In patients with pudendal neuralgia, prior studies have shown efficacy in chronic stimulation with Interstim® (Medtronic, Inc.). This feasibility study reports on the initial experience of using a wireless system to power an implanted lead at the pudendal nerve, StimWave®, to treat pudendal neuralgia.Methods: Retrospective chart review identified patients with a lead placed at the pudendal nerve for neuralgia and powered wirelessly. Clinical outcomes were assessed at Postoperative visits and phone calls. Administered non-validated followup questionnaire evaluated the Global Response Assessment, percentage of pain improvement, satisfaction with device, and initial and current settings of the device (h/day of stimulation). Results: Thirteen patients had the StimWave® lead placed at the pudendal nerve, 12 (92%) female and 1 (7.6%) male. Mean age was 50 years (range: 20-58). Failed prior therapies include medical therapy (100%), pelvic floor physical therapy (92%), pudendal nerve blocks (85%), pelvic floor muscle trigger point injections (69%), neuromodulation (30.7%), or surgeries for urogenital pain (23.1%). After the trial period, 10/13 (76.9%) had >50% improvement in pain with 6/13 (46.1%) reporting 100% pain improvement. Nine underwent permanent lead placement. At last postoperative visit (range, 6-83 days), 5/9 patients reported >50% pain improvement. Seven patients reached for phone calls (22-759 days) reported symptoms to be "markedly improved" (n = 2), "moderately improved" (n = 4), or "slightly improved" (n = 1). At follow up, complications included lead migration (n = 2), broken wire (n = 1), or nonfunctioning antenna (n = 2). Conclusion:Complex patients with pudendal neuralgia may benefit from pudendal nerve stimulation via StimWave®.

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Fissures of the lung separate bronchopulmonary segments to form detachment planes for distention upon respiration and localization of pulmonary lesions. Knowledge of variations in lung fissures is necessary for locating lobes of the lung to exactly interpret radiographs, computed tomography scans, and thorough planning of surgical procedures. 24 pairs of lungs obtained from routine dissection of adult formalin fixed cadavers used for first‐year regional anatomy course at Oakland University William Beaumont School of Medicine were used in this study. There was a total of 12 male and 12 female cadavers with an average age of 82 years. The lungs were observed and photographed for presence or absence of fissures and lobes. We report a case of a tri‐lobed left lung with a complete horizontal fissure inferior to the left root of the lung, and each lobe features its own independent secondary lobar bronchus. The corresponding right lung features normal fissures and lobes. 8 additional right lobes had incomplete accessory fissures measuring <5cm in length with greatest depth of 2cm. 6 additional left lobes had incomplete accessory (4) and horizontal (2) fissures of <4cm in length with greatest depth of 2cm. Collectively, our results demonstrate a lung variation for awareness and for interpretation of radiological images and locating the bronchopulmonary segments in lobectomies, bronchoscopies, and segmental resection.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

INTRODUCTION AND OBJECTIVE: Many institutions rely on historical data to guide preoperative type and screen (T/S) requirements. Our objective was to evaluate the cost-effectiveness of obtaining preoperative T/S for common urological procedures and determine patient and hospital factors associated with receiving blood transfusions.METHODS: Retrospective database analysis of the 2006-2015 National (Nationwide) Inpatient Sample (NIS) was performed to identify patients undergoing a variety of urological procedures where T/S is generally obtained. A total of 4,113,144 cases were identified. Transfusion rates were then determined from NIS data, and multivariate regression analyses was used to identify factors associated with transfusions. A cost-effectiveness analysis was performed to determine the incremental cost-effectiveness ratio (ICER) of obtaining preoperative T/S to prevent an emergency-release transfusion (ERT), with a willingness-to-pay threshold of $1,500.RESULTS: On multivariate modeling, all Elixhauser comorbidities with the exception of obesity were significant associated with transfusion Some examples included chronic blood loss anemia (OR,