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Results for “Recurrence”

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At least 199 records · Page 11Linked to original sources

PubMed1999

Intraoperative electromyogram monitoring of the recurrent laryngeal nerve: experience with an intralaryngeal surface electrode. A method to reduce the risk of recurrent laryngeal nerve injury during thyroid surgery.

INTRODUCTION: A clinical method to localize the recurrent laryngeal nerve intraoperatively in order to minimize the risk of accidental injury is presented. METHODS AND RESULTS: By means of an electrode, the nerve was stimulated by a pulsed contact current. The resulting muscle potential was detected using an electrode placed in the larynx. We applied this technique during the time period between 1 January 1997 and 31 December 1998. In 96 cases of primary thyroid resection, the recurrent nerve was identified 167 times. The patients were operated on for nodular thyroid (n=85), Grave's disease (n=9) and malignant papillary goiter (n=2). Retrospectively, the rate of intraoperative nerve injury, equivalent to the rate of postoperative transient and permanent nerve palsy, was 1.04% in the 96 patients and 0.60% with respect to the 167 nerves at risk. The rate of failure of the method was 7.29%.

Electrodes, Implanted↗

PubMed1981

[Surgery of the recurrent nerve. Studies on the problem of functional rehabilitation after recurrent nerve injuries].

One of the most important problems involved in rehabilitation surgery of the recurrent nerve arises from the fact that this nerve carries fibers displaying antagonistic activities which is an accordance with the different functions of the larynx as an organ of phonation, respiration and swallowing. As a consequence of random reinnervation of the internal laryngeal musculature taking place after reconstruction of the N. recurrens, the complicated sequence of vocal cord movements, varying with the different functions of the larynx, cannot be restituted in its proper order. To avoid such functional failures, a method for selective reinnervation of the M. posticus as the most important glottis opener on the one hand, and of the glottis-closing musculature on the other, was tested in animal experiments. Two different anastomoses are forming the basis of the experimental model. 1. Phrenicus-ramus posterior anastomosis for reinnervation of the M. posticus. 2. Recurrens-ramus anterior anastomosis for reinnervation of the adductors. The results show that successful reinnervation of the abductor by means of the phrenic nerve, and of the adductors by means of the recurrence nerve separated from the vagus, can be achieved, and that this reinnervation also permits satisfactory phase-synchronous regulation.

Humans↗

PubMed1978

Defective leukocytotaxia and recurrent staphylococcal infecion: deficiency of leukocytotaxia and abnormal granulocytes associated with increase serum IgE levels in an adult with recurrent staphylococcal infection.

A man who was suffering from recurrent staphylococcal infection had antecedent symptoms of severe pruritus. Laboratory investigations showed leukocytosis with eosinophilia, hyperimmunoglobulinemia of all fractions, but particularly of IgE, and a deficiency of cell-mediated immunity on in vivo testing. Phagocytosis and bactericidal activity of polymorphonuclear leukocytes were normal, but a cellular and serum-associated defect in leukocytotaxia was present. Ultrastructural changes were observed in polymorphonuclear leukocytes. Association of impaired leukocytotaxia and elevated levels of IgE is not uncommon. Recurrent bacterial infections in the patient described are probably related to defective chemotaxis.

Aged↗

PubMed1987

Local recurrence of breast cancer: treatment of nine patients with a recurrence in the skin flap of the chest wall.

From 1975 through 1985, nine patients with a local recurrent lesion (LRL) of breast cancer to the skin flap of the chest wall were treated. Four had undergone primary mastectomies in our clinic and the other five were referred from other surgeons, following signs of recurrence. Aggressive topical therapy, such as resection or irradiation, proved effective in eradicating the LRL in all cases, thereby indicating that topical therapy is useful for improving quality of life. Adjuvant systemic chemo-immuno-endocrine therapy is also required for patients with LRL, to increase longevity. Seven of the patients died of a distant metastasis within 66 months after the onset of LRL.

Adult↗

PubMed1997

Osteoarthritis and recurrences after Putti-Platt and Eden-Hybbinette operations for recurrent dislocation of the shoulder.

Thirty-five patients who had operations for recurrent anterior dislocation of the shoulder were reviewed, with a further 26 answering a questionnaire; the results were not as good as reported by others. The mean follow up was 26.9 years. Ten out of 43 patients had recurrent dislocations after the Putti-Platt and 6 out of 18 after the Eden-Hybbinette operation. Osteoarthritis developed in 15 shoulders of 26 patients who were followed-up after the former procedure and in 8 out of 9 shoulders after the latter. These sequelae depend on the age at the first dislocation rather than the number of dislocations. The overall satisfaction rate was acceptable for both procedures.

Adolescent↗

PubMed2006

[Recurrence of hepatitis C virus (HCV) infection after liver transplantation for HCV-related disease: host factors and viral factors implicated in the occurrence and the severity of HCV recurrence].

Cirrhosis due to chronic infection by hepatitis C virus (HCV), associated or not to a primary hepatocarcinoma, has become the first indication of liver transplantation. Graft reinfection by HCV is considered to be systematic while its prognosis is variable from one patient to another. A better knowledge of factors implicated in the occurrence and severity of hepatitis C recurrence is crucial in order to make optimal patients' monitoring. This article aims to present available data in this field, clarifying the role of viral factors (viral load, genotype, evolution of viral quasispecies) and host-related factors (immune response) which could take part in the development of hepatitis C recurrence.

Carcinoma, Hepatocellular↗

PubMed1988

Recurrent IgA nephropathy in living-related donor transplantation: recurrence or transmission of familial disease?

We describe a patient who developed terminal renal failure of two HLA-identical renal allografts due to crescentic IgA nephropathy. The first graft contained IgA deposits at the time of donation, suggesting that transmission of IgA deposits may have contributed to the nephritis of the first allograft. The second graft was free of IgA deposits at the time of donation, but the recipient developed a similar, rapidly progressive nephritis. This case points up the malignant potential of IgA nephropathy and the complex nature of transplant planning for patients with end-stage renal disease (ESRD) secondary to IgA nephropathy. Living-related donor (LRD) transplants seem to be associated with a higher rate of recurrence than cadaveric grafts. This higher rate may partly reflect the inadvertent transmission of subclinical IgA deposits from donor to recipient and a genetic susceptibility of certain HLA types (specifically B35 and DR4) to recurrent disease. Cadaveric transplants may be preferable in the setting of high-risk HLA types or familial patterns of IgA nephropathy.

Adult↗

PubMed1997

Loco-regional recurrence following mastectomy for early breast carcinoma: efficacy of radiotherapy at the time of recurrence.

This study aims to define the risk factors for loco-regional relapse following mastectomy, and to assess the efficacy of radiotherapy at the time of relapse. To achieve this 272 patients with loco-regional relapse treated at a single institution with modified radical or radical mastectomy were reviewed. Tumour size, axillary node involvement and tumour grade were found to be significant risk factors for loco-regional recurrence of disease. Radiotherapy given at the time of relapse controlled disease in 61% of cases, compared with 34% of patients treated with systemic treatment only. Altogether, 146 (54%) of the 269 evaluable patients with local failure had uncontrolled disease at the same site, either at the time of death or at the date last seen. The result of this retrospective study showed that delayed radiotherapy was effective in controlling the disease in patients with developing loco-regional relapses. However, as adjuvant radiotherapy reduces the incidence of local disease recurrence it should be recommended to patients considered to be at high risk of local relapse following mastectomy; namely those with tumours bigger than 5 cm with four or more positive axillary nodes.

Adult↗

PubMed1999

Family history of breast cancer and local recurrence after breast-conserving therapy. The Dutch Study Group on Local Recurrence after Breast Conservation (BORST).

The impact of a family history of breast cancer on the local recurrence (LR) risk after breast-conserving therapy (BCT) was performed within the framework of a large, multicentre matched case-control study of risk factors for LR after BCT (BORST study). Family history was assessed for 218 breast cancer patients with LR (cases) and 480 patients without LR (controls). Detailed histological tumour features were determined by review of the primary tumour. The risk of LR for patients with a positive family history was similar to or less than that of non-familial patients (unadjusted odds ratio (ORunadj) 0.66 (95% confidence interval (CI) 0.40-1.08)). Familial patients were older than non-familial patients (P = 0.07) and their tumours had a lower histological grade (P = 0.07). A second primary tumour occurred significantly more often in familial patients (P = 0.02). Adjustment for these factors did not essentially alter the results (ORadj 0.71 (0.38-1.32)). Separate analyses according to age at onset (younger and older than 50 years) and time to LR/site of LR produced similar results. The sole presence of a positive family history of breast cancer does not appear to be a risk factor for local recurrence after BCT. Whilst this might be different for genetically predisposed patients, a positive family history does not appear to be a contra-indication for BCT.

Breast Neoplasms↗

PubMed2002

Recurrent bronchogenic cyst causing recurrent laryngeal nerve palsy.

A case of a 50-year-old male who developed left recurrent laryngeal nerve palsy due to a bronchogenic cyst is presented. The bronchogenic cyst recurred following incomplete excision and multiple attempts at percutaneous aspiration. Recurrent laryngeal nerve palsy is an unusual complication of bronchogenic cysts. This case highlights the need for complete excision of these cysts and the lack of efficacy of cyst aspiration.

Bronchogenic Cyst↗

PubMed2002

Recurrent pseudomembranous colitis as a cause of recurrent severe sepsis.

