RESUMEN
An increase in plasma calcitonin concentration is widely regarded as a specific and sensitive indication of underlying medullary thyroid carcinoma (MTC). We present a case in which the association of increased plasma calcitonin concentration and a thyroid nodule was not due to MTC. Subsequent measurement of plasma calcitonin by a variety of methods highlighted the variability that exists in calcitonin measurement and the potential for clinically misleading results. The rationale for investigation and treatment of MTC, including a recommendation to screen all patients with thyroid nodules using plasma calcitonin measurement, is based on the use of specific two-site calcitonin assays which are not universally used in the UK or USA.
Asunto(s)
Calcitonina/sangre , Neoplasias de la Tiroides/sangre , Nódulo Tiroideo/sangre , Biomarcadores/sangre , Femenino , Humanos , Persona de Mediana Edad , Radioinmunoensayo , Valores de Referencia , Neoplasias de la Tiroides/cirugía , Nódulo Tiroideo/cirugíaRESUMEN
We report the first documented case of intralesional interferon administration for the palliation of carcinoid tumour metastases. This was performed under ultrasound guidance and gave a good clinical response, which correlated with tumour necrosis demonstrated by serial CT scanning.
Asunto(s)
Antineoplásicos/uso terapéutico , Neoplasias de la Mama/patología , Tumor Carcinoide/tratamiento farmacológico , Tumor Carcinoide/secundario , Interferones/uso terapéutico , Neoplasias Hepáticas/tratamiento farmacológico , Neoplasias Hepáticas/secundario , Anciano , Antineoplásicos/administración & dosificación , Femenino , Humanos , Inyecciones Intralesiones , Interferones/administración & dosificaciónRESUMEN
A patient with recurrent medullary thyroid cancer in the neck in whom previous surgery for recurrence had been undertaken with only partial success had the diseased tissue localized preoperatively by indium-111 pentetreotide. Scanning with technetium-99m V dimercaptosuccinic acid and iodine-123 metaiodobenzylguanidine failed to localize the tumor. Utilization of a nuclear surgical probe after preoperative 111In pentetreotide allowed accurate surgical localization of the tumour tissue.
Asunto(s)
Carcinoma Medular/diagnóstico por imagen , Carcinoma Medular/cirugía , Radioisótopos de Indio , Recurrencia Local de Neoplasia/diagnóstico por imagen , Recurrencia Local de Neoplasia/cirugía , Somatostatina/análogos & derivados , Neoplasias de la Tiroides/diagnóstico por imagen , Neoplasias de la Tiroides/cirugía , Adulto , Humanos , Cuidados Intraoperatorios , Masculino , CintigrafíaAsunto(s)
Neoplasias de la Mama/terapia , Marcapaso Artificial , Adulto , Anciano , Terapia Combinada , Femenino , HumanosRESUMEN
A series of 18 consecutive patients who underwent primary resection and immediate anastomosis as the treatment for malignant left-sided large bowel obstruction are presented. Intraoperative mechanical preparation of the colon was omitted. There was no clinical evidence of anastomotic dehiscence or wound infection. The mean duration of hospital stay was 11 days. It is suggested that colonic continuity can be restored immediately and safely without mechanical bowel preparation, providing attention is directed to constructing an anastomosis that has a good blood supply and is free from tension.
Asunto(s)
Colectomía/métodos , Enfermedades del Colon/cirugía , Neoplasias del Colon/cirugía , Obstrucción Intestinal/cirugía , Anciano , Anciano de 80 o más Años , Anastomosis Quirúrgica , Enfermedades del Colon/etiología , Neoplasias del Colon/complicaciones , Humanos , Obstrucción Intestinal/etiología , Persona de Mediana Edad , Factores de TiempoRESUMEN
Major infections of Dacron aortic grafts involving the proximal anastomosis or the whole graft are rare but lethal. Traditional surgical treatment involves radical excision of the graft and extra-anatomic revascularisation of the lower limbs, and carries a forbidding mortality and complication rate. This paper describes an alternative conservative approach used on four patients, three of whom appear to have been successfully treated by continuous antibiotic irrigation of the prosthesis without removal of the graft, whilst the fourth died 42 months later of recurrent graft infection. This is the first time that prolonged survival has been reported following conservative treatment of major graft infection. The authors believe this method may offer substantial advantages over the traditional surgical treatment for this dreaded complication of aortic surgery.
Asunto(s)
Antibacterianos , Enfermedades de la Aorta/tratamiento farmacológico , Prótesis Vascular , Quimioterapia Combinada/uso terapéutico , Infección de la Herida Quirúrgica/tratamiento farmacológico , Anciano , Aorta Abdominal , Infecciones por Escherichia coli/tratamiento farmacológico , Humanos , Masculino , Persona de Mediana Edad , Infecciones por Proteus/tratamiento farmacológico , Irrigación TerapéuticaRESUMEN
This is a study of the use of myocutaneous flaps by general surgeons in a district general hospital over a 5 year period, and shows that such work can be satisfactorily performed by general surgeons.
Asunto(s)
Colgajos Quirúrgicos , Adulto , Anciano , Anciano de 80 o más Años , Mama/cirugía , Neoplasias de la Mama/cirugía , Carcinoma/cirugía , Estudios de Evaluación como Asunto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/cirugía , Úlcera por Presión/cirugía , Reoperación , Estudios Retrospectivos , Colgajos Quirúrgicos/efectos adversos , Fístula Traqueoesofágica/cirugíaRESUMEN
We present the technique and our results in using a plug of Prolene mesh to repair femoral hernias. By filling the femoral canal with a Prolene plug we achieved a sound hernia repair. Our results allow us to recommend the technique to others.
Asunto(s)
Hernia Femoral/cirugía , Plásticos , Polipropilenos , Prótesis e Implantes , Mallas Quirúrgicas , Femenino , Humanos , MasculinoAsunto(s)
Parálisis Facial/etiología , Neoplasias de la Parótida/complicaciones , Adulto , Anciano , Femenino , Humanos , MasculinoAsunto(s)
Hernia Inguinal/cirugía , Educación del Paciente como Asunto , Grabación en Cinta , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
A double blind trial is described comparing two methods of bowel preparation prior to barium enema. In 40 randomly selected patients a significant improvement was obtained by the use of an intestinal perfusion method.