Intra-abdominal Abscess in the Course of Intragastric Migration of an Adjustable Gastric Band: a Potentially Life-threatening Complication

Intragastric band migration is a potential complication of adjustable gastric banding. A 39-year-old morbidly obese female underwent laparoscopic adjustable gastric banding. After uneventful postoperative follow-up of 4 years, she had slow, steady failure of the restrictive effect, associated with regain of weight. Intragastric band migration was confirmed on GI series, and the patient was admitted to the hospital for revision. The patient presented no symptoms of acute abdomen. Intraoperatively, a huge intra-abdominal abscess was discovered in the epigastric area. The stomach with the band and tubing were involved in the inflammatory process. Labtobacillus acidofilus was found to be the causative organism. Removal of the gastric band with simultaneous resectional gastric bypass was performed. The recovery proceeded with no complications. Intragastric band migration can cause intra-abdominal abscess; thus, we believe that every case of band migration should be treated without delay to avoid further complications.     

Sutureless amniotic membrane fixation using fibrin glue for ocular surface reconstruction in a rabbit model

PURPOSE: Amniotic membrane transplantation has become an important treatment option for corneal surface reconstruction. However, suture fixation of the transplant has various disadvantages like corneal irritation, scarring, graft loss due to membrane shrinkage, and the need for subsequent suture removal. Replacement of sutures by bioadhesives might be an advantageous alternative. This controlled study was designed to evaluate a new sutureless technique for amniotic membrane fixation onto the corneal surface by using fibrin glue. METHODS: Standardized disks of cryopreserved amniotic membranes were transplanted onto the deepithelialized cornea of 12 rabbits using either conventional suture fixation or a new fibrin glue technique. The rabbits were followed-up with slit-lamp examination and fluorescein staining until epithelialization was completed. Consecutively, the rabbits were killed and the eyes processed for histology and immunohistochemistry for cytokeratin-3. RESULTS: All membranes of both groups stayed in place throughout the follow-up time and showed a progressive graft epithelialization that was completed after 12 days. Whereas suture-fixated membranes showed progressive tissue shrinkage, fibrin-glued sheets remained unaltered. In the bioadhesive group, histology revealed a smooth fibrin layer in the graft-host interface and a continuous, stratified layer of cytokeratin-3 expressing corneal epithelial cells on the membrane surface. In contrast, suture-fixated membranes showed contracted and prominent membrane edges with epithelial ingrowth into the submembrane interface. CONCLUSION: Our results demonstrate the general feasibility of reproducible and reliable sutureless amniotic membrane fixation onto the corneal surface in rabbits. Stable adherence is maintained until epithelialization is completed. The sutureless technique gives sufficient manipulation time for the sheet before the final cross-linking process is completed. Furthermore, several advantageous characteristics could be demonstrated as increased biocompatibility, better epithelialization pattern and the lack of membrane shrinkage.     

Role of SRC kinases in Neu-induced tumorigenesis: challenging the paradigm using Csk homologous kinase transgenic mice

Amplification of the HER-2/neu (ErbB2) gene is observed in approximately 30% of human breast cancers, correlating with a poor clinical prognosis. Src kinases are also involved in the etiology of breast cancer, and their activation was suggested to be necessary for Neu-induced oncogenesis. To address whether Src activity is essential for Neu-mediated tumorigenesis, we used a physiologic inhibitor of Src kinase activity, the Csk homologous kinase (CHK), expressed as a mammary tissue-specific transgene. Our data, using a physiologic inhibitor of Src activity (CHK), showed that blocking of Neu-induced Src activity without altering Src expression levels had no significant effects on Neu-mediated mammary tumorigenesis in vivo. This contradicts the current paradigm that activation of Src kinases is essential for Neu-induced oncogenesis. This study is the first to distinguish between the kinase-dependent and kinase-independent actions of Src and shows that its kinase-dependent properties are not requisite for Neu-induced tumorigenesis.     

