Gastrointestinal stromal tumors (GIST) represent rare malignancies of mesenchymal origin that can appear at any site of the gastrointestinal tract. Their classification, patient treatment and prognosis had been a source of controversy. The biology of these tumors revealed association to the type III tyrosine kinase receptor and the KIT CD117 protein expression. GIST mesenchymal lesions derive from the interstitial cells of Cajal. Classification methods include the one by Miettinen and Lasota and the ‘‘modi?ed NIH classi?cation’’. The treatment of choice is surgical intervention and complete removal of the neoplasm. In patients with tumors that cannot be excised, have given metastasis, or are of high risk for metastasis, treatment also involves Kit/PDGFRA tyrosine kinase inhibitors, such as imatinib. In Greece, several cases have been described.

Retro-rectal tumors are a very rare entity in the adult population, with an incidence of approximately 1 in every 40.000-63.000 patients. Gastrointestinal Stromal Tumors (GIST) are the most common mesenchymal tumors of the gastrointestinal tract. Clinical Case: 51-years-old patient with a clinical scenario of dysuria, vesical urgency and tenesmus, urinary retention, and constipation. Computer Tomography (CT) and Magnetic Resonance Imaging (MRI) shows a presacral mass. Pathology studies report GIST. Treated with abdominal resection and adjuvant therapy. Discussion: In 1983 the GIST was described with its origin in interstitial cells of Cajal, this tumor is more frequently found in the stomach, appearing in the 4th decade of life and being abdominal pain the most common symptom, the more used diagnostic tools are still the CT and MRI, they let the physician decide which of the three approaching surgical methods is used. There are 3 histologic types GIST and the stratification of risk for each one is given based on tumor site, size, number of mitosis, and rupture.

The incidence of pancreatic neuroendocrine tumors (PNETs) is growing, related in part to increased incidental diagnosis of small asymptomatic non-functionnal tumors. Arised from uncontrolled proliferation of neuroendocrine cell with genetic alterations inducing hormone secretion, the PNETs are majorly sporadic, non-functional, and associated with genetic syndromes, mainly Multiple Endocrines Neoplasm type 1 (MEN1) in up to 5%–10% of cases. Because of the very high heterogeneity, optimizing management and standardizing therapeutic strategies for PNETs remains a challenge for surgeons, requiring a multidisciplinary collaboration. Surgery for PNETs has evolved varying from radical resection to parenchyma sparing surgery and even now a selective conservative management. This review work aims to provide an update regarding the surgical treatment for PNETs, in the light of recent published reports.

Ultrasonic vibration is mainly used in minimally invasive surgery since it uses longitudinal mechanical waves with the ability to propagate in a solid and liquid medium, conducted to the tissues through an active tip, a large amount of vibrational energy is produced at the point of contact getting the section, coagulation and dissection of tissue. Objective. To evaluate the operating time and blood loss in major salivary glands benign tumors resection using harmonic scalpel during the period from August 2018 to March 2019 at the Dr. Darío Fernández General Hospital. Material and methods. Twelve patients with benign salivary gland tumors of both sexes between 39 and 76 years of age were included for the study, time and intraoperative bleeding were quantified and analyzed with measures of central tendency. Results: The most frequently performed surgery was submaxilectomy (50%), followed by superficial parotidectomy (33.3%) and submaxilectomy plus lymph node resection (16.6%). The intraoperative time lasted from 20 to 65 minutes with an average 44.16 minutes, bleeding in milliliters ranged from 25 to 60 milliliters with a mean of 42. 9 ml. Conclusions: The use of ultrasonic vibration significantly reduces operating time and blood loss due to coagulation and cutting simultaneously with less heat production.

Image design for healthcare instruction must be attuned to the way we learn and the formulation of our abstract knowledge. Images for a manual on how to use a medical device will differ significantly in presentation from images that are intended as guidance on how to improve corporal performance. Images for the former will rely on intentional recollection of life experiences, learned concepts and facts as tools. While not mutually exclusive, images for the latter should be designed to consciously work with procedural memory to improve bodily performance. The images in this article demonstrate this by imaging the relationship between the pelvic floor muscles, clitoris and demarking “Spots” indicated for sexual arousal. Qualitative data suggests that many individuals know little about the interactive relationship between the clitoris, pelvic floor muscles and the female orgasm. Social and educational venues are inadequate, and in some cases misleading. The use of appropriate images conveys meaning very effectively. So whether imaging for a medical condition, procedure (e.g., surgery) or device to enfranchise the patient in their wellness the individual’s experience and proclivity for learning must be considered. If the images are effectively planned and executed, images can play an important role in involving the patients in their wellness. Enfranchising the patient into the process can improve patient feedback therein contributing to advancements in medical procedure and device usage. The sequence of images is guidance based upon a woman’s innate understanding of her body, so that she may move to a higher state of knowledge where her body performs better. Further, if her mind is inspired by the success, then her body could proceed beyond the achieved state repeatedly. The data confirms this performance structure. Women who score high for pelvic floor strength and coordination report high sexual functioning and genital perception.