1/7. Possibilities of preventing osteoradionecrosis during complex therapy of tumors of the oral cavity.In recent years, there has been a dramatic increase in the number of tumors of the head and neck. Their successful treatment is one of the greatest challenges for physicians dealing with oncotherapy. An organic part of the complex therapy is preoperative or postoperative irradiation. Application of this is accompanied by a lower risk of recurrences, and by a higher proportion of cured patients. Unfortunately, irradiation also has a disadvantage: the development of osteoradionecrosis, a special form of osteomyelitis, in some patients (mainly in those cases where irradiation occurs after bone resection or after partial removal of the periosteum). Once the clinical picture of this irradiation complication has developed, its treatment is very difficult. A significant result or complete freedom from complaints can be attained only rarely. attention must therefore be focussed primarily on prevention, and the oral surgeon, the oncoradiologist and the patient too can all do much to help prevent the occurrence of osteoradionecrosis. Through coupling of an up-to-date, functional surgical attitude with knowledge relating to modern radiology and radiation physics, the way may be opened to forestall this complication that is so difficult to cure.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/7. Cyclical haematuria sequel to uterine myomectomy: a case report.A thirty-year old married nulliparous lady had a difficult myomectomy done by a general practitioner one year prior to presentation. Two months after the operation, she had her menstruation, but with a concurrent total, painless haematuria. This combination continued for nine months before her family physician referred her to the urological clinic. Full urological work-up revealed an iatrogenic vesico-uterine fistula, but the features were not consistent with those of the classical vesico-uterine fistula syndrome. Transabdominal fistulectomy not only controlled the haematuria but also helped the patient to achieve a viable pregnancy.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/7. Simultaneous gastropleural and gastrocolic fistulae in a quadriplegic male.A 56-year-old, quadriplegic man presented to a physician's office with a large, left pleural effusion. He subsequently was found to have a gastropleural and gastrocolic fistula. These two very rare complications of benign peptic ulcer disease are discussed with special reference to patients with profoundly altered sensation.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/7. Malignant lymphomas of the oral soft tissues.Two cases have been presented in which a malignant lymphocytic tumor was found in the oral soft tissues. The first was a "histiocytic lymphoma" that appeared as a rapidly growing, ulcerative lesion. This tumor was the initial presentation of disease and may be considered a primary lesion. The second was a "poorly differentiated lymphocytic lymphoma" which formed a mass in the mental area. In that case, the tumor was associated with widespread disease. Both of these lesions had previously been diagnosed by physicians as inflammatory processes.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/7. Aortoesophageal fistula. review of clinical, radiographic, and endoscopic features.Primary aortoesophageal fistula is a rare cause of severe and often fatal gastrointestinal bleeding. The classic diagnostic triad consists of midthoracic pain and sentinel hemorrhage, followed by fatal exsanguination. A prompt, definitive diagnosis at the time of the initial bleeding episode is essential for timely, life-saving surgery. Any combination of low-grade, intermittent hematemesis, with midthoracic chest pain, dysphagia, or a mediastinal mass, should alert the physician to this diagnosis, and an aggressive diagnostic and therapeutic approach. In this article, we report a case of aortoesophageal fistula and present photographs.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/7. Two-dimensional and pulsed Doppler echocardiographic abnormalities in coronary artery-pulmonary artery fistula.We describe two patients who presented with precordial continuous murmurs which were diagnosed clinically as due to patent ductus arteriosus; however, two-dimensional echocardiographic and pulsed Doppler echocardiographic studies showed dilatation of the left main coronary artery with turbulent flow during systole in the lumen in both patients. Subsequent selective coronary angiographic studies showed bilateral coronary artery-pulmonary artery fistula in one patient and left coronary artery-pulmonary artery fistula in the other. This study illustrates that in a patient presenting with a continuous murmur which is suggestive of patent ductus arteriosus, such two-dimensional and pulsed Doppler echocardiographic findings as were seen in our patients should immediately alert the physician that he may be dealing with a case of coronary arterial fistula.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/7. Enteric fistulization of a common iliac artery aneurysm: an unusual cause of gastrointestinal hemorrhage and shock.A 78-year-old man with a history of recent unexplained lower gastrointestinal bleeding presented to the emergency department with the acute onset of abdominal pain, tenesmus, and shock. Computed tomography of the abdomen showed a fistula between a common iliac artery aneurysm and the small intestine. laparotomy demonstrated a saccular aneurysm of the common and proximal internal iliac arteries with fistulous communication to the distal ileum. Aneurysmectomy, arteriorrhaphy, and segmental ileal resection with primary anastomosis were successfully performed. This case illustrates a rare complication of an uncommon aneurysm, emphasizing the need for emergency physicians to consider complicated vascular disease in the evaluation of a patient with abdominal pain and shock.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |