Pub Date : 2023-05-12DOI: 10.33597/2766-8304-v4-id1071
Kory M Ford, Joseph A Buckwalter V, Ignacio Garcia Fleury
Background: Chronic, complete ruptures of the distal biceps tendon are often difficult to surgically repair due to significant fibrosis and retraction. The use of a graft is recommended, with recent literature suggesting that an Achilles tendon allograft leads to superior clinical outcomes. The purpose of this study is to present the surgical technique and retrospectively review the clinical outcomes of a distal biceps reconstruction technique that utilizes an Achilles tendon allograft with an Endobutton bicortical fixation system through a single S-shaped incision. Methods: Seven male patients and eight cases of distal biceps reconstruction with Achilles tendon allograft were identified between January 2017 and March 2022. The mean age was 48.3 ± 8.9 years with a mean time from initial injury to surgery of 6.1 ± 3.8 months. Charts were retrospectively reviewed for patient demographics, procedural technique, preoperative and postoperative evaluation, and complications. Results: The cohort had a mean follow-up of 4.6 ± 2.0 months (range, 1.4-8.2). At the final office visit, full range of motion had returned for all patients except one, who had a persistent 10° extension deficit. Flexion strength had returned to equal preoperative and preinjury gross strength out of 5 (4.7 ± 0.5 preoperatively vs. 4.4 ± 0.5 postoperatively) and supination improved from preoperative strength (2.2 ± 1.1 preoperatively vs. 3.6 ± 1.2 postoperatively). Four out of eight cases resulted in a new neuropraxia identified in postoperative care: two lateral antebrachial cutaneous nerves, one superficial branch of radial nerve, and one ulnar nerve, with insufficient follow-up duration to determine resolution. One patient reported excessive scar formation; otherwise, there were no major complications. Conclusion: Reconstruction of the distal biceps tendon using an Achilles tendon allograft is a technically challenging, yet effective approach for the treatment of complete distal biceps tendon ruptures that are chronic in nature, resulting in an improvement in preoperative disability with few postoperative complications.
{"title":"Distal Biceps Tendon Reconstruction with Achilles Tendon Allograft: A Case-Series","authors":"Kory M Ford, Joseph A Buckwalter V, Ignacio Garcia Fleury","doi":"10.33597/2766-8304-v4-id1071","DOIUrl":"https://doi.org/10.33597/2766-8304-v4-id1071","url":null,"abstract":"Background: Chronic, complete ruptures of the distal biceps tendon are often difficult to surgically repair due to significant fibrosis and retraction. The use of a graft is recommended, with recent literature suggesting that an Achilles tendon allograft leads to superior clinical outcomes. The purpose of this study is to present the surgical technique and retrospectively review the clinical outcomes of a distal biceps reconstruction technique that utilizes an Achilles tendon allograft with an Endobutton bicortical fixation system through a single S-shaped incision. Methods: Seven male patients and eight cases of distal biceps reconstruction with Achilles tendon allograft were identified between January 2017 and March 2022. The mean age was 48.3 ± 8.9 years with a mean time from initial injury to surgery of 6.1 ± 3.8 months. Charts were retrospectively reviewed for patient demographics, procedural technique, preoperative and postoperative evaluation, and complications. Results: The cohort had a mean follow-up of 4.6 ± 2.0 months (range, 1.4-8.2). At the final office visit, full range of motion had returned for all patients except one, who had a persistent 10° extension deficit. Flexion strength had returned to equal preoperative and preinjury gross strength out of 5 (4.7 ± 0.5 preoperatively vs. 4.4 ± 0.5 postoperatively) and supination improved from preoperative strength (2.2 ± 1.1 preoperatively vs. 3.6 ± 1.2 postoperatively). Four out of eight cases resulted in a new neuropraxia identified in postoperative care: two lateral antebrachial cutaneous nerves, one superficial branch of radial nerve, and one ulnar nerve, with insufficient follow-up duration to determine resolution. One patient reported excessive scar formation; otherwise, there were no major complications. Conclusion: Reconstruction of the distal biceps tendon using an Achilles tendon allograft is a technically challenging, yet effective approach for the treatment of complete distal biceps tendon ruptures that are chronic in nature, resulting in an improvement in preoperative disability with few postoperative complications.","PeriodicalId":7649,"journal":{"name":"American Journal of Surgery and Clinical Case Reports","volume":"97 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135383126","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}
Schizophrenia patients often present with neurological signs such as left/right confusion, impaired coordination of movements, and motor abnormalities may occur secondary to antipsychotic medications. Neuropsychological tests identify various dysfunctions, such as difficulty in focusing attention, difficulty in abstract thinking or difficulty in changing the response frame, while Neurophysiological tests show slowing down of reaction time, problems with eye tracking, etc. There are no studies in the international literature dealing with the investigation of mental imagery of movement in Greek patients with schizophrenia. Also, the position that patients with schizophrenia – regardless of their symptom profile, age, sex, and chronicity of the disease – have a permanent difficulty in creating and manipulating an internal model of their movement prediction, has not been substantiated enough to date. Aim: In the present study we examine the function of visual-motor coordination and the time to achieve the goal-directed movement of the dominant hand of patients with schizophrenia Method: The sample we used in our research consisted of patients with diagnosed schizophrenia and healthy individuals. Schizophrenia patients belonged to the experimental group and healthy subjects to the control group. The number of examined patients was 39 and the healthy 51. the assessment of the movement and its mental representation was carried out with the real and mental movement of the dominant hand between two square targets located at a distance of 20 cm, on white paper of A4 size. Conclusions: Visuomotor coordination of a specific hand movement differs between patients with schizophrenia and the normal population. In particular, the means of the goal-directed hand movement achievement time in the actual execution condition and in the mental execution condition of the patients were significantly higher than the corresponding times of the standard population.
