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We present an overview of the epidemiology and differential diagnosis of Marcus Gunn jaw-winking syndrome. We scrutinize various hypotheses regarding its etiology and pathogenesis, encompassing abnormal nerve connections, heredity factors, genetic variation, and the release hypothesis, as proposed in prior studies. Furthermore, we discuss the clinical manifestations of Marcus Gunn jaw-winking syndrome and highlight cases with exceptional clinical presentations or concurrent diseases. Moreover, we not only describe the existing surgical and nonsurgical treatments for Marcus Gunn jaw-winking syndrome but also delineate therapies for related conditions such as Meige syndrome, sequelae of facial paralysis, and other oculopalpebral and facial synkinesis. This comprehensive approach serves as a valuable reference for the holistic management of Marcus Gunn jaw-winking syndrome. [ABSTRACT FROM AUTHOR]

Copyright of Médicas UIS is the property of Universidad Industrial de Santander and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This is a presentation of 10 unusual cases of hydatid cyst beyond the pulmonary sieve. One of these cases has not been described previously. Some comments and a discussion are included.

Two cases of antiperistaltic bowel segment in the treatment of the short bowel syndrome are presented here. We think that this is the best procedure for the treatment of this syndrome. The length of the reversed segment should be 9 cm.

Three consecutive groups of 50 obstetric patients received spinal anaesthesia. The control group received no prophylactic treatment for spinal headache, the second group were treated by the epidural injection of 20-25 ml of normal saline and the third group were treated by abdominal binder. There was no statistically significant difference between the two forms of treatment but the results show that the incidence of post spinal puncture headache can be significantly reduced by applying either of them.

The wife of a vasectomized man became pregnant by her husband. He was examined and a supernumerary testis with intact vas and with normal histology and normal spermatogenesis were discovered.

Spontaneous return of function after surgical excision of the seventh cranial nerve in surgery of parotid tumors is not impossible. This seems to occur through the several existing neural pathways between the fifth and seventh cranial nerves. It is probable that voluntary motor impulses by reeducation find their way from the cortex through the fifth cranial nerve to the respective muscles.

A patient with rheumatic heart disease developed right renal artery embolism and was treated by renal artery embolectomy. After a brief historical data, etiologic factors, clinicopathologic points, and treatment of the disease have been discussed.

This brief historical data of a patient dying of severe hematemesis as a result of broncho-esophago-aortal fistula in primary pulmonary cavitating carcinoma is presented. It indicates that the elastic wall of the arteries even that of the aorta, is not a barrier to the penetration of the malignant cells. The neoplasm was in an advanced stage with gross vascular involvement but distant metastases did not occur even in microscopic examination. Liomyoma of the uterus was associated with lung carcinoma.

We present 2 Iranian children, siblings, with the very rare but classical 'lobster-claw' deformities of hands and feet. We could not trace any hereditary influences.

The authors present a patient who has ascarid-containing jejunum herniated through the foramen of Winslow and incarcerated. Some remarkable anatomic abnormalities were noticed upon operation. These consisted of a short ascending colon, an unusually large foramen of Winslow, and smallness of the greater omentum. Before reduction, resection of the herniated and incarcerated segment of jejunum were performed. Barium enema and swallow are valuable diagnostic acids, as well as the plain film of the abdomen, but we prefer gastrographin study. With it the dangers of perforation and peritonitis are avoided.

The case of a woman who had had a perianal sinus tract for nine years, in whom squamous-cell carcinoma arose in the sinus tract, is presented. We believe that long-standing perianal sinus tracts should be examined carefully for tumor development. In suspected cases, a biopsy specimen should be obtained from the central part of the lesion.

An 8-year-old deaf-mute girl experienced syncopal attacks. Past medical history revealed cardiac arrhythmia which had developed following an abdominal surgery for a twisted ovarian cyst. Electrocardiogram showed a Q-Tc interval of 40/100 second. The diagnosis was Jervell and Lange-Nielsen syndrome. Etiology, physiopathology, clinical picture, and management of the disease are discussed.

