Subtrochanteric derotation osteotomy using a bent dynamic compression plate in children with medial femoral torsion

Subtrochanteric osteotomy of the femur using a bent dynamic compression plate is a simple, safe, and stable technique for correction of severe medial femoral torsion.     

Partial priapism secondary to tamsulosin: a case report and review of the literature

Partial priapism is also called partial segmental thrombosis of the corpus cavernosum. It is a rare pathology, and its aetiology, physiopathology and treatment are still not completely understood. To our knowledge, partial priapism due to alpha blockers has not been reported previously in the literature. In this study, a successfully treated case of partial priapism occurring after the usage of alpha blocker is presented and discussed in light of the related literature.     

Platelet gel does not improve peripheral nerve regeneration: An electrophysiological,stereological, and electron microscopic study

Although use of platelet gel (PG) for promoting tissue regeneration is a popular approach because of its capacity to accelerate tissue regeneration, to our knowledge, its effects on peripheral nerve have still not been elucidated. Therefore, the aim of this study was to investigate effects of PG on sciatic nerve regeneration using electrophysiology, stereology, and electron microscopy. The study was performed using five groups of rats: sham operated (Sham), collagen tube conduit (CT), collagen tube conduit plus platelet gel (CT + PG), autogenous nerve graft (ANG), and primary repair (PR) groups. Gap length for CT and CT + PG groups is 1 cm. Electrophysiology showed that nerve conduction velocity was not different among experimental groups; the amplitude of compound action potential of PR group was significantly higher than other groups. Examination of the nerves showed that Sham group not only had a larger axon diameter but also a thicker myelin sheath. A higher number of myelinated axon was found in both ANG and PR groups in comparison to Sham, CT, and CT+PG groups. There is no significant difference between morphological quantities of CT+PG and CT group. It was expected that regeneration degree of the nerve fibers of CT+PG group would be better than CT group, which was the control group permitting to disclose the presence of a positive effect of PG on nerve regeneration, but this was not the case. Therefore, our results suggest that PG does not improve axon regeneration after microsurgical reconstruction of a nerve gap by collagen tubes. © 2008 Wiley‐Liss, Inc. Microsurgery, 2009.     

The treatment of segmental bone defects in rabbit tibiae with vascular endothelial growth factor (VEGF)-loaded gelatin/hydroxyapatite “cryogel” scaffold

The aim of this study was to investigate the effectiveness of a novel hydroxyapatite containing gelatin scaffold—with and without local vascular endothelial growth factor (VEGF) administration—as the synthetic graft material in treatment of critical-sized bone defects. An experimental nonunion model was established by creating critical-sized (10 mm. in length) bone defects in the proximal tibiae of 30 skeletally mature New Zealand white rabbits. Following tibial intramedullary fixation, the rabbits were grouped into three: The defects were left empty in the first (control) group, the defects were grafted with synthetic scaffolds in the second group, and synthetic scaffolds loaded with VEGF were administered at bone defects in the third group. Five rabbits in each group were killed on 6th and 12th weeks, and new bone growth was assessed radiologically, histologically and with dual-energy X-ray absorptiometry (DEXA). At 6 weeks, VEGF-administered group had significantly better scores than the other two groups. The second group also had significantly better scores than the control group. At 12 weeks, while no significant difference was noted between the second and third groups, these two groups both had significantly better scores in all criteria compared with the control group. There were no signs of complete fracture healing in the control group. The administration of hydroxyapatite containing gelatin scaffold yielded favorable results in grafting the critical-sized bone defects in this experimental model. The local administration of VEGF on the graft had a positive effect in the early phase of fracture healing.     

Immediate versus delayed primary nerve repair in the rabbit sciatic nerve

It is well known that peripheral nerve injury should be treated immediately in the clinic, but in some instances, repair can be delayed. This study investigated the effects of immediate versus delayed （3 days after injury） neurorrhaphy on repair of transected sciatic nerve in New Zealand rabbits using stereological, histomorphological and biomechanical methods. At 8 weeks after immediate and delayed neurorrhaphy, axon number and area in the sciatic nerve, myelin sheath and epineurium thickness, Schwann cell morphology, and the mechanical property of nerve fibers did not differ obviously. These results indicate that delayed neurorrhaphy do not produce any deleterious effect on sciatic nerve repair.     

HLA-A, -B, -DRB1 Allele and Haplotype Frequencies and Comparison With Blood Group Antigens in Dialysis Patients in the East Anatolia Region of Turkey

Aim

The first aim of that study was to investigate HLA class I and class II allele and haplotype frequencies in renal dialysis patients who live in East Anatolia in Turkey. Our second aim was to investigate whether there was a relationship between ABO and D blood group antigens and HLA alleles and haplotypes for the study group.

Materials and methods

HLA class I and II polymorphisms in 408 renal dialysis patients were studied using sequence-specific primers (SSP) and sequence-specific oligonucleotides (SSO). Blood group antigens were detected by agglutination methods on microplates.

