Acute Appendicitis in an Incarcerated Femoral Hernia: A Case of De Garengeot Hernia

Appendicitis and incarcerated hernia are frequently encountered reasons of emergency surgery for acute abdomen. The treatment in early stages of each condition is generally simple, but when these conditions are combined, the symptoms become slightly complicated, obscuring specific symptoms. Especially the lack of symptoms for appendicitis leads to delayed diagnosis, resulting in high morbidity. Amyand hernia, which contains appendix in its inguinal hernia sac, is perhaps more familiar to the general surgeons than De Garengeot hernia, which is an incarcerated femoral hernia with an appendix in its sac. We report the case of a 90-year-old female with incarcerated femoral hernia who underwent emergency hernioplasty only to reveal an inflamed appendix in its sac. The patient underwent both appendectomy and hernia repair simultaneously with synthetic mesh and was discharged on postoperative day 7 without any complications. We will also discuss the physical and radiological findings of De Garengeot hernia

Two Cases of Primary Malignant Fibrous Histiocytoma of the Liver: Immunohistochemical Expression of Ezrin and Its Relationship with Prognosis

Malignant fibrous histiocytoma (MFH) as soft tissue sarcoma would not be especially noteworthy, but primary hepatic MFH reports are extremely rare. Herein, we report ezrin expression in tumor tissues from two primary hepatic MFH cases with different prognoses. Cases 1 and 2 were both women, ages 45 and 70 years, respectively. Case 1 had an 11×10 cm liver tumor in segment (S) 3, and case 2 had two liver tumors, 12×8 cm in S5 and 10×7 cm in S8. Neither had any other systemic tumors. Cases 1 and 2 survived for two year and ten months and for eight and a half months, respectively, after the initial tumor resection. Microscopically, the tumors of these two cases were similar and showed proliferation of atypical cells, including spindle, pleomorphic and multi-nucleated giant cells arranged in storiform, sheet and/or fascicle patterns, with scattered foci of inflammatory cells, indicating MFH. Ezrin expression in tumor tissue from case 1 was sparse, whereas that of case 2 showed strong ezrin expression in many tumor cells. The present results indicate ezrin immunoreactivity in primary hepatic MFH to correlate possible with prognosis, which is consistent with reports on some other types of malignancies

Differing deregulation of HER2 in primary gastric cancer and synchronous related metastatic lymph nodes

 Sorbtional properties of carbonic sorbents on the base of pine sawdust in the processes of purification of water mediums and complicated technological solution from petroleum products and phosphorus compounds are investigated. The possibility of carbonic sorbents modification by halogen organic compounds to increase the degree of purification of water ecosystems is analyzed. Исследованы сорбционные свойства углеродных сорбентов на основе опилок сосны в процессе очистки водных сред и сложных технологических растворов от нефтепродуктов и соединений фосфора. Рассмотрена возможность модифицирования углеродных сорбентов галогенсодержащих органическими соединениями с целью повыше-ния степени очистки водных экосистем. Досліджено сорбційні властивості вуглецевих сорбентів на основі обпилювань сосни у процесі очищення водних середовищ і складних технологічних розчинів від нафтопродуктів і з’єднань фосфору. Розглянуто можливість модифікування вуглецевих сорбентів галогеновмісними органічними з’єднаннями з метою підвищення ступеня очищення водних екосистем

Malignant Peritoneal Mesothelioma Mimicking Ischemic Colitis

The prognosis of malignant peritoneal mesothelioma is extremely poor with a mean survival time of 12 months. The initial symptoms are poor and atypical. Because of its rare entity and little knowledge of its treatments, there are few reports of long-term survival. We encountered a very unique case with strong impression on radiological findings of malignant peritoneal methothelioma. We had misdiagnosed it because of the findings and because the time course was similar to that of ischemic colitis. The radiological findings on CT and enema disappeared within one week after antibiotic therapy

Enhanced Merge Sort- A New Approach to the Merging Process

AbstractOne of the major fundamental issues of Computer Science is arrangement of elements in the database. The efficiency of the sorting algorithms is to optimize the importance of other sorting algorithms11. The optimality of these sorting algorithms is judged while calculating their time and space complexities12. The idea behind this paper is to modify the conventional Merge Sort Algorithm and to present a new method with reduced execution time. The newly proposed algorithm is faster than the conventional Merge Sort algorithm having a time complexity of O(n log2 n). The proposed algorithm has been tested, implemented, compared and the experimental results are promising

Current Approaches to the Treatment of Early Hepatocellular Carcinoma

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/139902/1/onco0034.pd

Surgical treatment of hepatocellular carcinoma: Evidence-based outcomes

Surgeons may be severely criticized from the perspective of evidence-based medicine because the majority of surgical publications appear not to be convincing. In the top nine surgical journals in 1996, half of the 175 publications refer to pilot studies lacking a control group, 18% to animal experiments, and only 5% to randomized controlled trials (RCT). There are five levels of clinical evidence: level 1 (randomized controlled trial), level 2 (prospective concurrent cohort study), level 3 (retrospective historical cohort study), level 4 (pre-post study), and level 5 (case report). Recently, a Japanese evidence-based guideline for the surgical treatment of hepatocellular carcinoma (HCC) was made by a committee (Chairman, Professor Makuuchi and five members). We searched the literature using the Medline Dialog System with four keywords: HCC, surgery, English papers, in the last 20 years. A total of 915 publications were identified systematically reviewed. At the first selection (in which surgery-dominant papers were selected), 478 papers survived. In the second selection (clearly concluded papers), 181 papers survived. In the final selection (clinically significant papers), 100 papers survived. The evidence level of the 100 surviving papers is shown here: level-1 papers (13%), level-2 papers (11%), level-3 papers (52%), and level-4 papers (24%); therefore, there were 24% prospective papers and 76% retrospective papers. Here, we present a part of the guideline on the five main surgical issues: indication to operation, operative procedure, peri-operative care, prognostic factor, and post-operative adjuvant therapy