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magnetic sphincter

William O Richards, Carly McRae
We have recently introduced laparoscopic magnetic sphincter augmentation (MSA) combined with hiatal hernia repair for treatment of patients with medically refractory gastroesophageal reflux disease (GERD). MSA is a novel surgical approach to the treatment of severe GERD, in which magnetic beads are secured around the lower esophageal sphincter, augmenting the lower esophageal sphincter function as an anti-reflux barrier. We hypothesize that patients undergoing MSA will achieve GERD relief, equal to that obtained after laparoscopic Nissen fundoplication...
November 1, 2018: American Surgeon
Omar Nafi, Bashar Ramadan, Olaf Riess, Rebecca Buchert, Tawfiq Froukh
BACKGROUND: Late infantile ceroid lipofuscinosis is a rare neurodegenerative disorder that appears between the ages of 2 and 4 years and is difficult to diagnose. In this report we present two sisters with this condition, and the clinical course consisted of delayed developmental skills initially and later regression of previously acquired skills. The cases were initially considered as childhood disintegrative disorder (CDD); however, when whole exome sequencing (WES) genetic testing was done, they proved to be variant late infantile ceroid lipofuscinosis...
January 26, 2019: World Journal of Clinical Cases
Rishi D Naik, Lauren Evers, Michael F Vaezi
PURPOSE OF REVIEW: Gastroesophageal reflux disease (GERD) is a common diagnosis encountered by both primary care providers and specialists, but despite its prevalence, there are limitations in the current diagnostic tests for GERD. Once an accurate diagnosis is made, treatment options can be offered, and this field continues to burgeon with options. In this review, we seek to review the recent advances in GERD diagnostics and subsequent treatment options. RECENT FINDINGS: Novel impedance markers and novel techniques (mucosal impedance testing, salivary pepsin, high-resolution manometry, and narrow-band imaging) have shown promise in diagnosing GERD...
January 25, 2019: Current Treatment Options in Gastroenterology
Sinan Balcı, Mehmet Ruhi Onur, Ali Devrim Karaosmanoğlu, Muşturay Karçaaltıncaba, Deniz Akata, Ali Konan, Mustafa Nasuh Özmen
Anal and perianal region is a commonly affected area in the course of several inflammatory, infectious, and neoplastic diseases. Several imaging modalities may be used in imaging evaluation of this area and magnetic resonance imaging (MRI) emerges as the imaging modality of choice due to its superb soft tissue resolution. MRI is not only useful for initial detection of anal/perianal pathologies but also in the follow-up of these disorders. In this article, we aimed to illustrate MRI findings of several diseases affecting this area including perianal fistula as well as anal fissure, hypertrophic myopathy of internal anal sphincter, hidradenitis suppurativa, pilonidal sinus, rectovaginal/anovaginal fistula and anal canal carcinoma...
December 24, 2018: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
S Nayar, B Pawar, L Einsiedel, D Fernandes, P George, S Thomas, C Sajiv
BACKGROUND: Human T-lymphotropic virus type 1 (HTLV-1) is endemic amongst the Aborigines of the Northern Territory of Australia. HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP) has been associated with this infection. In general population, isolated neurogenic bladder dysfunction in HTLV-1-infected individuals without HAM/TSP has been reported, and the HTLV-1 proviral load has been found to be higher in such patients compared with asymptomatic carriers. In solid organ transplantation, few cases of HAM/TSP have been reported worldwide, but not an isolated neurogenic bladder...
December 2018: Transplantation Proceedings
Kenneth R DeVault
No abstract text is available yet for this article.
January 2019: Gastrointestinal Endoscopy
Michael Antiporda, Chloe Jackson, C Daniel Smith, Steven P Bowers
INTRODUCTION: Laparoscopic magnetic sphincter augmentation (MSA) has been shown to be efficacious therapy for gastroesophageal reflux disease (GERD) refractory to maximal medical management. Herein, we present our experience with this procedure and an analysis of our outcomes. MATERIALS AND METHODS: Medical records were retrospectively reviewed of 98 patients who underwent laparoscopic MSA for GERD at a single institution from 2012 to 2016. Symptoms were assessed with gastroesophageal reflux disease-health-related quality of life (GERD-HRQL) questionnaire...
