Foramen of Winslow hernias are one of the most uncommon types of internal hernias that a surgeon will encounter. They are often initially indolent with vague symptoms that present over an extended period of time. Unfortunately, these hernias are not often diagnosed prior to requiring emergent operative intervention. This case report describes a patient who had a long history of vague abdominal pain and radiographic evidence of a foramen of Winslow hernia 4 years prior to presenting with acute obstructive symptoms. This raises the question: Should foramen of Winslow hernias, if diagnosed early, be repaired on an elective basis?

Quality control tests of molecular imaging systems are hampered by the complexity of phantom preparation. It is proposed that radioisotopes can be directly incorporated into photo-polymer resins. Use of the radio-polymer in a 3D printer allows phantoms with more complex and reliable activity distributions to be produced whilst simplifying source preparation. Initial tests have been performed to determine the practicality of integrating Tc-99m into a photo-polymer and example phantoms produced to test suitability for quality control. Samples of build and support resins were extracted from the print cartridges of an Objet30Pro Polyjet 3D printer. The response of the resin to external factors including ionising radiation, light and dilution with Tc-99m pertechnetate were explored. After success of the initial tests the radio-polymer was used in the production of different phantoms. Radionuclide dose calibrator and gamma camera acquisitions of the phantoms were used to test accuracy of activity concentration, print consistency, uniformity and heterogeneous reproducibility. Tomographic phantoms were also produced including a uniform hot sphere, a complex configuration of spheres and interlacing torus’s and a hot rod phantom. The coefficient of variation between repeat prints of a 12 g disk phantom was 0.08%. Measured activity within the disks agreed to within 98 ± 2% of the expected activity based on initial resin concentration. Gamma camera integral uniformity measured across a 3D printed flood field phantom was 5.2% compared to 6.0% measured with a commercial Co-57 flood source. Heterogeneous distributions of activity were successfully reproduced for both 2D and 3D imaging phantoms. Count concentration across regions of heterogeneity agreed with the planned activity assigned to those regions on the phantom design. 3D printing of radioactive phantoms has been successfully demonstrated and is a promising application for quality control of Positron Emission Tomography and Single Photon Emission Computed Tomography systems.

Endotracheal intubation of the rat under direct vision is described together with the details of procedures and apparatus for conducting inhalation anesthesia in this species. Our intubation method requires no special manufacture of equipment, because it employs the human laryngoscope equipped with an infant blade (size 0). Using inhalation anesthetics such as enflurane or halothane for induction, clear laryngoscopic visualization of the glottis is reliably obtained, allowing rapid and routine intubation of the rat in a highly predictable amount of time. In contrast, the injected anesthetics such as ketamine or pentobarbital sodium seem unsuited to laryngoscopic intubation as a result of problems of variable induction times, copious oral secretions, and strong pharyngeal-laryngeal reflexes.

Primary benign tumors of the sternum are an exceedingly rare entity. Surgical techniques regarding intervention for these lesions are not clearly defined in the literature given their scarcity. Operative techniques include en-bloc resection of the tumor, and this has proven to be successful in preventing local recurrence despite benign nature of the lesion. Given the often extensive defect created by the excision, reconstruction is frequently necessary; depending on the size of the defect, either autologous bone grafting or the use of synthetic materials may be indicated. This study serves to present two cases of rare primary benign tumors of the sternum, giant cell tumors and osteoma spongiosum and to summarize the available literature. We present a review of the literature of 17sternal giant cell tumor cases reported so far including our patient and unique case of osteoma spongiosum of the sternum, that discusses their surgical management, as well as reconstructive techniques that provided an excellent clinical result and a lack of recurrence on long term follow-up.

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