Search

The complex needs of the aerospace industry pushes the capabilities of computational structures technology (CST). The design and testing of Space Station Freedom, for example, requires highly advanced hardware and software programs. CST is being used along with other computational programs to deal with the huge amount of data generated by the finite element analysis of the system.

Pancreatic microadenomas are benign tumors of neuroendocrine origin less than 5 mm in size. Whereas most microadenomas are non-functional; a few rare functional pancreatic microadenomas have been described in the setting of multiple endocrine neoplasia type one (MEN-1). In this report, we describe a unique case of multiple functional microadenomas of the pancreatic head in a patient who presented with persistent secretory diarrhea, refractory hypokalemia, metabolic acidosis and elevated plasma vasoactive intestinal peptide (VIP) levels. Following extensive serologic, radiographic and endoscopic work up, our patient underwent open pancreaticoduodenectomy with subsequent resolution of diarrheal symptoms and electrolyte abnormalities on postoperative follow up. [ABSTRACT FROM AUTHOR]

Objectives: To determine the association between diabetes and the clinical features and treatment outcomes of TB in Kiribati.Methods: We enrolled consecutive patients with TB who presented from August 2010 to February 2012 and compared clinical features and TB treatment outcomes for patients with and without diabetes, as measured by haemoglobin A1c assay. Poor outcome was defined as death, default or treatment failure, and good outcome as treatment success or cure.Results: Two hundred and seventy-five eligible persons with TB disease were enrolled; 101 (37%) had diabetes. TB patients with diabetes were more likely to have acid-fast bacilli (AFB) seen on sputum smear microscopy (RR: 1.3; 95% CI: 1.03-1.62). The risk of poor outcome did not differ between patients with or without diabetes (RR: 1.1; 95% CI: 0.5-2.7).Conclusion: TB patients with diabetes are more likely than those without to have sputum with AFB on microscopy. This could increase transmission in the community. Early detection of TB by screening patients with diabetes, and the converse, could be important public health interventions where diabetes and TB are prevalent. [ABSTRACT FROM AUTHOR]

Background: Laparoscopic antireflux surgery (LARS) has replaced the open approach in most centers and has become the standard surgical treatment of this disease. One of the controversial technical issues is whether to use a bougie or not at the time of wrap. The aim of the study was to evaluate the long-term consequences of LARS in a series of patients without bougie. Methods: An institutional review board–approved study was conducted for patients who underwent LARS between 1998 and 2005. Patients were contacted and an SF-12 form was completed. Their charts were reviewed. Patient characteristics, preoperative evaluation, intraoperative details, and postoperative course were studied. Results: Overall, 135 patients were identified who underwent LARS from 1998 to 2005 with no bougie. Only 123 patients could be contacted for the study. Preoperative work-up included EGD in 100%, manometry in 98%, and 24-hour pH study in 25% of patients. Postoperative dysphagia to solids was seen in 11 of 123 (8.9%) patients. One patient (<1%) had dysphagia to liquids. Five patients (4%) had severe dysphagia. EGD and dilatation was required in 5 of 123 (4%) patients. Ten patients (8.1%) had recurrent reflux requiring medication. Also, 4 of 123 (3.2%) patients had bloating symptoms and 2 of 123 (1.6%) patients had difficulty vomiting. The mean follow-up of patients was 38.6 months. Conclusions: The overall rate of dysphagia in this series following LARS without bougie was 8.9%. Mild to moderate dysphagia was seen in 6 of 123 (4.8%) and 4% patients had severe dysphagia requiring dilatation. Endoscopic dilatation was successful in relieving symptoms in patients with severe dysphagia. The incidence of severe dysphagia reported in the literature is 2–5% and recurrent reflux 5–15%. Rate of dysphagia was comparable to other series reported in the literature, as was the rate of recurrent reflux. Based on our series of patients, LARS without bougie appears to be effective in terms of postoperative dysphagia and recurrent reflux. [ABSTRACT FROM AUTHOR]

Cystic teratomas are rare pluripotent embryonic tumors which most commonly originate in gonadal organs. Extra-gonadal cystic teratomas are exceedingly uncommon, accounting for only 1% of all cystic teratomas, and have been reported in unusual locations including the kidney, mediastinum and liver. These extra-ovarian cystic teratomas have also been known to harbor other neoplasms including carcinoid tumors. In this report, we describe a unique case of a hepatic cystic teratoma occurring as a combined tumor with a carcinoid in a young female. The patient underwent elective laparoscopic resection of her tumor after extensive radiographic and endoscopic work-up for chronic, non-localizable abdominal pain. We believe the carcinoid tumor arose de novo from committed differentiation of a cell line within the teratoma, and not metastatic spread. [ABSTRACT FROM AUTHOR]