Mast cell activation and arterial hypotension during proximal aortic repair requiring hypothermic circulatory arrest

Objective

Aortic surgeries requiring hypothermic circulatory arrest evoke systemic inflammatory responses that often manifest as vasoplegia and hypotension. Because mast cells can rapidly release vasoactive and proinflammatory effectors, we investigated their role in intraoperative hypotension.

Initial Experience with Laparoscopic Adjustable Gastric Banding in Hungary

Background: Laparoscopic adjustable gastric banding (LAGB) was started in Hungary in 1998. We used Lap-Band and SAGB devices. In this study we present our experience through the learning curve. Methods: From Jan 1999 to Dec 2002, 54 patients underwent laparoscopic surgery for morbid obesity in our department, using the Lap-Band? and SAGB. There were 33 men and 21 women, with median age 42 (range 20-64), and preoperative BMI 50 kg/m² (range 41-66). All underwent LAGB, except one patient who had laparoscopic vertical banded gastroplasty.The procedures used the 4-trocar technique. Results: The first patient required reoperation because of gastric rupture from drinking sparkling mineral water despite of our advice. Excluding this, we had no intraoperative or short-term postoperative complications. Mean operating time was 82 minutes (range 55-192), and hospital stay was 3 days. Followup ranges from 1 to 36 months. Mean weight loss was 47 kg at 12 months and 67 kg at 36 months. Mean BMI fell to 29 kg/m². Conclusion:With its safety and effectiveness, LAGB has been a good choice for handling morbidly obese patients in our early experience.     

Labiaplasty of the labia minora: patients' indications for pursuing surgery

IntroductionLimited information is available regarding patients’ indication for seeking labiaplasty of the labia minora.AimThe aim of this article is to investigate a patient's indications for seeking labiaplasty of the labia minora.MethodsThis is a retrospective review of the medical records of all patients undergoing labiaplasty at our clinic over a 27-month period.Main Outcome MeasuresIndications for surgery were assessed using standardized questionnaires during the patients’ initial history and physical. Patients were divided into three groups as based on the questionnaire, including: Group I—patients seeking the procedure strictly for aesthetic reasons; Group II—patients seeking the procedure strictly for functional impairment (i.e., pain and discomfort); and Group III—patients who feel they are having the surgery for both aesthetic and functional reasons. Patients undergoing the surgery for aesthetic reasons were also asked whether this was strictly a personal decision or was influenced by either another man or woman whether a friend, spouse, or partner.ResultsThe review revealed 131 patients had undergone a labia reduction surgery: Group I—those who received labia reduction surgery for strictly aesthetic reasons equaled 37% (49/131); Group II—those seeking the surgery strictly for functional impairment equaled 32% (42/131); and Group III—those seeking the surgery for both functional and aesthetic reasons equaled 31% (40/131).ConclusionThe majority of patients undergoing reduction of the labia minora do so for functional reasons with minimal outside influences affecting their decision for treatment. Miklos JR, and Moore RD. Labiaplasty of the labia minora: Patients's indications for pursuing surgery.     

Regional distribution of glutamate and aspartate in adult and old human brain

In previous studies on rat brain we found that the observed heterogeneity of the regional distribution of amino acids was much greater when small well-defined anatomical structures were assayed. We therefore reinvestigated the distribution of glutamate and aspartate in 50 discrete areas from adult and old human brain. The concentration of glutamate in the area of highest level was 4.5 and 4.7 times as high as in the area of lowest level in adult and old brain respectively; for aspartate these values were 3.0 and 6.6. Several changes in old brain were noted. The human pattern differed from that in rat.