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[Incidence of chondrocalcinosis in a series of 1,000 surgically excised intervertebral disks].

This study is based on the histological examination of a series of 1000 intervertebral discs which were excised surgically for a painful spinal or nerve root syndrome. The authors observed in 31 cases (18 men and 13 women) a chondrocalcinosis that was not found clinically (small circumscribed deposits of crystals identified as calcium pyrophosphate after examination in compensated polarized light microscopy). The frequency is higher than that of chondrocalcinosis observed in the menisci excised surgically from the knees of subjects with the same average age; but it is lower than that for the menisci taken from autopsy material of subjects with a higher average age. The histological examination of all surgically excised discs would permit the findings of signs of chondrocalcinosis, thus emphasizing the risk for the patient of a further evolution to arthropathies (spinal or peripheral). This can offer bases for statistical longitudinal studies.

Adolescent

Breastfeeding Outcomes After Radiofrequency Ablation and Surgical Excision of Fibroadenomas Compared to Natural History: A Retrospective Cohort Study.

BACKGROUND: Fibroadenomas, common benign breast tumors in women of reproductive age, are increasingly managed with minimally invasive radiofrequency ablation (RFA) or surgical excision. However, their impact on breastfeeding outcomes remains underexplored. We aimed to assess breastfeeding ability and breast tissue changes in women treated with RFA or surgery compared to those with untreated fibroadenomas. METHODS: In this retrospective cohort study, we evaluated 153 women with biopsy-confirmed fibroadenomas across five groups: RFA with prior breastfeeding (RFA-PreBF; n = 26), RFA with posttreatment breastfeeding (RFA-PostBF; n = 22), surgical excision with prior breastfeeding (Surgical-PreBF; n = 30), surgical excision with posttreatment breastfeeding (Surgical-PostBF; n = 20), and noninterventional with breastfeeding (Observation-BF; n = 55). Breastfeeding ability was assessed using a 5-point scale, and breast tissue changes were evaluated via ultrasound at 18 months, and all breastfeeding attempts occurred at a minimum of 12 months postprocedure. Fisher's exact test compared complete lactation failure rates, and a power analysis validated the study design (Fig. 1). FINDINGS: The combined RFA group (n = 48) had a higher complete lactation failure rate (14.6%) than the Observation-BF group (3.6%; Fisher's exact test, p = 0.045). Similarly, the combined surgical group (n = 50) had a higher complete lactation failure rate (16.0%) than the Observation-BF group (p = 0.034). When pooled, the combined intervention group (n = 98) showed a complete lactation failure rate of 15.3% versus 3.6% in the Observation-BF group. Residual tissue correlated with lactation impairment in the RFA group (Spearman's &#x3c1;, p < 0.05). Ultrasound showed no tumor recurrence, with cystic changes in some cases not linked to breastfeeding impairment. Power analysis confirmed 80% power to detect a medium effect size (f = 0.25, Fig. 1), supporting the study's robustness.7 RFA-PreBF (n = 26), RFA-PostBF (n = 22), Surgical-PreBF (n = 30), Surgical-PostBF (n = 20), and Observation-BF (n = 55). Breastfeeding ability was assessed using a 5-point scale, and breast tissue changes were evaluated via ultrasound at 18 months. Fisher's exact test compared complete lactation failure rates, and a power analysis validated the study design (Fig. 1).[Figure: see text]Interpretation:RFA and surgical excision are effective for fibroadenoma management but increase the risk of complete lactation failure compared to untreated fibroadenomas. Careful patient selection, precise procedural techniques, and vigilant posttreatment monitoring are essential to optimize breastfeeding outcomes, particularly for women planning future pregnancies.

Humans

The effect of early surgical excision and homografting on survival of burned rats and of intraperitoneally-infected burned rats.

The effects of early and delayed surgical excision and skin homografting on survival in burned, uninfected rats and in burned rats infected with Pseudomonas aeruginosa, intraperitoneally, has been studied. The survival rate in animals treated with surgical excision and no coverage was significantly worse than in the animals who were simply burned. Immediate excision of the burn wound followed by prompt coverage with skin homografts resulted in decrease in the mortality rate from subsequent intraperitoneal infection of Pseudomonas. The beneficial effects of early surgical excisions and immediate skin homograft coverage were also achieved when formalin-fixed skin homografts were used.

Animals

Benign tumors and lesions of the larynx in children. Surgical excision by CO2 laser.

Benign lesions of the airway in infants and children may endanger the airway and compromise laryngeal function. The CO2 laser provides an elegant method of transoral surgical excision without compromising laryngeal function or airway competence. It avoids the risks of such other treatment modalities as external surgical approaches, prolonged steroid therapy, and radiation. It is applicable to a wide variety of lesions without the necessity of tracheotomy. Hospitalization is minimized. Ten cases are presented to show the wide applicability of this technique. Gross pathology and pre- and postoperative findings are demonstrated and discussed, as is the safety and efficacy of the laser soft-tissue interaction.

