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Look at the actual PrioCHECK™ Trichinella AAD package to identify Trichinella spiralis, Big t. britovi, along with To. pseudospiralis larvae in pork while using the computerized digestion of food method Trichomatic-35.
ancer patients at middle to advanced stage. 2019 Gland Surgery. All rights reserved.Background Prepectoral implant-based breast reconstruction involving full implant coverage with an acellular dermal matrix (ADM) is more convenient, provides better aesthetic results, and carries lower risk of complications than does the traditional dual-plane method with an ADM. However, the recently reported technique usually involves full wrapping of the implant using a single, large ADM. We aimed to clarify the usefulness of an implant covering technique using two double-crossed ADMs. Methods We retrospectively evaluated the records of 23 breast cancer patients who, between February 2017 and March 2018, received skin-sparing or nipple-sparing mastectomy followed by immediate prepectoral implant-breast reconstruction. We assessed preoperative characteristics, cancer treatment parameters, incidence of postoperative complications (necrosis, capsular contracture, infection), and patient satisfaction at 12 months postoperatively. Results This cohort (mean age, 45.5 years; body mass index, 22.1 kg/m2; preoperative breast volume, 315.7 cc, excised mass weight, 291.4 g; silicone implant size, 252.4 cc) included 11 patients with ductal carcinoma in situ and 12 with invasive ductal carcinoma. Postoperatively, one patient received radiotherapy and nine received chemotherapy. Among postoperative complications, we noted capsular contracture (1/23, 4.3%), wound dehiscence (2/23, 8.7%), and seroma (3/23, 13.0%). Good patient satisfaction (mean score, 4.2-4.8 on the KNUH Breast Reconstruction Satisfaction Questionnaire) was obtained in all categories (breast symmetry, reconstructed breast size, shape, feel, pain, scar, self-confidence, sexual attractiveness, and overall satisfaction). Conclusions Prepectoral breast reconstruction involving complete implant coverage with double-crossed ADMs represents a good alternative to the traditional dual-plane subpectoral method, providing good patient satisfaction without adverse outcomes. 2019 Gland Surgery. All rights reserved.Background To investigate the short-term efficacy and safety of drug-eluting bead transcatheter arterial chemoembolization (DEB-TACE) using CalliSpheres® microspheres in the treatment of unresectable locally advanced breast cancer (LABC). Methods DEB-TACE using CSM was performed in 15 patients with LABC after failure of medical treatment. The efficacy was evaluated based on the modified Response Evaluation Criteria in Solid Tumors (mRECIST). The postoperative adverse reactions and complications were analyzed. The changes of white blood cell (WBC) count, creatine kinase isoenzyme-MB (CK-MB), B-type natriuretic peptide (BNP), and carbohydrate antigen15-3 (CA15-3) before and after treatment were compared by using Wilcoxon signed-rank test. Results The surgeries were successful in all patients. The subjects were followed up for 2-60 months (median 10 months). According to the mRECIST, no patient achieved complete remission (CR) 1, 3, and 5 months after surgery, and partial response (PR) was achieved in 9, 11, and 11 cases; also, there were 6, 4, and 2 stable disease (SD) cases, and 0, 0, and 2 progressive disease (PD) cases. The postoperative WBC count, CK-MB level, and BNP level were not significantly different from those before surgery, whereas the CA15-3 level significantly decreased. The main postoperative adverse reactions were pain, fever, and gastrointestinal reactions. No severe adverse reactions were observed. Conclusions DEB-TACE with CalliSpheres® microspheres is a safe and feasible treatment for LABC. However, more multi-center studies with larger sample sizes are still warranted. 2019 Gland Surgery. All rights reserved.Background Due to risk of haemodynamic instability (HDI), it has been recommended that patients undergoing adrenalectomy for phaeochromocytoma should be monitored in an intensive care facility. The aim of this study was to evaluate the incidence, risk factors and outcomes of postoperative HDI in these patients. Retrospective cohort study of 46 consecutive patients who underwent open (OA, N=26) or laparoscopic (LA, N=20) adrenalectomy for phaeochromocytoma at a single centre [2007-2017]. Methods HDI was defined as systolic BP >200 or 120 or less then 50 bpm or vasopressor therapy within 24 hours. Risk factors for intraoperative and postoperative HDI were evaluated by univariable and multivariable analyses. Results Intraoperative hypertension occurred in 25/42 patients (60%). Preoperative plasma normetanephrine levels ≥3,500 pmol/L were significantly associated with intraoperative hypertension on multivariable analysis [odds ratio (OR) 42; 95% CI 4-429; P=0.002). check details Postoperative hypotension occurred in 21/45 patients (47%), and 13 (29%) required vasopressor therapy. Preoperative beta-blockade therapy was the only independent risk factor for postoperative hypotension on multivariable analysis (OR 4.0; 95% CI 1.2-13.9, P=0.029). No patients (0/9) with tumours less then 5 cm treated by LA needed postoperative vasopressor therapy, compared to 39% (7/18) treated by OA (P=0.059). Complications developed in 9 patients (20%), and were less likely in those with intraoperative hypertension (8% vs. 41%; P=0.019). There was one postoperative death. Conclusions Preoperative beta-blockade therapy is an independent risk factor for postoperative HDI after adrenalectomy for phaeochromocytoma. Patients who undergo laparoscopic adrenalectomy (LA) for phaeochromocytomas less then 5 cm are unlikely to need postoperative vasopressor therapy, and may not require intensive care monitoring. 2019 Gland Surgery. All rights reserved.Background Thyroidectomy is a commonly performed procedure with large centres performing thousands of thyroid surgeries per year. The traditional Kocher mid-cervical incision has been the standard approach to thyroidectomy since the late 1870s with predictable results. The introduction of minimally invasive and remote access techniques seeks to reduce the morbidity of a mid-cervical scar incision. Methods Ninety-five [95] patients who underwent this approach over the thirty [30] months period from January 2015 to July 2017 were administered the validated Patient Scar Assessment Questionnaire and the collected data analysed. Results Forty-eight [48] patients, (50.5%) met inclusion criteria and provided responses with a mean time since surgery of 18.9 months. There is a high level of satisfaction with 91.7% of patients in the study having scores consistent with scar satisfaction after conventional thyroidectomy. While patients were satisfied with the appearance of their scars, a majority of patients (n=28, 58.3%) were at least slightly conscious of their incisions, with more than 10% of patients (n=5) reporting significant levels of self-consciousness.
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