Background: To investigate the effects of a reversed segment of the distal small intestine to improve weight gain in an experimental short bowel syndrome (SBS) model in piglets.Methods: Twenty-four piglets underwent resection of 70% of the distal small intestine. In half of the animals a conventional anastomosis was performed, and in the other half, the distal 25 cm of the remnant jejunum was reversed before the intestinal continuity was recreated. Weight was measured daily until day 28, where the animals were euthanized. Glucagon-Like Peptide-2 (GLP-2) and Glucose-dependent Insulinotropic Peptide (GIP) was measured pre- and postoperatively at day 28.Results: The group with reversal of small intestine had a significant lower weight gain at 5.26 ± 3.39 kg (mean ± SD) compared to the control group with 11.14 ± 3.83 kg (p < 0.05). In the control group greater villus height and crypt depth was found distally, and greater muscular thickness was found proximally in the intervention group. GLP-2 and GIP levels increased significantly in the control group.Conclusions: Treatment of short bowel syndrome with a reversed jejunal segment of 25 cm had a detrimental effect on the weight gain. [ABSTRACT FROM AUTHOR]

An abdominal binder could be used effectively in a patient showing CSF leakage in the coccygeal area with post‐dural puncture headache, which is not controlled by conventional compressive dressing. [ABSTRACT FROM AUTHOR]

Introduction: Short bowel syndrome represents the leading etiology that causes intestinal failure both in children and adults. Total parenteral nutrition support has dramatically improved the prognosis for these patients but, if related irreversible complications occur, the alternative is represented by surgery and/or transplantation. Areas covered: Autologous gastrointestinal reconstructive procedures are a feasible, alternative approach with good long-term outcome data inexperienced surgical centers. Expert opinion: Ongoing innovative efforts have driven the surgical options for successful autologous reconstructive surgery: bowel elongation/tapering techniques (LILT, STEP, and the new SILT) together with the 'reversed bowel segment' procedure are now recognized procedures and all must be tailored to the individual patient needs to obtain the optimal result in terms of enteral autonomy. Background laboratory experimentation with new procedures e.g. options for bowel dilation techniques and distraction-induced enterogenesis, may provide additional management and treatment modalities. [ABSTRACT FROM AUTHOR]

Background: The female rectovaginal septum may become involved by a variety of mass-like lesions, which may be challenging to providers who treat women. Objectives: To review the scope of lesions affecting the rectovaginal septum. Methods: A literature review was conducted. A Medline search was used, using the terms Vaginal diseases, Vaginal neoplasms, Rectal diseases, and Rectal neoplasms. Results: Reported lesions of the rectovaginal septum were reviewed. Many of these lesions can be mistaken for each other clinically. Conclusions: A review of the scope of rectovaginal lesions is presented to assist in developing a differential diagnosis if a patient with such a lesion is encountered. (J GYNECOL SURG 31:303) [ABSTRACT FROM AUTHOR]

The authors discuss aspects of the absence of testes which feature abnormalities to children with abdominal cryptorchidism. They highlight the types of unilateral anorchidis such as congenital testicular absence and vanishing testis. The authors cite the use of laparoscopy to detect the presence of spermatic blood vessels and anorchidism.

The authors review the literature on massive soft tissue neurofibroma. The methods included a review of 71 reports (PubMed search 1929-2012) with a total of 91 massive soft tissue neurofibroma patients and illustration of clinical and radiological progression of massive soft tissue neurofibroma on a patient with neurofibromatosis type 1. The mean age at initial examination was 21 years. Tumor onset was mostly in childhood years. The commonest affected body segment was the lower extremity (46%), followed by head/neck (30%). Surgical management was pursued in the majority of cases (79%). Bleeding was a common complication (25%). Recurrence was described in 12%; multiple resections cases were described. Malignant transformation occurred in 5%. Although massive soft tissue neurofibroma may be present early in life, massive tumor overgrowth may take years. Predicting disease progression and/or benefit of surgical intervention early in the disease course is challenging. Recurrence and malignant transformation are possible. Massive soft tissue neurofibroma does not respond to chemotherapy or radiotherapy and is associated with life-threatening surgical complications. [ABSTRACT FROM AUTHOR]