Carbon Dioxide

Histological and immunological studies on the fowl lacrimal gland following surgical excision of Harder's gland.

Surgical removal of the Harderian gland of the domestic fowl resulted in increased secretory activity in the lacrimal gland and also in an increase in goblet cell numbers along the length of the lacrimal gland duct. Plasma cells were more numerous in the lacrimal glands of operated birds and they were capable of antibody responses to both systemically and topically applied bovine serum albumin (BSA). Gel diffusion studies showed the presence of anti-BSA activity in the tears and serum of fowls stimulated after surgical removal of the Harderian gland.

Animals

The value of typing basal cell carcinomas in predicting recurrence after surgical excision.

A classification, based on growth pattern was devised and applied to 156 basal cell carcinomas from 134 patients. The tumours were divided into four main groups; (I) nodular; (2) nodular with infiltrative margin; (3) infiltrative; (4) multifocal. The infiltrative and multifocal types exhibited a high rate of recurrence following surgical excision whereas recurrence of nodular tumours was much rarer. It is therefore suggested that growth pattern should always be stated in the routine histopathological reporting of these neoplasms. Other features were studied and found to have no prognostic value. These included the various types of epithelial differentiation and such stromal factors as the degree of lymphocyte and plasma cell infiltration and the presence of amyloid or elastic fibres.

Basal Cell Carcinoma

[Indication for selective surgical excision of hepatic metastases].

451 patients undergoing surgery for colorectal cancer showed synchronous hepatic metastases in 24.4% (110 cases). Survival of patients with hepatic metastases appears to depend on both the age of the patient and the site of metastatic deposit. A relatively good prognosis group with median survival of 14 months can be separated from the other patients with only 5 months survival. Survival of patients with hepatic metastases can thus be predicted and long-term survival (5 and 10 years) obtained by surgical excision of these metastases. Postoperative CEA determinations will also increase the rate of early surgery for hepatic metastases.

Adult

Embolization and surgical excision of giant arterio-venous malformation.

A case of a giant arteriovenous malformation involving almost the entire dominant hemisphere in a 32-year-old white male with progressive neurologic deterioration, presumbaly due to cerebral steal, is described. Special management included surgical intravascular embolization with latex spheres. and at a later date, resection of the arteriovenous malformation.

Adult

[Cold nodules of the thyroid. Reevaluation of surgical excision on the basis of a new group of 607 patients(author's transl)].

In a serie of 607 cold nodules developing in normal or apparently normal (on preoperative clinical examination) thyroids, the results of histopathological examination were compared with those in an identical series studied 10 years before. Carcinoma was frequent: 9.7% in the current series and 19% in the first series. Insofar as neither clinical examination nor special investigations at the present time make it possible to affirm that a cold nodule is not malignant, surgical complete lobectomy with frozen section examination remains the required procedure in view of its harmless nature and the good prognosis in differentiated tumours operated upon before any visceral extension has taken place, contrasting with the poor prognosis of others. Recurrences may be prevented by special operative techniques (routine excision of Lalouette's pyramid, division of the contralateral ligament of Grubert) and routine postoperative thyroid extracts in patients with a morphological, familial or biological risk of recurrence.

Adenoma

Keratoacanthoma recurrent after surgical excision.

A 62-year-old man developed a recurrent keratoacanthoma within two and a half weeks after grossly and microscopically complete removal of the primary tumor. X-irradiation of the recurrent lesion caused partial regression, and then intralesional injections of a suspension of triamicinolone caused final resolution of it. Although dermatologists generally practice partial destruction and surgeons almost always do total excision, neither method invariably cures this benign tumor, and repeated treatment may be necessary.

Humans

Prognosis after surgical excision of canine melanomas.

One hundred and thirty-four dogs from which melanomas had been excised were studied until death or for at least 2 years after surgery. Seven of 49 (14%) intraoral and lip tumours and 52 of 85 (61%) skin tumours were histologically benign; in spite of this, three of seven (43%) "benign" oral and four of 52 (8%) "benign" skin lesions led to the eventual death of the host. Thirty eight of 42 (90%) dogs with a histologically malignant melanoma of the lip or oral cavity died because of the tumour but only 15 of 33 (45%) with malignant skin melanomas died. Six of 59 (10%) dogs with a tumour of mitotic index 2 or less died from the tumour 2 years after surgery compared to 19 of 26 (73%) dogs having a tumour with a mitotic index of 3 or more.

Animals