{"title":"Assessment of Mental Imagery of Movement in Schizophrenia","authors":"Savvidis George, Sofologi Maria, Hanopoulou Margarita, Tsagaridis Konstantinos, Karakatsoulis Grigoris, Fountoulakis Konstantinos, Nimatoudis Ioannis, Papaxanthis Charalampos","doi":"10.58489/2837-3332/004","DOIUrl":"https://doi.org/10.58489/2837-3332/004","url":null,"abstract":"Schizophrenia patients often present with neurological signs such as left/right confusion, impaired coordination of movements, and motor abnormalities may occur secondary to antipsychotic medications. Neuropsychological tests identify various dysfunctions, such as difficulty in focusing attention, difficulty in abstract thinking or difficulty in changing the response frame, while Neurophysiological tests show slowing down of reaction time, problems with eye tracking, etc. There are no studies in the international literature dealing with the investigation of mental imagery of movement in Greek patients with schizophrenia. Also, the position that patients with schizophrenia – regardless of their symptom profile, age, sex, and chronicity of the disease – have a permanent difficulty in creating and manipulating an internal model of their movement prediction, has not been substantiated enough to date. Aim: In the present study we examine the function of visual-motor coordination and the time to achieve the goal-directed movement of the dominant hand of patients with schizophrenia Method: The sample we used in our research consisted of patients with diagnosed schizophrenia and healthy individuals. Schizophrenia patients belonged to the experimental group and healthy subjects to the control group. The number of examined patients was 39 and the healthy 51. the assessment of the movement and its mental representation was carried out with the real and mental movement of the dominant hand between two square targets located at a distance of 20 cm, on white paper of A4 size. Conclusions: Visuomotor coordination of a specific hand movement differs between patients with schizophrenia and the normal population. In particular, the means of the goal-directed hand movement achievement time in the actual execution condition and in the mental execution condition of the patients were significantly higher than the corresponding times of the standard population.","PeriodicalId":7649,"journal":{"name":"American Journal of Surgery and Clinical Case Reports","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82942514","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}
A recent breakthrough innovation on pondering cases on xx-xy male female system aberrations emerged which have been getting applied for betterments in diverse directions of life course advancements. The present study was devoted on making social legacies survive forever, which flourished and then vanished creating its disappearances.
{"title":"Innovative advances overcoming xx-xy male female system theory aberrations keeping social legacies survive forever","authors":"","doi":"10.58489/2837-3332/003","DOIUrl":"https://doi.org/10.58489/2837-3332/003","url":null,"abstract":"A recent breakthrough innovation on pondering cases on xx-xy male female system aberrations emerged which have been getting applied for betterments in diverse directions of life course advancements. The present study was devoted on making social legacies survive forever, which flourished and then vanished creating its disappearances.","PeriodicalId":7649,"journal":{"name":"American Journal of Surgery and Clinical Case Reports","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83754052","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}
Background: the analysis in adolescent’s smokers as prevention from the medical sciences is one of the lines of the work team in the consultation of ceasing tobacco. Objective: to analyze the psychosocial intervention to prevent the tobacco in patients with Diabetes Mellitus.The investigation embraced one period from October 2018 to September 2019. Method: was carried out a study decriptive, restrospective, for sampling intentional non probabilistic and with an universe composed by 18 old adolescents of the Policlinic "José Ramón León Acosta. It gathers it of the data was carried out through the empiric method as the clinical histories, interviews structured, the questionnaire and for the analysis of the data the statistical calculation was used. Results: the state of individual health of this group prevailed as for knowledge that will allow them to modify its lifestyle and in turn an aging very happened to the minimum of limitations. Conclusion: the difficulties are focused in the sistematic of the development psicosocial and to prevent risk factors in adolescentes with addiction.
