly-differentiated NEC is made, which does not fit neatly into a specific category in the current classification of neuroendocrine neoplasms of the digestive system. Reporting more cases like this will be helpful for the revision of the current classification system.","PeriodicalId":7649,"journal":{"name":"American Journal of Surgery and Clinical Case Reports","volume":"73 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84277219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Logistic Regression Model of Factors Influencing Maternal Health Care Service Utilization in Bangladesh: A Nationwide Cross-Sectional Study","authors":"None Hasan F","doi":"10.47829/ajsccr.2022.6462","DOIUrl":"https://doi.org/10.47829/ajsccr.2022.6462","url":null,"abstract":"","PeriodicalId":7649,"journal":{"name":"American Journal of Surgery and Clinical Case Reports","volume":"2013 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135495817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computed Tomography Cardiac Veins Evaluation in Congenital Transposition of Great Vessels Prior to Cardiac Resynchronization Therapy (Crt)","authors":"Groudeva V, Chilingirova N, Nedevska M, Iovev S","doi":"10.47829/ajsccr.2023.6919","DOIUrl":"https://doi.org/10.47829/ajsccr.2023.6919","url":null,"abstract":"Adult patients with transposition of great vessels are often candidates for cardiac resynchronization therapy (CRT). Cardiac vein anatomy is of crucial importance in planning optimal CRT therapy. Cardiac veins are very variable. In congenitally corrected transposition of great vessels coronary arteries have an unusual course but coronary veins although much less studied have much more varieties. In such cases cardiac computed tomography (CT) might offer important information prior to electrophysiological procedures. The objective of this study is to present a series of patients with transposition of the great arteries (TGA) both congenitally corrected TGA and D TGA in which imaging was used to help planning placement of leads for CRT. CT findings are thoroughly described as well as the consequent interventional procedure.","PeriodicalId":7649,"journal":{"name":"American Journal of Surgery and Clinical Case Reports","volume":"94 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83686428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoughts and Suggestions of Grassroots Doctors (Gastroenterologists and General Practitioners) of Lower Gastrointestinal Bleeding Caused by Long-Term Use of Non-Steroidal Anti-Inflammatory Drugs and a Case Report","authors":"S. J, L. C, H. L.","doi":"10.47829/ajsccr.2023.6601","DOIUrl":"https://doi.org/10.47829/ajsccr.2023.6601","url":null,"abstract":"","PeriodicalId":7649,"journal":{"name":"American Journal of Surgery and Clinical Case Reports","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75472618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Quest of Happiness-Increase Happy Neurotransmitter Serotonin in the Brain","authors":"S. Chatterjee, TK Chatterjee, Tapan Kumar Chatterjee","doi":"10.47829/ajsccr.2023.61001","DOIUrl":"https://doi.org/10.47829/ajsccr.2023.61001","url":null,"abstract":"When discussing happiness, it’s worth noting that serotonin, a magical substance found in the body, is essential to achieving a state of well-being. Serotonin is a naturally occurring monoamine neurotransmitter that transmits signals between nerve cells throughout the body, contributing significantly to mood stabilization and supporting other bodily functions such as digestion, blood clotting, and sleep. When serotonin levels in the brain are low, it can cause changes in mood and disrupt sleep patterns, which can lead to depression. However, it’s important to note that although 95% of the serotonin in the body is produced in the gut, it cannot cross the “blood-brain barrier” and thus has no impact on emotional status. Increasing serotonin levels in the brain appears to enhance communication between brain cells, resulting in an uplifted mood and reduced depression symptoms. Prescription antidepressants like Selective Serotonin Reuptake Inhibitors (SSRIs) are frequently employed to treat clinical depression and other mood disorders by increasing serotonin levels in the brain via blocking the Serotonin reuptake process. The 5-HT system is also thought to be a connection between the circadian system, stress, and mood. 5-HT not only plays a part in generating non-photic phase shifts, but it also counteracts the effects of light in the SCN (Suprachiasmatic nucleus) . It has been found that food and exercise can increase serotonin levels in the brain. Thus SSRIs use can be minimized (Figure 1).","PeriodicalId":7649,"journal":{"name":"American Journal of Surgery and Clinical Case Reports","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87699417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adult Giant Choledochal Cyst Conundrum: A Case Report","authors":"F. Rah, N. A, Jamtani I, W. A., Saunar Ry","doi":"10.47829/ajsccr.2023.6501","DOIUrl":"https://doi.org/10.47829/ajsccr.2023.6501","url":null,"abstract":"Introduction: Choledochal cyst is rare malformation of the biliary system, characterized by abnormal cystic dilation in the biliary duct. There is no clear explanation regarding the etiology of the disease. Choledochal cysts are more common in Asian population, mainly diagnosed in children, particularly in females. Due to the rare incidence of giant choledochal cyst, evidence regarding safe operative approach was still scarce. This study aims to present the management option of type 1 giant choledochal cyst. Case presentation: We present a 26-year-old female patient with a chief complaint of intermittent right upper quadrant abdominal pain, which radiated to the back. The pain worsened while the patient was pregnant. The patient was then diagnosed with a giant choledochal cyst and concomitant left- and right- hepatic duct dilation with multiple gallstones. Results: We utilize Lilly’s technique, which involves cauterizing the mucosa while leaving the serosa connected to the adhering tissues. This method is helpful in giant long standing cyst, where the mucosa could not be entirely removed because it adhered to another structure, such as the pancreatic parenchyma, inferior vena cava, or hepatic hilar arteries. Conclusion: A complicated gigantic Type 1 choledochal cyst case benefits from Lilly’s method.","PeriodicalId":7649,"journal":{"name":"American Journal of Surgery and Clinical Case Reports","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84426131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous Endoscopic Necrosectomy of Walled-Off Necrosis in Post-ERCP Pancreatitis","authors":"G. Lauri, M. Di Stasi, G. Marinone, P. Arcidiacono, S. Russo, R. Conigliaro, G. Aragona","doi":"10.47496/sl.ajscr.2022.01.02","DOIUrl":"https://doi.org/10.47496/sl.ajscr.2022.01.02","url":null,"abstract":"Introduction: Acute pancreatitis is the most frequent complication in patients who undergo endoscopic retrograde cholangiopancreatography (ERCP), with an incidence rate of 3.5-9.7% [1]. 