Comparison of antioxidant enzyme activity in the internal spermatic vein and brachial veins of patients with infertile varicocele

AIM: Recent studies have shown that both oxidative and reductive stresses are present within the internal spermatic vein of patients with varicocele. The aim of this study was to compare the activities of antioxidant enzymes in the internal spermatic vein and brachial vein of patients with varicocele. METHODS: Fifteen primary infertile varicocele patients and ten normal-nonvaricocele-fertile control subjects participated in this study. The patients and subjects were first given a physical and color doppler examination, and then whole blood samples were drawn from the brachial vein and a dilated internal spermatic vein during surgery. Superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) enzyme activities were assessed by enzymatic methods, and the results were compared using the Mann-Whitney U test. RESULTS: The activity of SOD in the internal spermatic veins and brachial veins of patients with varicocele was 60.17 +/- 2.15 and 42.10 +/- 1.60 U/g protein, respectively; that of GSH-Px was 5.44 +/- 0.14 and 3.92 +/- 0.14 U/g protein, respectively. The results were statistically significant (P < 0.05). In the control group, the activity of SOD in the internal spermatic veins and brachial veins was 43.12 +/- 1.80 and 40.01 +/- 2.10 U/g protein, respectively; that of GSH-Px was 3.35 +/- 0.20 and 3.7 +/- 0.10 U/g protein, respectively (P > 0.05). CONCLUSIONS: Increased antioxidant enzyme activity in the internal spermatic vein may be due to increased oxidative stress in the internal spermatic vein: the increase in antioxidant enzyme activity may be a response to offset the toxic actions of reactive oxygen species. Further studies are needed to confirm this suggestion.     

Ropivacaine 0.25% is as effective as bupivacaine 0.25% in providing surgical anaesthesia for lumbar plexus and sciatic nerve block in high-risk patients: preliminary report

Ropivacaine is potentially less cardiotoxic and neurotoxic than bupivacaine. The aim of this study was to compare the effectiveness of ropivacaine 0.25% and bupivacaine 0.25% for surgical anaesthesia and postoperative analgesia during lumbar plexus and sciatic nerve block in high-risk patients. We performed combined lumbar plexus and sciatic nerve blockade on 62 consecutive ASA III or IV patients undergoing unilateral hip or femur surgery. The first 30 patients received bupivacaine (Group 1) and the remaining 32 patients received ropivacaine (Group 2). Perioperative management was otherwise similar The groups were compared for the time of onset of the block, additional analgesics and sedatives required, time from end of surgery to the first analgesic requirement and the need for rescue analgesia. Ninety percent (29/32) of the patients in the ropivacaine group and 86% (26/30) of the patients in the bupivacaine group reached surgical anaesthesia. The time from the end of the surgery to the first analgesic requirement was similar between the two groups (10.3 +/- 5.2 hours for ropivacaine, 11.2 +/- 4.6 hours for bupivacaine). There was no statistically significant difference between the two groups in any of the measured variables (P > 0.05). The results of this preliminary study suggest that ropivacaine 0.25% is as effective as bupivacaine 0.25% when used for blocking lumbar plexus and sciatic nerve in high-risk patients undergoing hip or femur surgery.     

The effect of polishing techniques on the surface roughness and color change of composite resins

STATEMENT OF PROBLEM: Surface characteristics may affect the color change and surface roughness of composite resins. PURPOSE: This study evaluated the surface roughness and color change of a hybrid, a microhybrid, and a nanohybrid composite resin polished with the use of polishing discs, wheels, and a glaze material. MATERIAL AND METHODS: Fifty discs (10 x 2 mm) were fabricated for each composite resin (nanohybrid, Grandio; microhybrid, Filtek Z250; hybrid, Quadrant Universal LC) for a total of 150 discs, prepared using polyester strips and divided into 5 groups of 10. One of the groups served as control (C) and had no surface treatment (n=10). The specimens of the experimental groups were ground with 1000-grit silicon carbide paper. In 4 experimental groups (n=10), specimen surfaces were polished with polishing discs (D) (Sof-Lex), with polishing wheels (W) (Astropol), with polishing discs preceding the glaze application (DG) (Biscover), or with polishing wheels preceding the glaze application (WG), respectively. Color was assessed using a small area colorimeter. The color differences (DeltaE) values between the specimens of Group C and the experimental groups were calculated, and the data were compared using 2-way analysis of variance (ANOVA) (alpha=.05). Subsequently, the surface roughness (Ra) of the specimens was evaluated using a profilometer, and the data were analyzed by 2-way ANOVA followed by a Tukey multiple comparisons test (alpha=.05). RESULTS: The polishing technique and type of composite resin significantly affected the Ra and DeltaE values of the composite resins (P<.001). While the use of polishing wheels produced the highest Ra values when compared to the other polishing techniques (P<.001), the nanohybrid composite resin showed the lowest Ra values compared to the other composite resins in the control groups (P<.001). All of the nanohybrid and microhybrid composite resin groups were found to be significantly different from each other in terms of color difference (P<.001). CONCLUSION: The highest Ra values were obtained with hybrid composite resins due to the size of the filler particles that were exposed after polishing. Although the smoothest surfaces were obtained with polyester strips, the use of glaze material after polishing discs or polishing wheels resulted in significantly lower Ra and DeltaE values than the use of the latter alone. The glaze appears to fill the structural microdefects and provide a more uniform, regular surface.     

Perforator artery based flap debulking: an alternative method

The postoperative bulky appearance of a musculocutaneous flap constitutes aesthetic problems that could necessitate secondary operations. Three patients who were reconstructed with free musculocutaneous flaps were re-operated at the postoperative sixth month. The fasciocutaneous flaps were elevated based on perforator arteries, and the excess skin, dermal, and adipose tissues were excised. There were no complications in the follow-up. This one-staged, perforator artery based flap debulking is proposed as an efficient and alternative method.     

A rare cause of carpal tunnel syndrome in childhood: Benign recurrent intrahepatic cholestasis

Carpal tunnel syndrome and benign recurrent intrahepatic cholestasis are rare conditions in childhood. Benign intrahepatic cholestasis is characterized by repeated self-limited attacks of cholestasis that can start at any age and last from weeks to months. The patients are asymptomatic between these attacks. We report a 16 year-old male patient with benign recurrent intrahepatic cholestasis who developed carpal tunnel syndrome during a cholestatic attack. He was admitted with complaints of jaundice, pruritus and pain, tingling and muscle weakness in both hands for 15 days. Nerve conduction studies revealed findings compatible with carpal tunnel syndrome. He was started on ursodeoxycholic acid, fat soluble vitamins and cholestyramine and cholestasis regressed after four weeks of therapy. With the improvement of cholestasis, the symptoms of carpal tunnel syndrome also disappeared. In conclusion, benign recurrent intrahepatic cholestasis can be a rare cause of carpal tunnel syndrome in childhood. We also advocate treating the underlying disease as an appropriate conservative treatment before surgery.     

Femoral and sciatic nerve block with 0.25% bupivacaine for surgical management of diabetic foot syndrome: an anesthetic technique for high-risk patients with diabetic nephropathy

A case series of patients with diabetic nephropathy, who underwent lower limb debridement or amputation below the knee during successful combined sciatic and femoral nerve block with bupivacaine 0.25%, is presented. Because impaired nerve conduction in diabetes mellitus results in lower local anesthetic agent requirement, a dose-sparing, minimal effective concentration for surgical anesthesia for peripheral nerve blockade may be more favorable for patients with diabetes and chronic renal disease.