Monday, September 26, 2011

Surgical Clinics of North America Volume 90, Issue 4 , Pages xvii-xviii, August 2010
In this issue of Surgical Clinics of North America, a spectrum of liver surgery topics is summarized bringing the reader up to date with the era of modern hepatic resection surgery. The basics of liver anatomy and history are reviewed, along with the current molecular mechanisms of liver ischemia/reperfusion injury relevant to liver transplantation, hepatic trauma, and elective hepatic resections. Hepatic imaging techniques of ultrasound, CT, and MRI have improved and greatly facilitate our diagnostic capabilities for benign lesions and malignancies; however, the conundrum of the subcentimeter indeterminate liver lesion remains. The often confusing nomenclature of hepatic resection surgery was standardized at the 2000 Brisbane, Australia, International Heptao-Pancreato-Biliary Association meeting and is now known as the Brisbane 2000 terminology. Advances in the past decade include the development of laparoscopic liver resection techniques, which have been reported in more than 3000 cases worldwide. Further, robotic liver resection surgery has been described but remains in its infancy. Repair of laparoscopic cholecystectomy injury remains an uncommon but important task for the hepatobiliary surgeon, as is the potentially life-saving emergency hepatic resection for traumatic liver injury. Resection of hepatic colorectal cancer metastases has seen a paradigm shift from a prior emphasis on number of lesions to the present-day focus on sufficient liver remnant and invokes strategies of portal vein embolization and two-stage hepatectomies to increase resectability rates. Current approaches to management of hepatocellular carcinoma continue to evolve, including live donor liver transplantation, selective hepatic resection, ablative techniques, regional liver therapies, and newer systemic chemotherapy. Intrahepatic cholangiocarcinoma is on the rise, and major hepatic resections have been advocated for metastatic neuroendocrine cancers. Successful liver surgery requires a fundamental understanding of liver anatomy, disease pathophysiology, and modern hepatic resection techniques. Two questions always need to be addressed when contemplating hepatic resection surgery that requires both technical expertise and judgment: (1) Can the lesion technically be resected and (2) Should the lesion be resected? https://rapidshare.com/files/3965833881/91_5.rar
Surgical Clinics of North America Volume 87, Issue 2 , Pages xix-xx, April 2007 This issue of the Surgical Clinics of North America is dedicated to surgical trainees at the level of house officers and fellows. The evaluation and management of both benign and malignant diseases of the breast are likely to demand a substantial fraction of a general surgeon's practice, yet general surgery residents frequently receive their breast pathology education in a fragmented fashion. Exposure to outpatient clinics and office-based management (where much of the decision-making processes in breast cancer take place) is limited, and surgical breast procedures are often assigned to junior trainees, who do not necessarily understand the subtle judgment that is required in planning incisions, skin flaps, and extent of breast resections. The surgical chief resident must finish his/her training program with the requisite number of breast procedures documented in their case log, but the majority of them may have been performed during the first half of the residency, and there may have been very little exposure to considerations regarding neoadjuvant therapy versus postoperative adjuvant therapy, postmastectomy radiation, and breast cancer risk reduction. Our goal was to develop a collection of articles that cover essential areas of surgical as well as nonsurgical breast cancer management. We have therefore compiled 18 articles that focus on several important aspects of breast disease management; most of the articles have been coauthored by surgery trainees so that resident-level perspectives are provided. These articles can be categorized in general as having an emphasis on one of the following areas: (1) contemporary surgical treatment strategies (eg, lymphatic mapping and breast reconstruction); (2) new systemic therapy strategies (adjuvant and neoadjuvant); (3) breast cancer risk reduction (surgical and medical); and (4) novel research directions that trainees should consider (eg, disparity-related research and breast tumor ablation techniques).
https://rapidshare.com/files/4419322/87_2.rar

Friday, March 11, 2011

Contemporary Understanding and Management of Renal Cortical Rumors

Urologic Clinics of North America
Volume 35, Issue 4, Pages 543-710 (November 2008)
Search Within This Issue
Contemporary Understanding and Management of Renal Cortical Rumors
Edited by P. Russo
In this issue of the Urologic Clinics of North America numerous experts in this field present a contemporary understanding of the epidemiology, pathology, molecular biology, radiology, and clinical management of renal cortical tumors with an encouraging eye toward the future.
http://rapidshare.com/files/452057532/nov_2008.rar

Urologic Clinics of North America august 2010

Urologic Clinics of North America
Volume 37, Issue 3, Pages 327-486 (August 2010)
Penile and Urethral Cancer
In this issue of the Urologic Clinics of North America, a compilation of experts has delineated the imaging techniques for these lesions and outlined the surgical, radiation, and chemotherapy treatments of the disease. They have also addressed controversies involving the management of lymph node dissections, microsurgery, and reconstruction. This issue provides a strong, comprehensive, contemporary summary of penile and urethral cancers and should be an important part of any urologist's library.
http://rapidshare.com/files/452056403/aug_2010.rar

Tuesday, February 22, 2011

Diagnostic Imaging for the General Surgeon

Surgical Clinics of North America
Volume 91, Issue 1, Pages 1-276 (February 2011)

Diagnostic Imaging for the General Surgeon
Edited by Thomas H. Cogbill, Benjamin T. Jarman


Medical imaging isn’t all that much different from creative photography in some ways. Most of the images we use don’t really look like the real subject at all. Livers aren’t some Hounsfield gray color. Pulmonary arteries don’t have bright white blood running through them. Yet, we get used to looking at these images and making the translation in our minds. Even though current imaging devices are far more sophisticated in terms of digital manipulation of the acquired data, the images are still shadows of reality. To really understand what these shadows mean, one has to do two things: understand the process by which the images are created and compare a lot of images to the gold standard of reality.

The constant fractionation of care has divided the medical community into two nonequal groups: those who look at the images they request and those who read the reports. Perhaps one of my most annoying professional disappointments is when someone calls me about a patient and tells me what the “report” of an imaging study states without having looked at the images, even when the person calling requested the study be performed. One night on call, I was asked by a calling physician to see a patient because “the CT said (sic) the patient had a bowel obstruction.” I asked if he had seen the images of the patient he was calling me about. He replied, “Why should I? I am not a radiologist.” It turned out he had not seen the patient either---disappointing on many levels.

To get the best out of imaging, we need to choose imaging studies wisely and interpret them correctly. In order to do that, we have to understand the power and limitations of imaging and its applications, especially how these studies complement clinical evaluation instead of replacing the history and physical exam. Drs Cogbill and Jarman, along with their colleagues, have assembled a collection of articles that will give the reader a much better foundation upon which to improve their understanding of imaging. Still, practice will be required in order to refine these skills. One will only see what one looks for but only if one actually looks.
http://rapidshare.com/files/449298301/scna_feb_2011.rar