Stereological evaluation of liver volume in living donor liver transplantation using MDCT via the Cavalieri method.

In living donor liver transplantation (LDLT), obtaining the precise volume of the graft is very important to decrease volume-related postoperative complications, especially in cases with suspected small-for size grafts. We used stereology based on the Cavalieri method (CM), a new method to measure liver graft volume, and compared the results with those obtained through intraoperative measurement (IOM) and through multidetector computed tomography (MDCT) measurement. Liver volumes estimated using the 3 methods were well-correlated with each other (r(2) = 0.94 and P < 0.001 for IOM and CM; r(2) = 0.91 and P < 0.001 for IOM and MDCT, and r(2) = 0.95 and P < 0.001 for CM and MDCT); however, they were different from each other (in descending order, 908 +/- 124 cm(2), 861 +/- 121 cm(2), and 777 +/- 168 cm(2) for MDCT, CM, and IOM, respectively). Although MDCT and CM overestimated the volumes, the results of CM were almost similar to those obtained via IOM. In conclusion, our results suggest that CM measured the liver graft volume more reliably. Thus, its use, particularly in cases with suspected small-for-size graft, may prove useful.     

Treatment of horizontal root‐fractured maxillary incisors – a case report

Abstract – Traumatic dental injuries often occur to the teeth and their supporting tissues and they are the main reasons for emergency visit to a dental clinic. Management of a fracture depends on its position and the extent of root involvement. Horizontal root fractures are not seen frequently and the treatment consists of reduction and long‐term rigid fixation of the coronal segment. The present case demonstrates the successful management of two horizontally fractured maxillary central incisors with a follow‐up period of 9 months.     

A practical method of fabricating a lingual retainer.

Retention is a major part of orthodontic treatment, not an optional secondary protocol. In recent years, studies investigating dentofacial changes during and after the growth period have led most clinicians to use fixed retention appliances after treatment. Fixed retainers can be attached to the teeth directly or indirectly. We present a practical, indirect method for bonding fixed retainers, using Sondhi Rapid-set Indirect Bonding Adhesive (3M Unitek, Monrovia, Calif).     

Iatrogenic injuries to ureter, bladder and urethra during abdominal and pelvic operations

Abdominal and pelvic operations at Departments of Obstetrics and Gynaecology, and General Surgery play an important role in ureteral, bladder and rarely urethral injuries. Fifty-nine patients with iatrogenic ureteral, bladder and urethral injuries were treated at the Department of Urology, Atatürk University Research Hospital, between 1985 and 1995. These injuries were urinary vaginal fistulas in 43 patients (vesicovaginal 33, ureterovaginal 7, urethrovaginal 2 and vesicovaginal plus urethrovaginal 1), ureteric ligation in 9, bladder laceration in 7. These injuries were treated by different methods. All patients were followed up by intravenous urography (IVU) and urine culture three months later. It must be borne in mind that iatrogenic urinary tract injuries are not rare. Bladder and ureteral catheterization must be performed to prevent these complications.     

The effect of pneumoperitoneum on bacterial clearance and RES functions in a model of E. coli peritonitis

The use of laparoscopic surgery in peritonitis has increased rapidly. The present study examined the effects of pneumoperitoneum on bacterial clearance. Spraque-Dawley rats were divided into six groups of seven animals. In groups 1 and 4, laparotomy with a midline incision was performed and 10(9) E. coli in a volume of 1 ml inserted into the peritoneal cavity. Groups 2, 3, 5, 6 received an identical quantity of E. coli by intraperitoneal injection. Groups 3 and 6 received carbon dioxide pneumoperitoneum at a constant pressure of 5 mmHg for 60 minutes after intraperitoneal injection of E. coli. In one hour groups; the mean bacterial counts per lung from the E. coli injection with laparotomy group was significantly higher than for the E. coli injection with pneumoperitoneum group (p < 0.05). The mean bacterial counts per kidney in the E. coli injection with laparotomy group was higher compared with the E. coli injection and E. coli injection with pneumoperitoneum groups (p < 0.0001). There was statistically significant difference in quantitative bacteraemia between the E. coli injection with laparotomy group and the E. coli injection or E. coli injection with pneumoperitoneum groups (p < 0.05). In four-hour groups; the mean bacterial counts of lungs and liver-spleen were significantly higher in the E. coli injection with laparotomy group than in the E. coli injection and E. coli injection with pneumoperitoneum groups (p < 0.05 and p < 0.001 respectively). The quantitative bacteria was significantly higher in the E. coli injection with laparotomy group than in the E. coli injection and E. coli injection with pneumoperitoneum groups (p < 0.05). This study demonstrates that pneumoperitoneum impairs the clearance of bacteria from the peritoneal cavity in an experimental model of peritonitis. However, we could not detect the deleterious effects of pneumoperitoneum compared with laparotomy.     

Adult intussusception secondary to inflammatory fibroid polyp: demonstration by MRI

Adult intussusception secondary to inflammatory polyp occurs rarely. Imaging of intussusception on ultrasound, CT and MRI has been previously described. In this report we describe a case of an adult intussusception secondary to inflammatory fibroid polyp. Both the lead point (inflammatory fibroid polyp) and intussusception were depicted on multiplanar MR images. Findings on MRI were confirmed at surgery and histopathological examination. Received: 11 January 2000; Revised: 3 May 2000; Accepted: 4 May 2000