December 15, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Ali Zifan, Marco Reisert, Shantanu Sinha, Melissa Ledgerwood-Lee, Esther Cory, Robert Sah, Ravinder K Mittal
Despite the importance of pelvic floor muscles, significant controversy still exists about the true structural details of these muscles. We provide an objective analysis of the architecture and orientation of the superficial muscles of the perineum using a novel approach. Magnetic Resonance Diffusion Tensor Images (MR-DTI) were acquired in 10 healthy asymptomatic nulliparous women, and 4 healthy males. Global tractography was then used to generate the architecture of the muscles. Micro-CT imaging of a male cadaver was performed for validation of the fiber tracking results...
December 14, 2018: Scientific Reports
Takuya Sadahira, Yosuke Mitsui, Motoo Araki, Yuki Maruyama, Koichiro Wada, Kohei Edamura, Yasuyuki Kobayashi, Masami Watanabe, Toyohiko Watanabe, Yasutomo Nasu
OBJECTIVE: Urinary incontinence (UI) is a major prostate cancer (PCa) treatment-related morbidity. It has been reported that post-prostatectomy UI is related to the width of the pelvic floor muscles (PFM) and the length of the urethra. However, the details of these anatomical parameters are unknown. The aim of this study was to investigate whether preoperative pelvic parameters or anatomical parameters of the urethra, as measured by magnetic resonance imaging (MRI), are correlated with UI...
December 12, 2018: Lower Urinary Tract Symptoms
I Mohamed Iqbal, R Morris, M Hersch
We report a case of serious neurologic injury due to inadvertent epidural injection of 8 ml of the antiseptic 2% chlorhexidine in 70% alcohol during a procedure aimed to relieve the pain of labour. This resulted in immediate severe back pain, progressive tetraparesis and sphincter dysfunction caused by damage to the spinal cord and nerve roots. Subacute hydrocephalus necessitated drainage, but cranial nerve and cognitive function were spared. Magnetic resonance imaging documented marked abnormality of the spinal cord and surrounding leptomeninges...
November 2018: Anaesthesia and Intensive Care
Eric Knull, Aytekin Oto, Scott Eggener, David Tessier, Serkan Guneyli, Aritrick Chatterjee, Aaron Fenster
PURPOSE: Prostate cancer is the most common non-cutaneous cancer among men in the USA.[1] Focal laser thermal ablation (FLA) has the potential to control small tumours while preserving urinary and erectile function by leaving the neurovascular bundles and urethral sphincters intact. Accurate needle guidance is critical to the success of FLA. Multi-parametric magnetic resonance images (mpMRI) can be used to identify targets, guide needles, and assess treatment outcomes. In this study, we evaluated the location of ablation zones relative to targeted lesions in 23 patients who underwent FLA therapy in a phase II trial...
November 17, 2018: Medical Physics
Alan H Appelbaum, Jeffrey K Zuber, Roberto Levi-D'Ancona, Harris L Cohen
OBJECTIVES: To demonstrate and confirm the presence of three anatomic zones of the vagina (a superficial sphincteric zone; a central wedge shaped transition zone; and a deep, expanded forniceal zone) using pelvic magnetic resonance imaging with contrast distention of the vagina. METHODS: A total of 107 consecutive female pelvic magnetic resonance imaging scans using vaginal contrast distention were retrospectively reviewed. The images were observed for the three-zone configuration...
November 2018: Southern Medical Journal
James M Tatum, Evan Alicuben, Nikolai Bildzukewicz, Kamran Samakar, Caitlin C Houghton, John C Lipham
BACKGROUND: Recurrent or persistent symptoms of reflux, dysphagia, or device erosion can lead to removal of the magnetic sphincter augmentation (MSA aka Linx) device. Device removal has been previously reported, and outcomes of various surgical management strategies at the time of removal have not been well described. METHODS: This is a retrospective review of patients undergoing MSA removal from March 2009 to September 2017 in a single institution. Reason for removal, operative management, and short-term outcomes are reported...
November 1, 2018: Surgical Endoscopy
Paula Salgado, Ricardo Taipa, Joana Domingos, Daniel Dias, Manuel Melo Pires, Marina Magalhães
Background: Chorea may occur as a manifestation of an acute stroke. Patients with vascular-related chorea typically present with an acute or subacute onset of hemichorea, contralateral to the lesion. Methods and Findings: In this clinico-pathological case, we report a 90-year-old female who presented, at age 81, with a transient episode of generalized chorea. Over the years, the patient continued to have intermittent episodes of generalized chorea or hemichorea, followed by a progressive dementia syndrome with gait and sphincter disturbance...
