We report portable, user-friendly reagents and equipment for visual, hands-on biology activities with supporting curriculum.
Analysis of emergent SBO cases between 2005 and 2015 demonstrates that laparoscopy is not utilized as often as open approaches in surgical treatment. Laparoscopic surgery resulted in reduced postoperative morbidity and significantly shorter hospital stays compared to open intervention and was not associated with significant differences in odds of reoperation compared to open surgery.
A 14-year-old boy presented with one year history of mass in the oral cavity which was initially small and progressively increased in size. He complained of difficulty in speaking and swallowing since four months. There was no history of respiratory difficulty sore throat or bleeding. Patient was undergoing psychiatric treatment for behavioral problems and is on resperidone therapy. Otorhinological examination of oral cavity revealed a smooth pinkish white mobile nontender firm pedunculated mass arising from superior pole of left tonsil and extending over the anterolateral surface of the tongue [Table/ Fig-1]. Patient could voluntarily swallow and regurgitate the mass. Rest of the oral cavity, nasopharynx and larynx were normal. There was no evidence of cervical lymphadenopathy. Systemic examination and all other routine investigations were normal. A left tonsillectomy with tonsillar mass excision was done under general anesthesia and the specimen was sent for histopathological examination. Grossly the left tonsil measured 2.5x1.5cms. A polypoid large smooth mass was seen arising from the superior pole of the tonsil attached to it by a small stalk measuring 7x2x2cms [Table / Fig-2]. Cut section was homogenous white tan and the mass had a firm consistency. Microscopic examination of hematoxylin and eosin stained sections showed a polypoid mass lined by nonkeratinising stratified squamous lining. Subepithelium showed a dense collection of lymphocytes along with few lymphoid follicles [Table/ Fig-3]. Stroma of the polyp showed many dilated lymphatic and blood vessels admixed with fibrocollagenous and adipose tissue [Table / Fig-4 [
Beginning in the early 1980s, clinical trials have tested iteratively improving acute reperfusion interventions for both myocardial infarction and ischemic stroke. In both circulatory beds, treatments have evolved in a similar pattern, beginning with intravenous fibrinolytics, followed by intraarterial fibrinolytics, then mechanical endovascular therapies, and finally exploration of combined intravenous and catheter treatments. 1,2 However, in important ways, therapies in the different vascular beds have evolved distinctively. For example, primary stenting has become a mainstay of acute coronary reperfusion, reflecting its efficacy in treating target atherosclerotic plaques with supervening thrombi, whereas mechanical retrieval and aspiration techniques are the leading endovascular therapies for cerebral ischemia, because of their appropriateness for target embolic thrombi residing in relatively normal recipient vessels.Even more importantly, the technical efficacy of lytic and mechanical treatments in achieving reperfusion has evolved at different rates in the cerebral and cardiac circulatory beds. However, the difference in success rates of reperfusion treatments for brain and heart have not been previously systematically characterized and quantified. We therefore undertook a formal systematic analysis of reperfusion efficacy over the past 30 years of cerebral and cardiac revascularization strategies. Methods Search and Inclusion CriteriaA systematic search was performed to identify all multi-arm trials of coronary revascularization for acute myocardial infarction and multicenter trials of cerebral revascularization for acute ischemic stroke (AIS) with reperfusion assessed by catheter angiography. Medline was searched from 1950 to 2010: (1) crossing the terms Background and Purpose-Early reperfusion is the most effective therapy for both acute brain and cardiac ischemia.However, the cervicocephalic circulatory bed offers more challenges to recanalization interventions. The historical development of reperfusion interventions has not previously been systematically compared. Methods-Medline search identified all multi-arm, controlled trials of coronary revascularization for acute myocardial infarction and multicenter trials of cerebral revascularization for acute ischemic stroke reporting angiographic reperfusion rates. Results-Thirty-seven trials of coronary reperfusion enrolled 10 908 patients from 1983 to 2009, and 10 trials of cerebral reperfusion enrolled 1064 patients from 1992 to 2009. Coronary reperfusion trials included 10 of intravenous fibrinolysis alone, 8 combined intravenous fibrinolysis and percutaneous transluminal coronary angioplasty with or without stenting, 3 intra-arterial fibrinolysis, and 16 percutaneous transluminal coronary angioplasty with or without stenting. Cerebral reperfusion trials included 1 of intravenous fibrinolysis alone, 3 intra-arterial fibrinolysis, 3 endovascular device alone, and 3 of endovascular treatment ± intravenous fibrinolysis. In both circulatory beds, endovasc...
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