{"title":"Psychosocial Intervention to Prevent the Tobacco in Patients with Diabetes Mellitus","authors":"Mercedes Fusté Bruzaín","doi":"10.58489/2837-3332/001","DOIUrl":"https://doi.org/10.58489/2837-3332/001","url":null,"abstract":"Background: the analysis in adolescent’s smokers as prevention from the medical sciences is one of the lines of the work team in the consultation of ceasing tobacco. Objective: to analyze the psychosocial intervention to prevent the tobacco in patients with Diabetes Mellitus.The investigation embraced one period from October 2018 to September 2019. Method: was carried out a study decriptive, restrospective, for sampling intentional non probabilistic and with an universe composed by 18 old adolescents of the Policlinic \"José Ramón León Acosta. It gathers it of the data was carried out through the empiric method as the clinical histories, interviews structured, the questionnaire and for the analysis of the data the statistical calculation was used. Results: the state of individual health of this group prevailed as for knowledge that will allow them to modify its lifestyle and in turn an aging very happened to the minimum of limitations. Conclusion: the difficulties are focused in the sistematic of the development psicosocial and to prevent risk factors in adolescentes with addiction.","PeriodicalId":7649,"journal":{"name":"American Journal of Surgery and Clinical Case Reports","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76944705","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}
Pub Date : 2023-01-31DOI: 10.33597/2766-5844-v4-id1074
Bele Dan-Nicolae
Abstract Objectives: Colorectal cancer is the third most diagnosed cancer worldwide and the second most common cause of cancer death. If diagnosed at an early stage, however, it is one of the most curable malignancies. Patients with biopsy-proven adenocarcinoma of the colon without evidence of distant metastasis, and without contraindications to major surgery, are commonly treated with surgical resection. Methods and results: A 49-year-old male patient without any significant history is admitted at Surgery 5 Service, Cluj-Napoca for abdominal pain, diarrhoea, and important weight loss in the last 7 months. CT showed thickening of the sigmoid colon as well as bladder and small bowel invasion. The final diagnosis was completed by a colonoscopy and biopsy which was of stenotic sigmoid tumour, chemo treated. Unfortunately, the chemotherapy was unsuccessful, as the tumour did not regress. A multidisciplinary team was gathered debating the possibility of pelvic exenteration. As of surgical treatment, the following were performed: Sigmoidectomy with manual colo-rectal T-T anastomosis and central lymphadenectomy, ileal segmental resection with manual T-T anastomosis, resection of 2/3 of bladder, jejunostomy, evacuation of bladder abscess and the introduction of a double J ureteral stent. Consecutive to all procedures, the patient is in good health and can live a normal life. Conclusion: Even though surgery is curative in most cases of colorectal cancer, the survival rate of unoperated colorectal cancer is 0%. Thus, it is of utmost importance to diagnose colorectal cancer as soon as possible. Identification of populations at risk and screening of asymptomatic patients are therefore crucial imperatives.