November 2017: Movement Disorders Clinical Practice
Kazuhiko Morikawa, Shinsuke Takenaga, Koichi Masuda, Asami Kano, Takao Igarashi, Hiroya Ojiri, Kaoru Ueda, Mamoru Ishiyama, Nei Fukasawa
BACKGROUND: A solitary fibrous tumor (SFT) is a rare mesenchymal tumor that occurs mostly in pleural sites, and an SFT occurring in the ischiorectal fossa is extremely rare. Because of the rarity, there are few reports detailing an SFT in the ischiorectal fossa. CASE PRESENTATION: A pararectal tumor was incidentally found in a 42-year-old man during a routine medical examination. The patient had no symptoms and no previous medical history. In the physical examination, a smooth-margined and hard elastic mass was felt, and in a digital rectal examination, the rectal mucosa appeared normal...
October 3, 2018: Surgical Case Reports
Ali Konan, Mehmet Ruhi Onur, Mustafa Nasuh Özmen
PURPOSE: Anal fistula is an abnormal tract or cavity between the anal canal and perianal skin. Surgical treatment of anal fistulas requires the identification of the course of the primary and secondary tracts and their relation with the sphincter musculature in order to appropriately manage them and drain any abscess. Physical examination alone is not as accurate as imaging modalities in detecting these features of the fistula, and recurrences are usually due to missed or inadequately managed infective components...
November 2018: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
Akira Dobashi, Shu-Wei Wu, Jodie L Deters, Charles A Miller, Mary A Knipschield, Graham P Cameron, Lichun Lu, Elizabeth Rajan, Christopher J Gostout
BACKGROUND AND AIMS: Endolumenal therapies serve as a treatment option for gastroesophageal reflux disease (GERD). This study aimed to determine if magnets could be placed endoscopically using the adventitial layer creating a sub-adventitial space near the esophagogastric junction to augment the lower esophageal sphincter using the submucosal endoscopy. METHODS: This study consisted of 2 phases, ex vivo and in vivo, with domestic pig esophagus. A long submucosal tunnel was made at mid to lower esophagus...
September 24, 2018: Gastrointestinal Endoscopy
L Dormegny, S Chibbaro, M Ganau, Mdn Santin, L Kremer, F Proust
Spinal cord biopsy is a difficult procedure fraught with the risk of false-negative results or even misdiagnosis in up to 30% of cases. Differential diagnoses of spinal cord lesions include a wide range of inflammatory, infectious and neoplastic diseases. Given the importance of correctly managing these pathologies, it is crucial to avoid delays in making the correct diagnosis in order to improve the patient's outcome. We present here the case of a 21-year-old male with rapidly progressing sphincter and lower limb motor dysfunctions up to complete paraplegia with evidence of thoracic spinal cord lesion on magnetic resonance imaging...
September 19, 2018: Neuro-Chirurgie
Soumya Jagannath, Pramod Kumar Garg
PURPOSE OF REVIEW: There have been significant developments in the diagnosis, clinical approach, and management of patients with recurrent acute pancreatitis (RAP) in the last decade. This review systematically summarizes our current understanding of RAP. NEW FINDINGS: Gallstones and alcohol are common causes of RAP. Non-alcohol non-biliary RAP (nAnB RAP) is a difficult group of patients after excluding these two causes because extensive workup is required to elucidate the etiology...
December 2018: Current Treatment Options in Gastroenterology
Jonathan Zadeh, Anthony Andreoni, Daniela Treitl, Kfir Ben-David
Background: The initial approach to gastroesophageal reflux disease (GERD) management typically involves lifestyle modification and medical therapy utilizing acid reducing agents such as histamine blockers and proton pump inhibitors. In severe cases refractory to such treatments, surgical therapy may be indicated. The gold standard for surgical treatment of GERD is the laparoscopic Nissen fundoplication. In recent years, a new technique known as magnetic sphincter augmentation (MSA) has been developed using the Linx™ Reflux Management System...
2018: Medical Devices: Evidence and Research
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