Ureteral Valve Masquerading as Obstructive Megaureter

Primary obstructed megaureter is a common urological condition in the pediatric age group. It is one of the differentials for congenital anomalies of the kidney and urinary tract that include a myriad of structural anomalies of the urinary tract.

The obstructive conditions are usually managed conservatively unless there is deterioration in renal function, repeated urinary tract infection, or any other symptom such as abdominal pain on ipsilateral side and hypertension.

Presented here is a case of left lower ureteral valve that was diagnosed as primary obstructed megaureter with pain in abdomen and reduced ipsilateral renal function wherein ureteral valve was detected incidentally intraoperatively.

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National Transplant Network Information System of US and England

National Transplant Network leads to integration of transplant activities chain amongst participating centers. Co-ordinate and timely information exchange among those centers is a key requirement of integration which is made possible by information system.

The present research studied US and England National Transplant Network Information System. In National Transplant Network of US, United Network for Organ Sharing, American Association of Tissue Banks, and National Marrow Donor Program have safe and online information systems which deal with the management of data associated with organs, tissues, and cells transplants respectively.

The American Division of Transplantation in the department of Health and Human Services supervises the activities of these systems.

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Success in the Treatment of Periapical Implant Lesion: Case Report

Discomfort of groin bulging after huge inguinal henioplasty occurs quite frequently, and it's not easy to control its development and to choose proper treatment of it accordingly.

The patient often feel some foreign body bulging when they enhance their abdominal pressure. Some serious situations always mean the upcoming hernia recurrence, which push both the patients and the surgeons into a dilemma. These presentations have aroused surgeons’ attention.

The definite cause of groin bulging after surgery is still unclear. In general, huge groin hernia (hernia size >15 cm × 20 cm) may prone to result in the phenomenon of bulging due to large defective anatomy, weak transversals fascia, or relaxed peritoneal due to huge ascites or chronic cough.

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Success in the Treatment of Periapical Implant Lesion: Case Report

The Implant periapical lesion (IPL=Implant Periapical Lesion) is an infectious-inflammatory alterations surrounding an implant apex. The diagnosis is based on the clinical manifestations as pain, swelling, presence of fistula and radiological findings, where a radiolucent lesion can be seen in the periapical area.

It is apparent that IPL has a multifactorial background, mainly caused by the presence of a pre-existing microbial pathology or surgical trauma during implant surgery.

To date, there are no clinical protocols for managing IPL. This case report presents a case history related to IPL, which was caused by a pre-existing lesion. For the treatment of the infected form of IPL, a sequential surgical therapy can be utilized, if there is no loss of the implant stability.

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Surgical Apgar Score, Predictor of Post-Emergency Abdominal Surgery Outcome

The surgical team always tries to provide consistently low incidence of major complications for patient undergoing any operation.

Recognizing patients at high risk of developing a complication will contribute substantially to quality of operation and of cost reduction in surgery. In operating room, surgical apgar score (SAS) has helped surgeons for objective assessment of the operative course for postoperative prognostication instead of their "gut- feeling".

Here we prospectively evaluated postoperative complications according to SAS. This was a hospital based, single centre longitudinal prospective observational study from October 2014 to March 2015 including 66 patients.

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Problems and Possibilities in Tissue Engineering

Organ and tissue transplantation in developed countries is in steady increase. We are living in fast changing world with path-breaking technological advancements as a norm of the day.

Development of the field of organ and tissue transplantation has accelerated remarkably since the human major histocompatibility complex (MHC) was discovered.

The major histocompatibility complex (MHC) contains a set of cell surface molecules responsible for binding peptide fragments derived from pathogens and display them on the cell surface for recognition by the appropriate T cells.

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Commentary: Current Status and Future of Corneal Xenotransplantation

Corneal transplantation is the treatment of choice for late stage of corneal decompensation.

According to “Cost-benefit analysis of corneal transplant”, which has been prepared by Eye Bank Association of America (EBAA) and reported by the Lewin group in 2013, net lifetime benefit from the transplantation is $118,000, while, the medical cost of the transplant is $16,500.

However, corneal donation does not meet the demand for corneal transplantation in developing countries and the number of the eligible cornea will be reduced in the future aged societies of the developed countries

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Pilon Fractures of Middle Phalanx Managed with Lag Screw and Early Mobilisation

Proximal interphalangeal (PIP) joint injuries are commonly seen in athletes and especially the pilon fractures are quite common due to axial loading injuries.

It is associated with volar lip fragment with dorsal subluxation of middle phalanx with varying degree of comminution of the base of middle phalanx.

Varied treatment options have been described ranging from extension block splint, external frame finger distraction and open reduction internal fixatio. The key is in restoring the joint congruity with early controlled mobilisation thereby preventing joint stiffness or deformity.