Results

A total of 16 HLA-A, 34 HLA-B, and 15 HLA-DRB1 alleles were identified. The most frequent HLA-A alleles were HLA-A*02, HLA-A*24, and HLA-A*11. The most frequent HLA-B alleles were HLA-B*35, HLA-B*51, and HLA-B*44. In case of HLA-DRB1; HLA-DRB1*11, HLA-DRB1*04, and HLA-DRB1*13 were first 3 alleles with higher frequency, in order. In the combination of those 3 alleles, the most frequent HLA-A-B-DRB1 haplotypes were HLA-A*02-B*51-DRB1*11, HLA-A*11-B*35-DRB1*11, A*24-B*35-DRB1*11. The frequency of ABO, D blood group antigens were observed as 0.168 for A Rh(+), 0.019 for A Rh(−), 0.057 for B Rh(+), 0.013 for B Rh(−), 0.123 for O Rh(+), 0.014 for O Rh(−), 0.018 for AB Rh(+), and 0.001 for AB Rh(−). While A Rh(+) samples with HLA-A*02 and HLA-DRB1*11 had the highest frequencies (0.067 and 0.088, respectively), O Rh(+) samples with HLA-B*51 had the highest frequency (0.06).

Conclusion

According to haplotype frequencies HLA-A*02-B*51-DRB1*11 is also found at higher frequencies in Bulgarian and Armenian populations. In case of HLA-associated diseases, the east Anatolian population could be susceptible to myastenia gravis, Behçet's disease, and systemic sclerosis due to the high frequencies of HLA-A*24, HLA-B*51, and HLA-DRB1*11 respectively. We did not observe a correlation between blood group antigens and HLA alleles or haplotypes in renal dialysis patients.     

Incidental appendectomy in donors undergoing hepatectomy for living-donor liver transplantation

Background

The aim of this study was to investigate the morbidity associated with appendectomy in living liver donors undergoing hepatectomy.

Methods

The medical records of 338 donors who underwent hepatectomies for living-donor liver transplantation between 2008 and 2010 were reviewed retrospectively. The patients were divided into 2 groups on the basis of appendectomy: patients in group A (n = 126) received incidental appendectomies in conjunction with donor hepatectomy, and those in group B (n = 212) underwent hepatectomy alone.

Results

No significant difference in age, gender, or body mass index was found between groups. The wound infection rate (P = .037) and length of hospital stay (P = .0038) were higher in group A than in group B. Intraoperative findings in 126 donors in group A were subserosal (n = 4), retrocecal (n = 6), or hard nodular (n = 11) appendix; hyperemic appendix with edema (n = 9); appendix length ≥8 cm (n = 18); and palpable fecalith (n = 78). Histopathologic examination of appendix specimens revealed lymphoid hyperplasia with a fecalith (n = 32), fecalith only (n = 32), acute appendicitis (n = 20), normal anatomy (n = 18), fibrous obliteration (n = 9), lymphoid hyperplasia (n = 9), Enterobius vermicularis (n = 3), appendiceal neuroma (n = 1), carcinoid tumor (n = 1), and mucoceles (n = 1).

Conclusion

Although incidental appendectomy increased the wound infection rate and length of hospital stay, this procedure is necessary for the prevention of potential complications due to appendicitis when the exploration of the ileocecal region in patients undergoing donor hepatectomy reveals one or more of the following: appendix length ≥8 cm; dropsical, hyperemic, subserosal, nodular, and/or retrocecal appendix; and/or palpable fecaloma.     

En bloc and dual kidney transplantation: two initial cases from a new kidney transplantation center

Aim

The aim of this study was to share our initial successful experiences with en bloc dual kidney transplantation.

Cases

En bloc kidney were obtained, for case 1 from a 3-year-old deceased pediatric donor who had undergone cadaveric liver transplantation due to fulminant hepatitis A virus infection 1 week prior. The donor length was 97 cm and weight 13 kg. According to the age and weight of the donor, we selected a 50-year-old respectively. For case 2, a kidney was retrieved from a 20-month-old pediatric donor after development of hypoxic brain injury secondary to status epilepticus. The donor lengh and weight were 75 cm and 13 kg respectively. A 30-year-old female patient was of 162 cm and 59 kg. The suprarenal aorta, suprarenal vena cava, and caval and aortic lumbar branches were closed with running sutures during the backtable procedures. After the classic Gibson incision, the donor aorta was anastomosed to the recipient right common iliac artery, and the donor inferior vena cava to the recipient right common iliac vein in end-to-side fashion. The ureters were implanted with mucosa-to-mucosa ureteroneocystostomies separately according to the Lich-Gregoir technique. After the vascular anastomoses the kidneys had immediate good perfusion in both cases. Postoperative recovery was rapid, the recipients were discharged uneventfullly.

Conclusion

En bloc dual kidney transplantation from young pediatric patients to adult recipients can be performed with low mortality and morbidity even by new centers.