Colour Doppler ultrasound assessment of well-functioning mature arteriovenous fistulas for haemodialysis access

OBJECTIVE: To summarize and compare the diagnostic accuracy of contrast and subtraction arthrography in the assessment of aseptic loosening of total hip arthroplasties. DESIGN: This meta-analysis was performed using methods described by the Cochrane Methods Group on Systematic Reviews of Screening and Diagnostic Tests. We included original, English-language papers published between January 1975 to October 2004 that examined contrast-enhanced arthrography with or without subtraction for diagnosis of loosening of total hip prostheses. A qualitative and quantitative analysis was performed by two investigators. RESULTS: With regard to the acetabular component, pooled sensitivity and specificity for contrast arthrography was 70% (95% confidence interval, 52-84) and 74% (95% CI, 53-87), respectively. Subtraction arthrography had a significantly higher sensitivity of 89% (95% CI, 84-93) (p=0.01), with a similar specificity of 76% (95% CI, 68-82). For the femoral component, pooled sensitivity and specificity for contrast arthrography were 63% (95% CI, 53-72) and 78% (95% CI, 68-86). Pooled estimates for subtraction arthrography revealed a significantly higher sensitivity of 86% (95% CI, 74-93) (p=0.003). Specificity was 85% (95% CI, 77-91) and was similar to the data of contrast arthrography (p=0.23). CONCLUSION: Using the present data we found that the subtraction arthrography is a sensitive technique for detection of loosening of total hip prostheses, offering added value over contrast arthrography, especially for evaluation of the femoral component.     

Triboluminescence Phenomenon Based on the Metal Complex Compounds—A Short Review

Triboluminescence (TL) is a phenomenon of light emission resulting from the mechanical force applied to a substance. Although TL has been observed for many ages, the radiation mechanism is still under investigation. One of the exemplary compounds which possesses triboluminescent properties are copper(I) thiocyanate bipyridine triphenylphosphine complex [Cu(NCS)(py)₂(PPh₃)], europium tetrakis dibenzoylmethide triethylammonium EuD₄TEA, tris(bipyridine)ruthenium(II) chloride [Ru(bpy)₃]Cl₂, and bis(triphenylphosphine oxide)manganese(II) bromide Mn(Ph₃PO)₂Br₂. Due to the effortless synthesis route and distinct photo- and triboluminescent properties, these compounds may be useful model substances for the research on the triboluminescence mechanism. The advance of TL studies may lead to the development of a new group of sensors based on force-responsive (mechanical stimuli) materials. This review constitutes a comprehensive theoretical study containing available information about the coordination of metal complex synthesis methodologies with their physical, chemical, and spectroscopic properties.     

Quadrantanopia as the only symptom of post-COVID stroke in the occipital pole: Case report

Rationale:This is a case report describing delayed complications of COVID-19 pneumonia, which evolved into the vascular-ischemic complications leading to quadrantanopia and MRI findings consistent with recent ischemic event in the occipital pole of the brain.Patient concerns:We report a case of a 46-year-old woman with quadrantanopia due to stroke confirmed with brain MRI, secondary to COVID-19 infection with chronically elevated D-dimers and treated with anticoagulation/antithrombotic modalities. Quadrantanopia was the only symptom recognized by the patient of a stroke localized in the occipital pole of the brain.Diagnosis:The patient was diagnosed with quadrantanopia due to stroke confirmed with brain MRI, secondary to COVID-19 infection.Intervention:Patient underwent ophthalmological examination and MRI.Outcomes:A thrombotic or ischemic risks in the chronic recovery from COVID-19 should be considered in patients with elevated D-dimers.Lessons:An MRI should be considered as a long term follow up for post-COVID-19 patients reporting ophthalmic or neurologic complains.     

Influence of spinal anesthesia on corrected QT interval

BACKGROUND AND OBJECTIVES: Prolongation of the QT interval may result in grave cardiac arrhythmias, polymorphic ventricular tachycardia ("torsades de pointes"), and ventricular fibrillation. We assessed the influence of spinal anesthesia on the QTc interval and the potential arrhythmogenicity of this method of anesthesia. METHODS: Assessment was performed in 20 male unpremedicated patients, I or II American Society of Anesthesiologists physical status, who underwent spinal anesthesia for elective surgical procedures. Values of the QTc interval, heart rate, and arterial pressure were measured before spinal anesthesia as well as after 1, 3, 5, and 15 minutes of adequate blockade. RESULTS: Statistically significant lengthening of the QTc interval (compared with initial values) was observed in the first minute after blockade and in subsequent measurements. No differences were observed between mean values of the QTc interval after the onset of blockade. No significant changes in heart rate were noted. From the third minute on, significant decreases of the systolic, diastolic, and mean arterial blood pressure were observed as compared with baseline. These decreases in systolic, diastolic, and mean arterial blood pressure persisted for the entire study duration. No one patient developed clinically important cardiac arrhythmias. CONCLUSIONS: Spinal anesthesia provokes significant QTc interval prolongation in patients without cardiovascular disorders.