1.A 12-Week Rehabilitation Protocol for the Management of Chronic Extensor Hallucis Longus Rupture Repaired with an Autograft of the Semitendinosus Tendon
Astuti PITARINI ; Mitchel ; Karina Sylvana GANI ; Ratna MONIQA ; Erica KHOLINNE
The Ewha Medical Journal 2023;46(4):e20-
Traumatic rupture of the extensor hallucis longus (EHL) is an uncommon finding in an outpatient setting. Surgical repair is typically necessary, particularly in chronic conditions that have persisted for six weeks or more. While several studies have reported EHL repair using autograft tendons, rehabilitation regimes vary, and standardized protocols have not yet been established. This case report presents with an inability to extend her left great toe. She underwent tendon reconstruction with an autograft semitendinosus tendon. At an 8-week follow-up, the patient reported greatly improved outcomes on the American Orthopaedic Foot and Ankle Society, Foot and Ankle Ability Measure, Foot and Ankle Disability Index questionnaire. Full recovery was achieved 12 weeks after surgery. The use of autograft semitendinosus tendon repair for chronic EHL tendon rupture, in conjunction with rehabilitation program, can be expected to yield favorable results.
2.Return to sports following arthroscopic Bankart repair: a narrative review
Shafira Widya UTAMI ; Savina Rifky PRATIWI ; Mitchel ; Karina Sylvana GANI ; Erica KHOLINNE
The Ewha Medical Journal 2024;47(2):e21-
A Bankart lesion is a tear of the labrum, the ring of cartilage that encircles the shoulder joint socket, that can occur when the shoulder is dislocated. This injury frequently affects young athletes and is associated with shoulder instability. This review was performed to provide an overview of anterior shoulder instability, with an emphasis on rehabilitation and the return to sports following arthroscopic Bankart repair. We searched the Google Scholar and PubMed academic databases through February 18th, 2024, utilizing keywords including “arthroscopic Bankart repair” and “return to sports”. Our findings indicate that athletes who undergo arthroscopic Bankart repair exhibit higher rates of returning to sports compared to those who receive other anterior shoulder stabilization procedures. Several factors are considered when determining readiness to return to athletics, including time elapsed since surgery, type of sport, strength, range of motion, pain, and proprioception. Surgeons typically advise athletes to wait approximately 6 months after surgery before resuming sports activities. They also recommend that athletes regain at least 80% of the strength of the uninjured shoulder or achieve strength levels comparable to those prior to the injury. Additionally, patients are expected to attain a full range of motion without pain, which should be symmetrical to the uninjured side, and demonstrate improved proprioception in the shoulder. The sport in which an athlete participates can also influence the timeline for return. Those involved in overhead sports, like baseball or tennis, often experience lower success rates in returning to their sport compared to athletes from other disciplines.
3.Differentiating Lymphovascular Invasion from Retraction Artifact on Histological Specimen of Breast Carcinoma and Their Implications on Prognosis.
Nicholas George ZAORSKY ; Ninad PATIL ; Gary Mitchel FREEDMAN ; Madalina TULUC
Journal of Breast Cancer 2012;15(4):478-480
On a pathological specimen of breast cancer cells, retraction artifact during histological processing mimics true lymphovascular invasion (LVI). The accurate determination of the presence or absence of LVI is a factor in determining risk of having a positive sentinel node, or having additional positive axillary nodes after a positive sentinel node biopsy in women with early-stage breast cancer. The determination of nodal risk influences the decision of the treating physicians as to whether a sentinel node biopsy or completion axillary dissection is necessary. On slide preparation, ideal factors favoring true LVI include: a definite endothelial lining, with endothelial nuclei that seem to protrude into the lymphatic space; invasion in one lymphatic vessel (LV) lumen with nearby cancer glands that have minimal or no retraction; a tumor embolus in a LV clear lumen with outside nearby tumor bulk; a tumor embolus that is different in shape than its surrounding clear LV space; and a positive stain for fibrin, CD31, or CD34 on tumor embolus periphery.
Artifacts
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Biopsy
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Breast
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Breast Neoplasms
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Embolism
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Female
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Fibrin
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Glycosaminoglycans
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Humans
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Lymphatic Vessels
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Nitriles
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Prognosis
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Pyrethrins
4.Clinical Factors Associated with the Non-Operative Airway Management of Patients with Robin Sequence.
Frank P ALBINO ; Benjamin C WOOD ; Kevin D HAN ; Sojung YI ; Mitchel SERUYA ; Gary F ROGERS ; Albert K OH
Archives of Plastic Surgery 2016;43(6):506-511
BACKGROUND: The indications for surgical airway management in patients with Robin sequence (RS) and severe airway obstruction have not been well defined. While certain patients with RS clearly require surgical airway intervention and other patients just as clearly can be managed with conservative measures alone, a significant proportion of patients with RS present with a more confusing and ambiguous clinical course. The purpose of this study was to describe the clinical features and objective findings of patients with RS whose airways were successfully managed without surgical intervention. METHODS: The authors retrospectively reviewed the medical charts of infants with RS evaluated for potential surgical airway management between 1994 and 2014. Patients who were successfully managed without surgical intervention were included. Patient demographics, nutritional and respiratory status, laboratory values, and polysomnography (PSG) findings were recorded. RESULTS: Thirty-two infants met the inclusion criteria. The average hospital stay was 16.8 days (range, 5–70 days). Oxygen desaturation (<70% by pulse oximetry) occurred in the majority of patients and was managed with temporary oxygen supplementation by nasal cannula (59%) or endotracheal intubation (31%). Seventy-five percent of patients required a temporary nasogastric tube for nutritional support, and a gastrostomy tube placed was placed in 9%. All patients continued to gain weight following the implementation of these conservative measures. PSG data (n=26) demonstrated mild to moderate obstruction, a mean apneahypopnea index (AHI) of 19.2±5.3 events/hour, and an oxygen saturation level <90% during only 4% of the total sleep time. CONCLUSIONS: Nonsurgical airway management was successful in patients who demonstrated consistent weight gain and mild to moderate obstruction on PSG, with a mean AHI of <20 events/hour.
Airway Management*
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Airway Obstruction
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Catheters
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Classification
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Demography
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Disease Management
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Gastrostomy
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Humans
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Infant
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Intubation, Intratracheal
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Length of Stay
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Nutritional Support
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Oxygen
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Pierre Robin Syndrome*
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Polysomnography
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Retrospective Studies
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Songbirds*
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Weight Gain