The zoonotic infection hydatidosis is caused by the tapeworm cestode, Echinococcus granulosus. Though considered endemic in India where association of humans with sheep and dogs form part of the livelihood, primary skeletal muscle involvement of the disease is an extremely rare event. We report a case of primary paraspinal hydatidosis with extradural extension causing acute paraplegia. Excision of the cyst and decompression of the cord was done along with albendazole therapy. Paraspinal hydatid disease is a rare entity, and in regions where hydatid disease is endemic, it can be involved in the differential diagnosis of acute compressive myelopathy. Although antihelminthic chemotherapy forms the mainstay of the treatment, surgical intervention forms a major part of the management. [ABSTRACT FROM AUTHOR]

Aim Stercoral perforation is a rarely suspected life-threatening condition. Early diagnosis is difficult but essential. A comprehensive systematic review was performed to evaluate its presentation, diagnosis and treatment. Method A systematic review was carried out of Embase, MEDLINE, PubMed and Cochrane databases for all articles published between 1998 and 2011. Only studies describing stercoral perforation were included. Results Twenty-four relevant articles were found including 137 patients (median age = 62 years) with stercoral perforation, of whom 81% had chronic constipation. Stercoral perforation was diagnosed by CT scan in 90% of 31 patients, with the commonest findings being a combination of faecal impaction (84%) and subphrenic (90%) or extraluminal air (61%). The commonest site of perforation was the sigmoid colon (50%) followed by the rectosigmoid junction (24%). The overall mortality was 34%. Conclusion Stercoral perforation should be suspected in elderly and chronically constipated patients with unexplained abdominal pain and investigated appropriately with a CT scan to allow timely and optimal treatment. [ABSTRACT FROM AUTHOR]

Copyright of Anaesthesist is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Central neuraxial block is an extensively implemented technique in anaesthetic practice. Spinal dural punctures occur deliberately in spinal anaesthesia and inadvertently during attempting epidural blocks. The incidence of disabling headache following dural perforation ranges from 0.3 to 20% in spinal anaesthesia and may be upto 70% after accidental dural puncture in epidural anaesthesia. Decreased CSF volume causing reduced pressure and responsive cerebral venodilation due to CSF leakage are deduced as the prime reasons for this post-dural puncture headache (PDPH). The headache is selflimiting and 88% of it resolves without any interference, if not superimposed by any pre-existing or a de novo complication. Anaesthesiologists have been perpetually active in reducing the incidence. Int’l and regional working groups have advocated the use of fine gauge pencil point needles, delicate bevel orientation techniques, some new drug regimens and various useful and effective measures for the treatment and prevention of PDPH. This review considers some contentious aspects of pathogenesis, treatment and prevention of PDPH and summarises the recommendations incorporated with updated guidelines of American Society of Regional Anesthesia (ASRA) and Society for Obstetric Anesthesia & Perinatology (SOAP) for the management of PDPH. [ABSTRACT FROM AUTHOR]

Copyright of Der Urologe A is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

PURPOSE: Stercoral perforation of the colon is reported to be a rare disease with poor prognosis. The aim of this study was to determine the frequency of stercoral perforation of the colon, to define diagnostic criteria for stercoral perforation of the colon, and to analyze the patient outcome in a university hospital gastrointestinal surgery unit. METHODS: From November 1993 until November 1998 all surgically treated patients with a colorectal disease were prospectively recorded in a computerized database. Diagnosis of stercoral perforation of the colon was made if 1) the colonic perforation was round or ovoid, exceeded 1 cm in diameter, and lay antimesenteric; 2) fecalomas were present within the colon, protruding through the perforation site or lying within the abdominal cavity; and 3) pressure necrosis or ulcer and chronic inflammatory reaction around the perforation site were present microscopically. Any additional colon pathology led to exclusion from the diagnosis of stercoral perforation of the colon. Using the same criteria, 81 cases in the literature were found to qualify and were further analyzed. RESULTS: In a five-year period 1,295 patients underwent colorectal interventions through laparotomy. A total of 566 (44 percent) cases were emergencies, 220 (17 percent) of these caused by colonic perforation. Seven patients had stercoral perforation of the colon. The incidence of stercoral perforation of the colon was 0.5 percent of all surgical colorectal procedures through laparotomy, 1.2 percent of all emergency colorectal procedures, and 32 percent of all colonic perforations. The mean age of the patients was 59 (median, 64; range, 22-85) years. All perforations were situated in the left hemicolon or upper rectum. The round or ovoid perforation had a mean diameter of 3.6 cm. Fecalomas were present in all patients and protruded from the perforation site or were found within the free abdominal cavity in three of them. Generalized stercoral peritonitis was a constant finding. Using a colonic resection without immediate restoration of continuity, an extensive intraoperative lavage, and antibiotics, there was no in-hospital mortality. Analysis of the reports in the literature revealed additionally that 28 percent of patients with stercoral perforation of the colon have multiple stercoral ulcers in the colon and that substantial mortality is encountered if only minor surgical procedures of treatment are used. CONCLUSIONS: The incidence of stercoral perforation of the colon seemed to have been underestimated. The reason for this might be the lack of defined diagnostic criteria for this disease. Low mortality is obtained by early surgical eradication of the affected part of the colon, including all stercoral ulcers, and by aggressive therapy for peritonitis. [ABSTRACT FROM AUTHOR]

Reversal of a distal intestinal loop is a surgical therapy intended to cure rapid intestinal transit in short bowel syndrome. To be active, a reversed loop must present a retrograde propagation of electromyographic patterns and must not be so long as to cause total obstruction. The aim of the current study was to propose methods to calculate the minimal length of the intestinal reversed loop taking into consideration the two previous conditions. Intestinal electromyograms were recorded in 65 rats at short-term (4 days after surgery) and ten rats at long-term (50 days after surgery). Control rats demonstrated that the preprandial regular spiking activity (RSA) of the migrating myoelectrical complex (MMC) extended simultaneously a definite part of the intestine which corresponds to the minimal length to reverse. A similar result can be obtained from a trigonometric representation. Whatever the method, the minimal lengths allowing the recording of RSA decreased along the rat intestine from 6 cm (proximal jejunum) to 4 cm (distal ileum). The experiments demonstrated that shorter loops did not present the preprandial RSA. In conclusion, the minimal reversed length depends on intestinal electromyographic parameters and, thereby, on the intestinal level. [ABSTRACT FROM AUTHOR]

Objective: To study the concept of facial muscle reinnervation from the trigeminal pathway following facial nerve paralysis. Design and Methods: We studied this phenomenon in an animal model using the neuronal marker, horseradish peroxidase (HRP). The temporalis transposition procedure was performed at varying intervals post facial nerve transection. To evaluate the trigeminal-facial reinnervation process and its timing, the zygomaticus major muscle was injected with HRP at varied periods after temporalis transposition, and histologic sections of the brainstem nuclei were examined for the final location of the HRP. Results: The presence of HRP in the trigeminal nucleus provided evidence of trigeminal-facial neurotization in those animals that underwent temporalis transposition up to 2 months following facial denervation and in which the HRP injection was performed 4 months after temporalis transposition. Conclusions: The findings of our pilot study are strongly supportive of the trigeminal-facial neurotization hypothesis in those animals that underwent temporalis transposition up to 2 months post facial denervation and in which 4 months were allowed thereafter for adequate neurite ingrowth and neurotization to occur. This suggests that the neurotrophic signals are greatest up to 2 months post denervation and denotes the optimal time for performance of reconstructive procedures. Future studies with a larger number of animals in each group will be necessary to ensure more potent statistical significance and to augment our experimental evidence that trigeminal-facial crossover does occur and can be used as an adjunctive concept to maximize early rehabilitation of the paralyzed face. [ABSTRACT FROM AUTHOR]

Copyright of Pan African Medical Journal is the property of Pan African Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)