Embolization of gastric veins in patients with esophageal hemorrhage during laparotomy

The authors discuss the possibility of a laparotomy approach for endovascular embolization of the gastric veins in patients with portal hypertension and gastroesophageal bleeding. This approach was used in four patients in whom transhepatic catheterization of the portal channel was impossible. After laparotomy, catheterization of the portal vein system was conducted through one of the veins of the small intestine. The effect of embolization in two of three patients who were subjected to the operation consisted in correction of esophagitis and complete cessation of esophageal bleeding. In view of the danger of the development of operative and postoperative complications due to the specific features of the pathological condition, the authors recommend using laparotomy endovascular embolization of the gastric veins only in the presence of strict indications.     

Outcomes of oesophageal atresia and tracheo‐oesophageal fistula repair

Oesophageal atresia and tracheo‐oesophageal fistula are congenital anomalies of the oesophagus requiring surgical repair in infancy, either by open or thoracoscopic approach. Although mortality rates associated with this procedure are low, children may go on to have complications throughout childhood and into adulthood, most commonly related to ongoing gastrointestinal and respiratory symptoms. This review outlines the early, mid and long‐term outcomes for these children in terms of quality of life and incidence of symptoms.     

The vascular bed as the primary target in the destruction of skin grafts by antiserum. I. Resistance of freshly placed xenografts of skin to antiserum

Rat skin grafted onto immunosuppressed mice is resistant to mouse anti-rat serum during the first 7-10 d after transplantation. It gradually acquires susceptibility, reaching a peak of sensitivity at 14-16 d after grafting. The grafts remain sensitive to antiserum, though at decreasing levels for an additional 3 wk, and grafts that persist beyond that time are resistant to antiserum for as long as they survive. In the study reported here, it is shown that the initial period of resistance to antiserum is due to factors acting locally within the graft and is entirely uninfluenced by the regimen of immunosuppression or the protective dressings that are used. After administration of antiserum, deposits of the injected immunoglobulin and of endogenous C3 are found on the luminal surfaces of graft vessels, although no significant tissue damage is observed. Rat skin that has become highly sensitive to antiserum 14-16 d after transplantation loses that sensitivity if it is regrafted to a new recipient, and then regains it 8-10 d later. Thus, the resistance of freshly grafted skin to antisera is associated with the process of healing into place, a conclusion that is supported by the observation that the intracutaneous administration of antisera to rats causes intense local inflammation and necrosis. The skin is therefore sensitive just before it is removed for grafting, but temporarily loses sensitivity thereafter. Resistance to antiserum during the first 3 or 4 d after transplantation is probably attributable to the fact that at that time grafts are vascularized poorly if at all. The state of resistance extends for several days after vascularization of the graft takes place and is then only gradually lost, a phenomenon that seems to be associated with the resistance of newly formed and regenerating blood vessels to vasoactive substances. This view is in accord with and, indeed, supports the idea that the induction of vascular injury is an essential step in antisera-mediated damage to tissue grafts.     

Bacterial regulation of antagonistic activity of bacteria

The phenomenon of microbial regulation of bacterial antagonism was studied using metabolites and cell walls of indicator microorganism culture as inductors. The algorithm of selection of stimulators of bacterial antagonistic activity is determined, experimental conditions are described, and methodological approach to stimulation of bacterial antagonistic activity is developed, which can be used for stimulation of probiotic antagonistic activity and for improving colonization resistance of the host organism during infection. __________ Translated from Byulleten’ Eksperimental’noi Biologii i Meditsiny, Vol. 144, No. 11, pp. 545–549, November, 2007     

Survival and half-life of red cells salvaged after hip and knee replacement surgery

The survival of autologous red cells collected intraoperatively has been reported previously. This study measures the survival and half- life of red cells collected 3 hours after hip and knee arthroplasty. For six patients, four having knee replacements and two having hip replacements, the salvaged red cells were labeled with radioactive 51Cr. Peripheral blood was simultaneously labeled with nonradioactive 52Cr. There was no significant difference in the survival or half-life of the salvaged and the venous blood.