Clostridium difficile (C. difficile) colitis accounts for nearly 15-20 % of antibiotic-associated diarrhea. Manifestations include asymptomatic carriage, self-limited diarrhea, and pseudomembranous colitis, which is sometimes life-threatening. Despite effective therapy with metronidazole and vancomycin relapse rates are 15-33 %. Although colitis is seen in critically ill patients treated with combinations of broad-spectrum antibiotics, reports describing severe sepsis as a result of C. difficile infection are limited. We describe the case of recurrent severe sepsis due to recurrent local intestinal C. difficile infection as the only identifiable etiology. The mechanism of severe sepsis may be a derangement of the gastrointestinal barrier function. This could result in absorption of microbes or endotoxin or activation of inflammatory cascades in the submucosa of the intestine or liver. In general, for successful treatment of C. difficile infections other than anticlostridial antibiotics should be discontinued. However, in the present case bacterial translocation from the intestine is an attractive explanation for severe sepsis and therefore additional antibiotics had been administered.

Enterocolitis, Pseudomembranous↗

PubMed1995

[Recurrent bleeding from colonic varices in portal hypertension. The successful prevention of recurrence by the implantation of a transjugular intrahepatic stent-shunt (TIPS)].

HISTORY AND CLINICAL FINDINGS: Sclerotherapy was performed in a 52-year-old patient with alcoholic liver cirrhosis (Child-Pugh stage A) for recurrent bleeding from oesophageal varices. Half a year later he again was admitted to hospital because of recurrent passage of bloody stools. The cardiovascular status was stable; the liver was enlarged by 15 cm in the medioclavicular line. INVESTIGATIONS: Endoscopy revealed several varices in the colon near the right flexure. One of the varices had an ulcer of 5 mm size. Duplex sonography revealed portal hypertension with cirrhosis of the liver and partial thrombosis of the main trunk of the portal vein without any sign of cavernous transformation. TREATMENT AND COURSE: Because of the partial portal vein thrombosis it was decided to insert a transjugular intrahepatic portosystemic stent shunt. This obviated the thrombosis and lowered the portosystemic pressure gradient by 6.8%. With the shunt functioning well there were no further bleedings in the subsequent year. CONCLUSION: The only slightly invasive TIPS implantation is an effective therapeutic procedure for bleeding from colon varices caused by portal hypertension.

Colon↗

PubMed2000

Doppler ultrasound screening predicts recurrence of poor pregnancy outcome in subsequent pregnancies, but not the recurrence of PIH or preeclampsia.

OBJECTIVE: To assess the role of Doppler uterine artery screening in the prediction of recurring hypertensive disorders in a high-risk population. METHODS: Ninety-four women with a history of hypertensive disorders in previous pregnancies underwent ultrasound color Doppler to analyze blood flow in the uterine arteries at 21-22 weeks of gestation. We evaluated the performance of the Pulsatility Index (PI) as well as the diastolic notch to predict recurring hypertensive disorders. Outcome measures were the recurrence of hypertensive disorders, and poor pregnancy outcome due to intrauterine death growth retardation, intrauterine death, placental abruption, hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome, eclampsia, or premature birth. Onset of symptoms was before 35 weeks in all cases of poor pregnancy outcome. RESULTS: Doppler flow recordings were obtained from a well-defined location in both uterine arteries. The predictive value of the uterine artery PI for recurring hypertensive disease was poor and not significant; interestingly, however, the predictive values for poor pregnancy outcome were good (sensitivity 83%, specificity 71%, p < 0.001). The PI also provides a good test for intrauterine growth retardation (sensitivity 80%, specificity 69%, p < 0.01). The "diastolic notch" did not perform as well as the PI. CONCLUSIONS: Uterine artery screening did significantly predict the recurrence of poor pregnancy outcome due to hypertensive complications in this high-risk group. In contrast, gestational hypertension and preeclampsia with normal pregnancy outcome were not significantly predicted by uterine artery screening.

Adult↗

PubMed1996

TGF-beta 1 immunohistochemistry in goiter: comparison of patients with recurrence or no recurrence.

