Laparoscopic Live Donor Nephrectomy: Techniques and Results

Living donation is still needed to overcome organ shortage. All countries seem to increase and encourage such kind of donation according to medical and ethical guidelines. The results of renal transplantation from living donors are better compared to those from cadaveric kidneys. Since the first successful kidney transplantation from a living donor, some 63 years ago, surgery has shifted toward a less invasive approach offering to the donor less pain, better cosmesis, a shorter hospital stay, and a quick return to normal activities. Laparoscopic living-donor nephrectomy (LLDN) is now considered as the gold standard approach for kidney retrieval on live donors and has undoubtedly revolutionized kidney donation. It must offer to the donor safety, low morbidity, and fast recovery and must obtain a graft with adequate vessel length, short warm ischemia time, and well-preserved ureteral blood supply. We describe our technique of LLDN according to safety principles and reproducible steps. Highly qualified and well-trained surgeons are allowed to perform such techniques within a very well-equipped environment and with experienced surgical staff. A living donor program should undertake at least 30 cases per year to maintain adequate experience and offer less complication rate

Metachronous, Single Metastasis to the Parotid, from Primary Breast Cancer: A Case Report and Review of the Literature

Background. The parotid gland is an unusual site for metastatic disease and when metastasis occurs, it commonly originates from head and neck primaries. Spread from distant infraclavicular sites such as the breast, into the parotid, is even more unusual with very few cases reported in the literature. Case Report. We describe the case of a 65-year-old woman presenting for a rapidly enlarging right parotid mass. She had a history of an invasive ductal carcinoma of the right breast and was disease-free in the past 6 years prior to her presentation. She was thereafter diagnosed as having a solitary parotid metastasis from breast origin. A total parotidectomy was done and she was referred for adjuvant radiotherapy. Conclusion. Any parotid metastasis should be investigated, especially in patients with a prior history of cancer where the possibility of metastasis, even if improbable, should be kept in mind. Fine needle aspiration biopsy (FNAB) is the first diagnostic procedure to be done and immunocytochemistry can provide valuable information even if it is not always needed for diagnosis. Superficial parotidectomy when feasible with adjuvant radiotherapy is the preferred approach for solitary metastasis of the parotid. The prognosis, however, remains poor regardless of the treatment modality used

Bilateral Reverse Total Shoulder Arthroplasty with Soft Tissue Release for Bilateral Posterior Fracture Dislocation after Status Epilepticus

Proximal humerus fracture is a common orthopedic presentation, with bimodal age distribution. On the other hand, bilateral proximal humerus fracture dislocation is a rarely reported pathology, especially when it is not the result of direct trauma. We present a case of a 71-year-old female patient found to have simultaneous bilateral 4-part proximal humerus fractures following status epilepticus treated surgically with bilateral reverse shoulder arthroplasty with constraint and soft tissue release. In a patient with recurrent status epilepticus episodes, the combination of constrained reverse shoulder arthroplasty and the extensive soft tissue release should decrease the rate of failure and dislocation dramatically. We conclude, after reviewing the literature, that there is no straightforward algorithm for treating such patients and that a clear classification should take into account both bone quality and patient comorbidities which has yet to be developed

Metastatic Parotid Myoepithelial Carcinoma in a 7-Year-Old Boy

Myoepithelial carcinoma is a rare malignancy of the parotid gland that is usually seen in adults. We report the first case in children of myoepithelial carcinoma of the parotid gland with massive invasion of the facial nerve and metastasis to cervical lymph nodes. Due to its rarity, the treatment and the clinical course of this tumor are not well defined yet. We performed a total parotidectomy, a modified neck dissection, and a postoperative radiotherapy in 7-year-old boy. Sparing of the facial nerve was impossible; it was sacrificed and grafted with a sural nerve. Histopathology confirmed the diagnosis of a parotid gland carcinoma and immunohistochemical markers showed that the tumor cells express cytokeratin, epithelial membrane antigen, cytokeratin 7, smooth muscle actin, P63, CEA, and S100. This pattern of immunostaining is consistent with the diagnosis of myoepithelial carcinoma. On the postoperative tenth month he presented with a pulmonary and lumbar vertebra metastasis

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Dynamiques de citoyenneté, d'éco-citoyenneté, de réseaux, de médias, de territoires, de culture et d'interculturalité. Pratiques journalistiques, innovations numériques, nouvelles formes de savoir, mouvements sociaux et divulgation des sciences… Autant de problématiques et de pratiques que l'approche communicationnelle relient. En croisant les regards théoriques et empiriques, cet ouvrage offre une contribution à la compréhension et à l'analyse des logiques d'actions et de construction des savoirs dans un espace méditerranéen en pleine mutation. Car, depuis près de trois décennies, par vagues successives, les relations scientifiques entre chercheurs en communication du nord et du sud de la Méditerranée ne cessent de s'intensifier. Il semble émerger sinon une identité méditerranéenne contemporaine, du moins des dynamiques et mouvements qui renvoient à un patrimoine commun issu d'une l'histoire millénaire et qui se traduit aujourd'hui dans les paradoxes d'une unité plurielle. Cet ouvrage apporte aussi la preuve que le champ de la communication favorise le dépassement des frontières institutionnelles et académiques, et nourrit une réflexion commune entre chercheurs de l'Université et du CNRS