{"title":"The Value of Colon Cancer Screening in Developing Countries","authors":"Bele Dan-Nicolae","doi":"10.33597/2766-5844-v4-id1074","DOIUrl":"https://doi.org/10.33597/2766-5844-v4-id1074","url":null,"abstract":"Abstract Objectives: Colorectal cancer is the third most diagnosed cancer worldwide and the second most common cause of cancer death. If diagnosed at an early stage, however, it is one of the most curable malignancies. Patients with biopsy-proven adenocarcinoma of the colon without evidence of distant metastasis, and without contraindications to major surgery, are commonly treated with surgical resection. Methods and results: A 49-year-old male patient without any significant history is admitted at Surgery 5 Service, Cluj-Napoca for abdominal pain, diarrhoea, and important weight loss in the last 7 months. CT showed thickening of the sigmoid colon as well as bladder and small bowel invasion. The final diagnosis was completed by a colonoscopy and biopsy which was of stenotic sigmoid tumour, chemo treated. Unfortunately, the chemotherapy was unsuccessful, as the tumour did not regress. A multidisciplinary team was gathered debating the possibility of pelvic exenteration. As of surgical treatment, the following were performed: Sigmoidectomy with manual colo-rectal T-T anastomosis and central lymphadenectomy, ileal segmental resection with manual T-T anastomosis, resection of 2/3 of bladder, jejunostomy, evacuation of bladder abscess and the introduction of a double J ureteral stent. Consecutive to all procedures, the patient is in good health and can live a normal life. Conclusion: Even though surgery is curative in most cases of colorectal cancer, the survival rate of unoperated colorectal cancer is 0%. Thus, it is of utmost importance to diagnose colorectal cancer as soon as possible. Identification of populations at risk and screening of asymptomatic patients are therefore crucial imperatives.","PeriodicalId":7649,"journal":{"name":"American Journal of Surgery and Clinical Case Reports","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81579700","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}
Pub Date : 2023-01-31DOI: 10.33597/2766-5844-v4-id1073
Balosin Marina-Georgia
Abstract Objectives: Partial or total necrosis of the bowel is a frequent cause of obstruction of the mesenteric artery or vein. Mesenteric infarction is usually the consequence of other associated pathologies of the patient and most often revealed by acute intestinal obstruction. Thus, it is of utmost importance to recognize the risk factors and treat all conditions that might have a link with a hypercoagulability state. Acute mesenteric ischemia is pathology difficult to treat due to the nonspecific symptomatology and late diagnosis consequently. Moreover, the majority the patients have other comorbidities resulting a mortality in over 50% of the cases. Methods and results: Identified risk factors in our patient’s case for the thrombus formations were oral contraceptive medication, hypertension, and obesity. Other secondary causes of Superior Mesenteric Vein (SMV) and Portal Vein (PV) thrombosis were investigated but all tests were negative leading to the incrimination of obesity and chronic use of oral contraceptives for over two decades. Conclusion: Rare, life-threatening complications of associated pathologies such as venous mesenteric thrombosis and bowel obstruction are unanticipated. Thus, it is of utmost importance to diagnose complications and risk factors as soon as possible whose resolutions will make it possible to prolong survival of many patients. Identification of populations at risk and screening of asymptomatic patients are therefore crucial imperatives.
{"title":"Link between Two Decades of Oral Contraceptives and Bowel Infarction: A Case Report","authors":"Balosin Marina-Georgia","doi":"10.33597/2766-5844-v4-id1073","DOIUrl":"https://doi.org/10.33597/2766-5844-v4-id1073","url":null,"abstract":"Abstract Objectives: Partial or total necrosis of the bowel is a frequent cause of obstruction of the mesenteric artery or vein. Mesenteric infarction is usually the consequence of other associated pathologies of the patient and most often revealed by acute intestinal obstruction. Thus, it is of utmost importance to recognize the risk factors and treat all conditions that might have a link with a hypercoagulability state. Acute mesenteric ischemia is pathology difficult to treat due to the nonspecific symptomatology and late diagnosis consequently. Moreover, the majority the patients have other comorbidities resulting a mortality in over 50% of the cases. Methods and results: Identified risk factors in our patient’s case for the thrombus formations were oral contraceptive medication, hypertension, and obesity. Other secondary causes of Superior Mesenteric Vein (SMV) and Portal Vein (PV) thrombosis were investigated but all tests were negative leading to the incrimination of obesity and chronic use of oral contraceptives for over two decades. Conclusion: Rare, life-threatening complications of associated pathologies such as venous mesenteric thrombosis and bowel obstruction are unanticipated. Thus, it is of utmost importance to diagnose complications and risk factors as soon as possible whose resolutions will make it possible to prolong survival of many patients. Identification of populations at risk and screening of asymptomatic patients are therefore crucial imperatives.","PeriodicalId":7649,"journal":{"name":"American Journal of Surgery and Clinical Case Reports","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89058223","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}
Pub Date : 2023-01-01DOI: 10.47829/ajsccr.2023.61002
Serrano-Méndez P, Perez-Chrzanowska H
{"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}
Pub Date : 2023-01-01DOI: 10.47829/ajsccr.2023.6602
C. J, Florenly, L. C
{"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}
Pub Date : 2023-01-01DOI: 10.47829/ajsccr.2023.61218
Young Ar, Amin A, Ram B, Sham S, Monika SA, Paterson J
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.
{"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}
Pub Date : 2023-01-01DOI: 10.47829/ajsccr.2022.6462
None Hasan F
{"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}
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