The aim of this work was to establish whether the immunohistochemical pattern for TGF-beta 1 in goiters that recur after thyroid surgery is different when compared with goiters that do not recur postoperatively. Twelve goiters, surgically removed by partial resection between 1977 and 1982, were studied. Ten years after surgery, 6 patients had recurrence of goiter or thyroid nodules (group 1); the others did not have any recurrence (group 2). The presence and location of TGF-beta 1 were evaluated a posteriori by immunohistochemistry in histological samples of the tissue that was removed. In each goiter specimen, 50 randomly selected subcapsular follicles were studied to evaluate the percentage of follicles negative or positive for TGF-beta 1 and the protein's intrathyrocyte location. In the slides of group 1, the percentage of TGF-beta 1-positive follicles was statistically (p < 0.01) greater (93.1%) than in group 2 (71.4%). No difference in the location of TGF-beta 1 was found. The authors found a greater percentage of positive follicles for the TGF-beta 1 protein in group 1 patients. In conclusion, TGF-beta 1 production in goiter is variable, time dependent, and may be a marker of active cellular proliferation due to chronic exposure to a goitrogen stimulus. Thus, the more TGF-beta 1 found, the more the cell is stimulated and, therefore, the greater the risk of relapse.

Adult↗

PubMed2000

Surgical salvage therapy: abdominoperineal resection for recurrent anal carcinoma, metastasectomy of recurrent colorectal cancer, and esophagectomy after combined chemoradiation.

This review highlights the advances in the salvage surgical therapies for recurrent disease after definitive therapy of anal carcinoma, colorectal cancer, including liver metastasectomy, and esophageal carcinoma treated primarily with chemoradiation. New diagnostic modalities, advances in neoadjuvant therapies for unresectable liver metastases, and, in addition, the importance of adjuvant hepatic arterial chemotherapy after curative liver resections are reviewed. Although chemoradiation is not the standard of care for esophageal cancer, salvage esophagectomy after such treatment is discussed. Definitive chemoradiation for squamous cell carcinoma of the anus has altered the role of surgical intervention to a salvage option instead of primary treatment. Although this is not yet the case for esophageal carcinoma, recent improved chemoradiation regimens have been reported by the French and Japanese, who use surgery for nonresponders. For recurrent colorectal carcinoma, including liver-only metastases, patients can be rendered disease free after surgical extirpation with evidence of improved survival. Appropriate surveillance in these patients may identify subsets of patients with disease amenable to resection.

Abdomen↗

PubMed1990

Recurrent bacterial endocarditis in a man with tetralogy of Fallot: earliest recurrence on record.

Enterococcal endocarditis occurred in a young man with tetralogy of Fallot who had just completed therapy for staphylococcal endocarditis. The patient had a transient reversal of flow through the ventricular septal defect during staphylococcal endocarditis with lung abscesses and had persistently elevated teichoic acid antibody titers during the second episode caused by enterococcus. Our review of the literature on recurrent infective endocarditis indicates that our case represents one of the shortest intervals of recurrence with a second organism.

Adult↗

PubMed1975

Acute and recurrent infection with herpes simplex virus in the mouse: a model for studying latency and recurrent disease.

Nineteen recent isolated and three laboratory strains of herpes simplex virus types 1 and 2 were tested for their ability to produce clinical signs in mice following intradermal inoculation in the ear. All viruses produced erythema at the inoculation site; this was the most sensitive clinical sign of infection. Virus multiplication in the ear tissue was similar for both types 1 and 2 up to the fifth day after inoculation but type 2 viruses persisted for longer. Latent infection was demonstrated in cervical dorsal root ganglia. Type 1 viruses required a much higher dose than type 2 to produce neurological signs and death after intradermal inoculation but the difference was less after intracerebral inoculation. Erythema of the inoculated ear recurred sporadically during several months observation in about half the mice that survived intradermal infection with a selected type 1 isolate. The presence of virus in the ear tissue during such recurrences was confirmed by electron microscopy and isolation of infectious virus. The system of ear infection in the mouse is presented as a new model for studying neurovirulence, and latent and recurrent infection with herpes simplex virus.

Animals↗

PubMed1989

The results of skin testing with food additives and the effect of an elimination diet in chronic and recurrent urticaria and recurrent angioedema.

Ninety-one subjects suffering from chronic or recurrent urticaria or recurrent angioedema of 2 months to 17 yr duration were skin-prick and scratch tested with 18 various food additives. Twenty-four of the subjects (26%) had at least one histamine equivalent skin test (ST) reaction. In contrast, only 24 (10%) of 247 non-urticaria control subjects showed comparable results. An oral provocation test with food additives was carried out on 10 of the 24 ST-positive subjects with urticaria or angioedema, but only one positive reaction, caused by benzoic acid, was recorded. All 91 subjects were advised to follow an additive-free diet. The effect of the diet was investigated with a retrospective postal survey. Twenty-three ST-positive subjects returned the questionnaire, 18 had followed the diet, and 16 (89%) of these 18 had experienced marked relief of their symptoms. Correspondingly, 42 of the 47 ST-negative subjects had followed the diet, and 17 (40%) had improved. The difference was significant (P less than 0.05). Our results suggest that skin tests with food additives can be used to measure skin hyperreactivity and that they may have a predictive value in identifying patients who will respond to an additive-free diet.

Adolescent↗