Pylorus preserving pancreatoduodenectomy in a 6-year-old girl with recurrent pancreatitis due to an annular pancreas

AbstractThe pancreatitis caused by an annular pancreas rarely needs a surgical management in children. Here, we report a case of a 6-year old girl in whom pylorus-preserving pancreatoduodenectomy (PPPD) was performed for the pancreatitis caused by an annular pancreas. As she had previous operations for duodenal atresia and pancreaticobiliary maljunction, PPPD was chosen as a definitive surgical treatment of annular pancreas. She has been free from symptoms for 2 years after the operation

Changes in bacterial number at different sites of oral cavity during perioperative oral care management in gastrointestinal cancer patients: preliminary study

Objective: The objective of this study was to clarify differences in bacterial accumulation between gastrointestinal cancer patients who underwent severely invasive surgery and those who underwent minimally invasive surgery. Material and Methods: We performed a preliminary investigation of gastrointestinal cancer patients who were treated at the Department of Surgery, Takarazuka Municipal Hospital, from 2015 to 2017 (n=71; 42 laparoscopic surgery, 29 open surgery) to determine changes in bacterial numbers at different sites of the oral cavity (tongue dorsum, gingiva of upper anterior teeth, palatoglossal arch), as well as mouth dryness and tongue coating indices. Specifically, patients received professional tooth cleaning (PTC), scaling, tongue cleaning, and self-care instruction regarding tooth brushing from a dental hygienist a day before the operation. Professional oral health care was also performed by a dental hygienist two and seven days after surgery. Oral bacteria numbers were determined using a bacterial counter with a dielectrophoretic impedance measurement method. Results: The number of bacteria at all three examined sites were significantly higher in the open surgery group when compared to the laparoscopic surgery group on the second postoperative day. Relevantly, bacterial count in samples from the gingiva of the upper anterior teeth remained greater seven days after the operation in patients who underwent open surgery. Furthermore, the dry mouth index level was higher in the open surgery group when compared to the laparoscopic surgery group on postoperative days 2 and 7. Conclusions: Even with regular oral health care, bacterial numbers remained high in the upper incisor tooth gingiva in gastrointestinal cancer patients who received open surgery. Additional procedures are likely needed to effectively reduce the number of bacteria in the gingival area associated with the upper anterior teet

The Natural Degeneration Course in the T1rho Values of Normal Knee Cartilage

The purpose of our study is to investigate whether there is an age-related change in T1 rho values and to evaluate the effects of weight bearing on age-related increase in T1 rho values of normal cartilage. Thirty-two asymptomatic patients were examined using a 3.0T MRI to determine knee cartilage T1 rho values. Femorotibial and patella cartilage was defined as weight-bearing cartilage (WB-C) and non-weight-bearing cartilage (NWB-C), respectively. The femoral cartilage was divided into weight-bearing (WB-P) and less-weight-bearing (LWB-P) portions. Pearson's correlation coefficient and single regression analysis were used to assess the relationship between cartilage T1 rho values and age. The slopes of the regression lines of cartilage T1 rho values and age were compared between WB-C and NWB-C and between WB-P and LWB-P. Cartilage T1 rho values correlated positively with aging for all cartilage regions and all age groups (p<0.001). In the medial femoral cartilage, the age-related increase in T1 rho values was significantly greater for WB-P than for NWB-P (p<0.05). For several cartilage regions, this increase was greater for WB-C than for LWB-C (p<0.05). The T1 rho value is very sensitive to age-related cartilage degeneration and weight bearing-related degeneration, and hence may be a very sensitive and useful measure for the early diagnosis of osteoarthritis