5-10% of these develop acute necrotizing pancreatitis, which may have a pancreatic or peripancreatic localization in 75-80% [2]. We describe a case report of post-ERCP acute necrotizing pancreatitis with walled-off necrosis (WON) treated with percutaneous endoscopic necrosectomy (PEN) [3]. Case Report: A 60-year-old man with obstructive jaundice and common bile duct stones at abdominal CT scan underwent ERCP to clear the biliary tract. In the following days, due to the onset of severe acute pancreatitis and sepsis, he repeated the abdominal CT scan where multiple necrotic collections were found around the pancreas with extension to the pelvic paracolic gutters. Following a step-up approach, targeted antibiotic therapy was started. After four weeks, it was not possible to perform Endoscopic Ultrasound-Guided drainage because of the distance from the stomach or the duodenum to the WON. Then percutaneous drainage was radiologically inserted into the collections through the left side of the abdomen of the patient to flush with hydrogen peroxide every day. Due to the persistent infection and necrosis in the collections, an esophageal fully covered self-expanding metal stent was temporarily inserted through the percutaneous fistula in order to increase the caliber of the fistula and to perform PEN. Discussion: The step-up approach suggests endoscopic or percutaneous drainage of infected WON as the first interventional method, depending on the location of the WON and the local expertise [1]. PEN is a safe and effective alternative to surgical treatment with a technical success rate of 47-93% and a complication rate of no more than 20% [4]. Conclusion: PEN is an advanced endoscopic technique that is showing promising results but still needs randomized controlled trials to establish safety and efficacy.","PeriodicalId":7649,"journal":{"name":"American Journal of Surgery and Clinical Case Reports","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78503795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical Affairs Support of Medical Information Requests during COVID-19 Pandemic","authors":"J. G., V. O, Holly G, Brad B, Jennifer C, Leonie R","doi":"10.33597/2766-8304-v3-id1031","DOIUrl":"https://doi.org/10.33597/2766-8304-v3-id1031","url":null,"abstract":"Introduction: Medical Affairs teams within Medical Device Companies receive Medical Information Requests (MIR) from Healthcare Professionals (HCP) seeking answers to medical, scientific, or technical information because they cannot be answered based on the individual product’s current prescribing information, indications, Instructions for Use (IFU), as cleared or approved by the appropriate competent regulatory authority (e.g., Food and Drug Administration (FDA), Notified Body in the European Union, or other regional governmental authority). In 2018, Johnson & Johnson MedTech launched a Cloud-based platform to harmonize Medical Affairs’ global management and processing of MIRs from HCPs, seeking scientific or medical information about our portfolio of products. The aim of this comparative retrospective analysis was to critically examine the 2020 MIR volumes in 2020 versus 2019 and assess the impact of COVID-19 on Medical Affairs support of patients and Health Care Providers (HCPs). Methods: The authors conducted a retrospective analysis of Johnson & Johnson MedTech MIR data, across quarters from January 2019 through the December 2020, to evaluate the potential impact of the COVID-19 pandemic on MIR intake volume and key metrics. Results: The Total Global (US, EMEA, and ASPAC) year over year analysis of Total Johnson & Johnson MedTech MIR volume totaled, 2018-656*, 2019-1155 and 2020-1153. When stratifying Global year over year analysis of Regional (US, EMEA, and ASPAC) MIR data: US MedTech MIR volume for quarterly periods, including initial COVID-19 pandemic, Q2 2020 resulted in a 48% decrease in MIR volume across US MedTech MIR submissions, compared to Q2 2019. Q3 2020 resulted in a 43% increase in MIR volume across US MedTech MIR submissions, compared to Q3 2019. EMEA MedTech MIR volume for the quarterly periods, including initial COVID-19 pandemic, Q2 2020 resulted in a 23% decrease in MIR volume across EMEA MedTech MIR submissions, compared to Q2 2019. Q3 2020 resulted in a 22% increase in MIR volume across EMEA MedTech MIR submissions, compared to Q3 2019. ASPAC MIR volume for the quarterly periods, including initial COVID-19 pandemic, Q2 2020 resulted in an 11% increase in MIR volume across ASPAC MedTech MIR submissions, compared to Q2 2019. Q3 2020 resulted in a 90% increase in MIR volume across ASPAC MedTech MIR submissions, compared to Q3 2019. Analysis of Quarterly MIR volume by Region (US, EMEA, and ASPAC) compared to Quarterly MIR volume from Prior Year (2019-2020): US Q1-18%, Q2 -48%, Q3+39%, and Q4+7%, EMEA Q1-29%, Q2-30%, Q3+25%, and Q4+15%, and ASPAC Q1-16%, Q2+11%, Q3+90%, and Q4+256%. Conclusion: Total MIR submissions and responses continued with only small variance from the previous year when compared to annual periods, including the impact from the COVID-19 pandemic (2019 vs. 2020). Across Johnson & Johnson MedTech, Healthcare professionals and the commercial sales teams increased their use of the MIR submission website during","PeriodicalId":7649,"journal":{"name":"American Journal of Surgery and Clinical Case Reports","volume":"280 2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86571674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}