Inflammatory myofibroblastic tumor has been defined as a histologically distinctive lesion with uncertain behaviour. The term inflammatory myofibroblastic tumor more commonly referred to as “pseudostumor ”, denotes a pseudosarcomatous inflammatory lesion that contains spindle cells, myofibroblasts, plasma cells, lymphocytes and histiocytes. It exhibits a variable biological behavior that ranges from frequently benign lesions to more aggressive variants. Inflammatory myofibroblastic tumor mostly occurs in the soft tissue of children and young adults, and the lungs are the most commonly affected site, but it has been recognized that any anatomic localization can be involved. Inflammatory myofibroblastic tumors in adults are very rare, especially in the stomach. We present a case of a 43-year old woman with primary inflammatory myofibiroblastic tumor in the stomach and a review of the literature.
In the period between 1 January 1978 and 1 January 2004, 85 patients with hypopharyngeal squamocellular carcinoma were admitted at the Department of Esophagogastric Surgery in Belgrade. Among them, only 46 patients (54.1%) had radical surgical en-block resection and functional neck dissection, and they were included into an historical cohort study. In 40 patients a pharyngolaryngoesophagectomy was performed using for reconstruction, stomach tissue in 29 and colon tissue in 11 patients. Since 1996, in six patients with localized hypopharyngeal carcinoma pharyngolaryngectomy was performed with resection of cervical esophagus and free jejunal graft interposition. The overall incidence of morbidity was 50.0% and the overall mortality rate was 13.0% (6 patients). Mean hospital stay was 35 days (range, 18-78 days). The median survival of patients was 26 months, and overall 5-year survival rate was 26.5%. At present, surgery seems to be the appropriate therapeutic choice for patients with advanced hypopharyngeal carcinoma, providing a definitive palliation of dysphagia and relatively good long-term survival. At our Institution, after pharyngolaryngoesophagectomy, reconstructive method of choice is gastric 'pull-up', and the colon is used only when stomach tissue is not available, that is, previous gastric resections, inappropriate blood supply, synchronous gastric carcinoma and so on. Recently, pharyngolaryngectomy and free jejunal transfer has become the standard technique in patients with small carcinomas (up to 3 cm) confined to the hypopharynx in the absence of synchronous esophageal and/or gastric carcinoma.
The authors present the preparation procedure and a computational model of a three-layered fibrous scaffold for prolonged drug release. The scaffold, produced by emulsion/sequential electrospinning, consists of a poly(d,l-lactic-co-glycolic acid) (PLGA) fiber layer sandwiched between two poly(εcaprolactone) (PCL) layers. Experimental results of drug release rates from the scaffold are compared with the results of the recently introduced computational finite element (FE) models for diffusive drug release from nanofibers to the three-dimensional (3D) surrounding medium. Two different FE models are used: (1) a 3D discretized continuum and fibers represented by a simple radial one-dimensional (1D) finite elements, and (2) a 3D continuum discretized by composite smeared finite elements (CSFEs) containing the fiber smeared and surrounding domains. Both models include the effects of polymer degradation and hydrophobicity (as partitioning) of the drug at the fiber/surrounding interface. The CSFE model includes a volumetric fraction of fibers and diameter distribution, and is additionally enhanced by using correction function to improve the accuracy of the model. The computational results are validated on Rhodamine B (fluorescent drug l) and other hydrophilic drugs. Agreement with experimental results proves that numerical models can serve as efficient tools for drug release to the surrounding porous medium or biological tissue. It is demonstrated that the introduced three-layered scaffold delays the drug release process and can be used for the time-controlled release of drugs in postoperative therapy. A promising approach in modern medicine for drug delivery over a long time period and with a desirable rate is the use of nano-scaffolds 1-3 , and specifically electrospun-made scaffolds composed of drug loaded nanofiber mats 4-8. Fibers are preferably prepared using a biodegradable polymer 7 , and their main function is targeted and cites specific drug delivery in human body 1-5 , without any burst release 7 , and with improved physicochemical properties 6. This kind of drug delivery systems have provided many mechanisms that improve the therapeutic efficacy of both new and already existing drugs 7 , and may be now used for various paramedical and medical applications such as wound healing and cancer therapy 1-5. The advantages of using biodegradable polymers for drug delivery are: no need for the second surgery to remove the scaffold once the drug is released 9 , their enhanced biocompatibility, degradability, bioactivity and resorbability 8,10-12. Among the most commonly used biodegradable synthetic polymers, poly(lactic-co-glycolide (PLGA) copolymer is well recognized for drug delivery processes 13. PLGA is known for good biocompatibility and ability to achieve complete drug release 14 , which is the result of its degradation and erosion properties 15,16. Many
We present a case report that demonstrates diagnostic and intraoperative challenges in the laparoscopic management of initially unrecognized splenic hydatid disease. A male patient, aged 44, was admitted to our department with a big unilocular splenic cyst, radiologically (ultrasonography, computed tomography) characterized as a simple cyst. Serological tests for anti-Echonococcus antibody were negative, and chests X-ray findings were unremarkable, so laparoscopic cyst fenestration with omentoplasty was planned. The intraoperative finding did not correspond to a simple splenic cyst. Hydatid daughter cysts were recognized after the careful opening of the cyst wall. The operation was completed without shifting to open procedures. Laparoscopic partial pericystectomy with omentoplasty is a safe and effective surgical procedure for the management of splenic hydatid disease.
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