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Surgical Treatment of Transplant Renal Artery Aneurysm: Case Report and Review of Literature

Authors report a case of transplant renal artery aneurysm. The aneurysm developed within three months of living unrelated kidney transplantation surgery.

The aneurysm involved origin of the transplant renal artery proximally and extended up to its bifurcation. The aneurysm was not amenable to endovascular corrective approach.

Surgical resection of the aneurysm was carried out; renal arteries were repaired and re-anastomosed with the right iliac artery. Allograft function recovered after a brief period of acute kidney injury.

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A Short Communication on the Need for Interdisciplinary Action with Families with Deaf Children Who Use Bilateral Cochlear Implants

Bilateral Cochlear Implantation (BCI), both simultaneous and short interval sequenced, is a widely advantageous and valuable resource with respect to unilateral cochlear implantation and long interval bilateral sequenced cochlear implantation,  generating new concerns for families with deaf children.

Lammers et al.Recently found more statistically significant results regarding the perception of sound and the expressive linguistic development of children with Simultaneous Cochlear Implantation (SCI) compared to those with sequential bilateral cochlear implantation after 1 year of hearing experience with the devices.

Moreover, the available data show that there is no proliferation in the risks associated to SCI, assuming that only one surgical, hospital episode was recorded.In this sense, relevant advances over BCI in deaf children are evident.

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Preventable Urological Complications Post Kidney Transplant with Modified Lich-Gregoir Technique

Various ureteroneocystostomy techniques for kidney transplant have been described with Lich-Gregoir (LG) being widely employed. However, even with multiple modifications on this technique, urine leakage and ureteric stenosis remain as most common complications. This study aims to evaluate urological complications by using our modified LG technique after kidney transplant.

From 26th January 2010 to 30th May 2014, 206 consecutive kidney transplants were performed at our institute. 124 were deceased-donor and 69 were live-donor kidney transplants; 13 patients received a small tumour excised kidney graft.

All transplants except one were done by conventional open surgery. The modification involves an additional stitch placed at proximal part of bladder muscular incision with peri ureteric tissue at the entrance of ureter to bladder. Urological complications were defined as urine leakage or ureteral stricture. The patients were followed-up from 12 to 64 months.

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Non Confluent Pulmonary Arteries with Bilateral Patent Ductus Arteriosus: Unifocalization and Concomitant Bilateral Bidirectional Glenn Procedure

Patent ductus arteriosus (PDA) is a common congenital cardiac lesion usually encountered one side. Rarely both left and right aortic arches may persist giving rise to bilateral PDA.

Embryologically the distal pulmonary arteries arise from respective lung buds, which join the proximal portion of the sixth aortic arch while the main pulmonary artery is derived from pulmonary arterial portion of truncoaortic sac.

We recently encountered a patient with bilateral PDA along with non -confluent pulmonary arteries. This patient also had a double outlet right ventricle (DORV), pulmonary atresia, right aortic arch and bilateral superior vena cavae (SVC), further adding to its rarity.

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A Rare Case of Renal Cell Carcinoma in Left Renal Ectopia with Cervical Spine Metastasis Presented as Quadriparesis

Renal Cell Carcinoma (RCC) is the most common solid tumor affecting adults, accounting 2% of the cancers worldwide.

The incidence of renal cell carcinoma in a pelvic kidney which represents the most common form of ectopic kidney is extremely rare.

We describe a case where an incidental pelvic kidney with a large sized renal cell carcinoma was diagnosed when a patient presented with cervical spondylitis myelopathy due to cervical metastasis.

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Postoperative Biological and Physiological Gastrointestinal Changes after Whipple Procedure

In the last years there was an increased interest towards the pancreatic cancer, especially considering its growing incidence (rapidly becoming the fifth cause of death by cancer in the developed countries), lack of any sustainable markers and/or risk factors and the chilling fact that almost 95% of the patients with this disorder are presenting to the hospital in the advanced and unresectable stages.

Even more, although known and developed for almost 70 years, the surgical approach for the pancreatic cancer is a subject of debate because its efficacy and postoperative biological changes.

It is known that the most common surgery in chronic pancreatitis and pancreatic cancer is represented by the Whipple pancreatico duodenectomy.

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Life-threatening Capillary Leak Syndrome in an Adult with Refractory Acute Myeloid Leukemia during Allogeneic Transplantation: a Case Report and Review of Literature

Although allogeneic hematopoietic stem cell transplantation (allo-HSCT) offers the possibility of cure for hematological malignancies, various complications have been described.

Capillary leak syndrome (CLS) has been previously observed in HSCT patients. CLS is a rare disease characterized by recurrent episodes of generalized edema and severe hypotension along with hypoproteinemia.

A 27-year-old Chinese man, diagnosed with refractory acute myeloid leukemia, was treated with a haploidentical stem cell transplant combined with an unrelated umbilical cord blood unit. The patient developed fatal CLS during the 9th day of the conditioning therapy.

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